临床评价VITEK2高级专家系统对常见细菌β内酰胺耐药表型的检测和分析

目的 评价VITEK2高级专家系统(AES)对临床常见细菌β内酰胺耐药表型的检测和分析。方法 用VITEK2 AES检测并分析已知耐药表型的葡萄球菌、大肠埃希菌、克雷伯菌和阴沟肠杆菌共124株。结果 VITEK2 AES耐甲氧西林葡萄球菌、大肠埃希菌、肺炎克雷伯菌、产酸克雷伯菌产超广语β内酰胺酶ESBLs(TEM型、SHV型或CTX—M型)]、阴沟肠杆菌产诱导型AmpC酶或高产AmpC酶、ESBLs均能正确检测。对9株同时产ESBLs和高产AmpC酶阴沟肠杆菌检测，其中1株正确，其余8株只报告高产AmpC酶。结论 VITEK2 AES能够对临床菌株中重要的β内酰胺耐药表型准确检测，并能根据所测耐药表型对某些影响临床抗菌药物治疗的药敏结果进行修订。对阴沟肠杆菌某些耐药表型的分析、判断有待进一步改进。

Clinical evaluation of VITEK2 advanced expert system for detection and analysis of betalactam phenotypes in common bacteria

Objective To evaluate VITEK2 Advanced Expert System (AES) for detection and analysis of clinically important beta-lactam phenotypes.Methods 124 known resistant phenotype strains including Staphylococcus spp, E.coli, Klebsiella spp. and Ent. cloacae were tested by VITEK2 AES. Results The resistant phenotypes for methicillin susceptible, and resistant Staphylococcus spp, producing ESBL E. coli, Klebsiella spp. and Ent. cloacae isolates, and inducible AmpC and hyperproduced AmpC Ent. cloacae isolates can be accurately identified by VITEK2 AES. The most Ent. cloacae strains for both producing ESBLs and hyperproduced AmpC were partially identified.Conclusion VITEK2 AES can be accurately identified most clinically important beta-lactam phenotypes and suggested additional therapeutic correction based on phenotype. Certain problems for Ent. cloacae in the study should be remediable with further work on AES.