本文選題：基質(zhì)輔助激光解析電離飛行時間質(zhì)譜　切入點：產(chǎn)碳青霉烯酶　出處：《中國感染與化療雜志》2016年05期

【摘要】：目的應用基質(zhì)輔助激光解析電離飛行時間質(zhì)譜(MALDI-TOF MS)檢測產(chǎn)KPC-2、NDM-1、VIM-2、IMP-1與IMP-4型碳青霉烯酶腸桿菌科細菌水解厄他培南的能力。方法收集2009年6月-2013年12月上海交通大學醫(yī)學院附屬新華醫(yī)院各種臨床標本中分離的耐碳青霉烯類腸桿菌科細菌(CRE),用改良Hodge試驗進行產(chǎn)碳青霉烯酶的表型篩選,用PCR擴增方法檢測其碳青霉烯酶基因,并經(jīng)測序確認。應用MALDI-TOF MS進行厄他培南水解預試驗以確定最適厄他培南濃度及孵育時間,隨后采用預試驗中的最適條件,應用MALDI-TOF MS檢測CRE水解厄他培南的能力。結(jié)果 108株CRE中,有102株改良Hodge試驗陽性,其中90株產(chǎn)KPC-2、4株產(chǎn)NDM-1、3株產(chǎn)VIM-2、2株產(chǎn)IMP-1、2株產(chǎn)IMP-4、1株同時產(chǎn)KPC-2和IMP-4型碳青霉烯酶,且在2 h內(nèi)均能水解厄他培南;另外6株CRE改良Hodge試驗陰性,未檢測出上述碳青霉烯酶基因,且不水解厄他培南。結(jié)論臨床微生物實驗室應用MALDI-TOF MS能夠快速準確檢測CRE水解厄他培南的能力,篩查產(chǎn)碳青霉烯酶腸桿菌科細菌,為臨床早期合理使用碳青霉烯類抗生素提供依據(jù)。
[Abstract]:Objective to detect the ability of KPC-2NdM-1 (VIM-2) IMP-1 and IMP-4 type carbapeninase enterobacteriaceae bacteria to hydrolyze ertapenem by matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS).Methods from June 2009 to December 2013, a series of clinical specimens from Xinhua Hospital affiliated to Shanghai Jiaotong University Medical College were collected, and the phenotypic screening of carbapenem producing enzymes was carried out by modified Hodge test, which was isolated from various clinical specimens of Enterobacteriaceae, Shanghai Jiaotong University.The carbapenem gene was detected by PCR and confirmed by sequencing.The optimal concentration and incubation time of etapenem were determined by using MALDI-TOF MS to determine the optimal concentration and incubation time. Then, the ability of CRE hydrolysis of ertapenem was detected by MALDI-TOF MS.Results of the 108 CRE strains, 102 were positive for modified Hodge test, 90 of which produced KPC-2P 4 strains and NDM-1 + 3 strains, and 2 strains produced IMP-1 and 2 strains produced both KPC-2 and IMP-4 carbapenem, and were able to hydrolyze ertapenem within 2 hours.The other 6 strains were negative in CRE modified Hodge test and did not detect these carbapenase genes and did not hydrolyze ertapenem.Conclusion MALDI-TOF MS in clinical microbiology laboratory can quickly and accurately detect the ability of CRE to hydrolyze ertapenem and screen Enterobacteriaceae bacteria producing carbapenem so as to provide evidence for the rational use of carbapenem antibiotics in early clinical stage.
【作者單位】： 上海交通大學醫(yī)學院附屬新華醫(yī)院檢驗科臨床微生物室;
【分類號】：R446.5

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