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两个组合磁盘方法的性能作为证实ESBL和AmpC在临床肠杆菌分离物中的存在

L Doornekamp¹, C H W Klaassen¹, W H A Zandijk¹

¹Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.

Diagnostic microbiology and infectious disease

|February 19, 2025

概括

一种新的克洛克萨西林组合磁盘方法 (CDM) 显示,在检测扩展光谱β-乳糖酶 (ESBL) 生产方面,与cefepime-CDM相比,它没有劣势. 这种克洛萨西林-CDM还可以识别AmpC酶的存在,为检测抗微生物耐药性提供了双重好处.

科学领域:

临床微生物学临床微生物学
抗微生物耐药性抗微生物耐药性
分子诊断学分子诊断

背景情况:

扩展光谱β-乳糖酶 (ESBL) 的产生是治疗细菌感染的一个主要挑战.
目前的指导方针推用cefepime-clavulanic acid组合磁盘方法 (CDM) 进行ESBL确认.
另一种可替代的克洛西林-CDM可同时检测ESBL和AmpC.

研究的目的:

为了评估与ESBL检测的标准cefepime-CDM相比,cloxacillin-CDM的非劣势.
评估克洛西林-CDM检测AmpC酶生产的能力.
为了确定两个CDM的诊断性能与分子方法相比.

主要方法:

收集了102个临床肠杆菌分离物,这些分离物之前被选为ESBL阳性.
通过使用cefepime-CDM和cloxacillin-CDM进行了表型确认.
将CDM结果与多重ESBL实时PCR和常规AmpCPCR进行比较.

主要成果:

塞费皮姆-CDM与ESBL PCR显示了99%的一致性 (98.6%的特异性,100%的灵敏性).
克洛克萨西林-CDM与ESBL PCR (93.2%的特异性,96.6%的敏感性) 显示出94%的一致性.
克洛克萨西林-CDM在AmpC检测方面表现出100%的特异性和92%的灵敏性.

结论:

塞费皮姆-CDM和克洛西林-CDM都是有效的ESBL确认方法.
克洛萨西林-CDM提供了关于AmpC生产的额外有价值的信息.
克洛西林-CDM被提议作为临床环境中的另一种ESBL确认方法.

关键词:

这就是AmpCC.时间的首席执行官.组合磁盘方法组合磁盘方法这就是ESBL.现象类型的现象类型的

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