CAJ | 학술논문

目的：探讨分析双纸片抑制增效试验在肺炎克雷伯菌产 AmpC 酶的检测应用，评价该方法在临床实验室的应用价值。方法采用头孢西丁纸片法，头孢西丁三维试验，双纸片抑制增效试验，以及耐药基因多重 PCR 技术对临床分离菌株进行检测。结果137株临床分离肺炎克雷伯菌中，对头孢西丁不敏感的菌株共有22株，头孢西丁三维试验阳性有11株；双纸片抑制增效试验 FOX/FOX＋PBA 双纸片组中阳性有18株，CTT/CTT＋PBA 双纸片组中阳性有11株；多重 PCR 技术检测阳性有19株。头孢西丁三维试验阳性结果与 PCR 结果符合率为47．4％（9/19），双纸片抑制增效试验中，CTT/CTT＋PBA 双纸片组阳性结果与 PCR 结果符合率为57．9％（11/19）；FOX/FOX＋PBA 双纸片组阳性结果与 PCR 结果符合率为94．7％（18/19）。结论双纸片抑制增效试验，其方法简便，结果准确性高，其中 FOX/FOX＋PBA 双纸片组可应用于临床分离肺炎克雷伯菌产 AmpC 酶的检测。
목적：탐토분석쌍지편억제증효시험재폐염극뢰백균산 AmpC 매적검측응용，평개해방법재림상실험실적응용개치。방법채용두포서정지편법，두포서정삼유시험，쌍지편억제증효시험，이급내약기인다중 PCR 기술대림상분리균주진행검측。결과137주림상분리폐염극뢰백균중，대두포서정불민감적균주공유22주，두포서정삼유시험양성유11주；쌍지편억제증효시험 FOX/FOX＋PBA 쌍지편조중양성유18주，CTT/CTT＋PBA 쌍지편조중양성유11주；다중 PCR 기술검측양성유19주。두포서정삼유시험양성결과여 PCR 결과부합솔위47．4％（9/19），쌍지편억제증효시험중，CTT/CTT＋PBA 쌍지편조양성결과여 PCR 결과부합솔위57．9％（11/19）；FOX/FOX＋PBA 쌍지편조양성결과여 PCR 결과부합솔위94．7％（18/19）。결론쌍지편억제증효시험，기방법간편，결과준학성고，기중 FOX/FOX＋PBA 쌍지편조가응용우림상분리폐염극뢰백균산 AmpC 매적검측。
Objective To investigate and analyze the double-disk inhibiting synergy test for detecting AmpC β-lactamase pro-duced by Klebsiella pneumoniae and to evaluate its application value in clinical laboratory.Methods The cefoxitin disk agar diffu-sion method,cefoxitin three-dimensional method,double-disk inhibiting synergy test and drug resistance gene multiplex PCR assay were adopted to detect the clinically isolated bacterial strains.Results Among 137 clinically isolated strains of Klebsiella pneumoni-ae,22 strains were insensitive to cefoxitin and 11 strains were positive by the three-dimensional method;in the double-disk inhibiting synergy test,18 strains were positive for the FOX/FOX+PBA group and 11 strains were positive for the CTT/CTT+PBA group respectively;in the multiplex PCR assay,19 strains were positive.The coincidence rate of the cefoxitin three-dimensional method and multiplex PCR methods was 47.4%(9/19),in the double-disk inhibiting synergy test,the coincidence rate of the positive re-sults in the CTT/CTT+PBA group and the multiplex PCR methods was 57.9%(11/19);the coincidence rate of the FOX/FOX+PBA group and multiplex PCR methods was 94.7%(18/19).Conclusion The double-disk inhibiting synergy test is simple with highly accurate results,in which the FOX/FOX+PBA double-disk synergy test could be applied to detect AmpC β-lactamase pro-duced by clinical isolates of Klebsiella pneumoniae.