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| 实时荧光定量PCR法对ICU患者痰液标本中鲍曼不动杆菌耐药基因的检测及其评价 | |
| 引用本文： | 马亚楠,谭兵,徐磊,张健东. 实时荧光定量PCR法对ICU患者痰液标本中鲍曼不动杆菌耐药基因的检测及其评价[J]. 吉林大学学报(医学版), 2022, 48(6): 1623-1628. DOI: 10.13481/j.1671-587X.20220631 |
| 作者姓名： | 马亚楠 谭兵 徐磊 张健东 |
| 作者单位： | 天津市第三中心医院检验科 天津市重症疾病体外生命支持重点实验室 天津市人工细胞工程技术研究中心 天津市肝胆研究所,天津 300170 天津市第三中心医院重症医学科,天津 300170 |
| 基金项目： | 天津市卫健委科技人才培育项目(KJ20134);天津市卫健委医学重点学科（专科）建设项目(TJYXZDXK-047A) |
| 摘 要： | 目的 探讨重症监护病房（ICU）患者感染鲍曼不动杆菌（AB）的碳青霉烯类药物耐药情况,阐明实时荧光定量PCR（RT-qPCR）法进行耐药基因检测的临床应用价值。 方法 收集ICU患者的痰液标本285份,分别进行传统培养鉴定药敏和RT-qPCR耐药基因检测。统计分析耐碳青霉烯类鲍曼不动杆菌（CRAB）检出率、耐药基因检测的符合率和其他抗菌药物的耐药情况。 结果 共检出AB 151株,检出率为52.98%。AB对碳青霉烯类药物耐药率为72.20%。采用RT-qPCR法检测OXA-51基因检出AB的符合率与传统培养方法比较差异无统计学意义（P>0.05）。OXA-23基因检出CRAB的符合率与传统培养方法比较差异无统计学意义（P>0.05）。108株AB感染OXA-23阳性标本对米诺环素、头孢哌酮/舒巴坦、黏菌素和替加环素的耐药率较低。 结论 ICU患者痰液标本培养鉴定出AB的耐碳青霉烯类药物的检出率高。与传统培养方法比较,RT-qPCR法更简便、快速,且检测符合率更高。CRAB对米诺环素、头孢哌酮/舒巴坦、黏菌素和替加环素的耐药率低。 |
| 关 键 词： | 耐碳青霉烯类鲍曼不动杆菌 重症监护病房 耐药基因 实时荧光定量PCR |
| 收稿时间： | 2022-01-23 |
Detection of drug resistance genes of Acinetobacter baumannii in sputum samples of ICU patients by real-time fluorescence quantitative PCR method and its evaluation |
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| Yanan MA,Bing TAN,Lei XU,Jiandong ZHANG. Detection of drug resistance genes of Acinetobacter baumannii in sputum samples of ICU patients by real-time fluorescence quantitative PCR method and its evaluation[J]. Journal of Jilin University: Med Ed, 2022, 48(6): 1623-1628. DOI: 10.13481/j.1671-587X.20220631 | |
| Authors: | Yanan MA Bing TAN Lei XU Jiandong ZHANG |
| Affiliation: | Department of Laboratory Medicine,Tianjin Third Central Hospital,Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases,Tianjin Artificial Cell Engineering Technology Research Center,Tianjin Institute of Hepatobiliary Disease,Tianjin 300170,China Department of Critical Care Medicine,Tianjin Third Central Hospital,Tianjin 300170,China |
| Abstract: | Objective To investigate the carbapenem drug resistance of the intensive care unit（ICU） patients infected with Acinetobacter baumannii（AB）, and to clarify the clinical application value of real-time fluorescence quantitative PCR（RT-qPCR） method for the detection of drug resistance genes. Methods A total of 285 sputum specimens from the ICU patients were collected for identification of the drug susceptibility by traditional culture method and detection of the drug resistance genes by RT-qPCR method. Statistical analysis was performed on the detection rate of the carbapenem-resistant Acinetobacter baumannii （CRAB）, the coincidence rate of the drug resistance gene detection and the drug resistance of other antibiotics. Results A total of 151 strains of AB were obtained, the detection rate was 52.98%. The drug resistance rate of AB to carbapenem was 72.20%.There was no significant difference in the coincidence rate of OXA-51 gene detected by RT-qPCR method compared with the traditional culture method（P>0.05）. There was no significant difference in the coincidence rate of CRAB detected by OXA-23 gene compared with the traditional culture method （P>0.05）.The drug resistance rates of 108 OXA-23 positive specimens infected with AB to minocycline,cefoperazone/sulbactam, myxin,and tegacyclin were lower. Conclusion The detection rate of carbapenem resistant drugs of AB identified by sputum culture of the ICU patients is high. Compared with traditional culture method, RT-qPCR method is simpler, faster and has a higher consistent rate of detection.The drug resistance rates of CRAB to minocycline, cefoperazone/sulbactam, myxin and tegacyclin are low. |
| Keywords: | Carbapenem-resistant Acinetobacter baumannii Intensive care unit Drug resistance gene Real-time fluorescence quantitative PCR |
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