本文選題：金黃色葡萄球菌　切入點：萬古霉素耐藥　出處：《中國感染與化療雜志》2016年04期 　論文類型：期刊論文

【摘要】：目的探討耐甲氧西林金黃色葡萄球菌(金葡菌)(MRSA)對萬古霉素耐藥的折點調(diào)整后,對異質(zhì)性萬古霉素中介金葡菌(h VISA)的平皿篩選方法選擇的影響,尋求一種敏感、有效的平皿篩選方法。方法收集臨床MRSA菌株215株,分別用濃度為6 mg/L、4 mg/L、2 mg/L萬古霉素腦心浸液瓊脂平皿(BHIV6、BHIV4、BHIV2)及濃度為5 mg/L替考拉寧腦心浸液瓊脂(BHIT5)進(jìn)行h VISA篩選,同時應(yīng)用菌群分析/曲線下面積(PAP/AUC)法檢測h VISA,以PAP/AUC法作為金標(biāo)準(zhǔn),對比上述4種平皿篩選方法的敏感度及特異度。結(jié)果 PAP/AUC檢測h VISA的陽性菌株分別為12株,BHIV6、BHIV4、BHIV2、BHIT5篩選陽性菌株分別為6、18、54、20株;以PAP/AUC法作為金標(biāo)準(zhǔn),上述4種平皿篩選方法靈敏度分別為41.7%、83.3%、91.7%、83.3%,特異度分別為99.0%、95.9%、77.8%、94.8%。結(jié)論 MRSA對萬古霉素耐藥折點調(diào)整后,BHIV6篩選法靈敏度較低、BHIV2篩選法特異度較低,不應(yīng)作為h VISA的篩選方法,BHIV4和BHIT5平皿篩選法靈敏度和特異度均較高,可作為萬古霉素耐藥折點調(diào)整后對h VISA的常規(guī)篩選方法。
[Abstract]:Objective to investigate the effect of MRSA-resistant to vancomycin-resistant Staphylococcus aureus (MRSAs) on the selection of a pandish screening method for heterogeneous vancomycin-mediated staphylococcus aureus (h VISAs), and to find a sensitive method for the screening of vancomycin-resistant Staphylococcus aureus. Methods 215 strains of clinical MRSA strains were collected and screened with 6 mg / L 4 mg / L ~ (2) mg/L vancomycin brain extract (Agar) and 5 mg/L teicolanine brain heart extract (Agar BHIT5) and the concentration of 5 mg/L teicolanine (Agar BHIT5), respectively. At the same time, the method of microflora analysis / area under curve was used to detect hVISA.The PAP/AUC method was used as the gold standard. The sensitivity and specificity of the four screening methods were compared. Results the positive strains of h VISA detected by PAP/AUC were 12 strains of BHIV6, BHIV4, HIV2, HIV2, BHIT5, respectively, and 20 strains were screened by PAP/AUC as gold standard. The sensitivity of the four screening methods were 41.7 and 83.37, and the specificity was 99.00.95. 9 and 77.80.Conclusion the sensitivity of MRSA in screening vancomycin resistant to vancomycin was lower than that of BHIV6, and the sensitivity of HIV6 screening was lower than that of BHIV6, and the specificity was 99.09.90.Conclusion the sensitivity of MRSA for vancomycin resistant screening was lower than that of BHIV6. It should not be used as a screening method for h VISA. Both HIV4 and BHIT5 plate screening methods have higher sensitivity and specificity. They can be used as routine screening methods for h VISA after adjusting vancomycin resistance point.
【作者單位】： 山東省濱州市人民醫(yī)院內(nèi)科;
【基金】：山東省醫(yī)藥衛(wèi)生發(fā)展計劃(2014WS0310)
【分類號】：R446.5

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本文編號：1579253