耐万古霉素肠球菌筛选培养基的临床应用评估

目的 比较ChromID VRE产色琼脂培养基和含万古霉素6μg/ml血琼脂培养基对耐万古霉素肠球菌(VRE)的筛选和鉴定作用.方法 以VITEK-2 Compact鉴定和PCR方法对耐药基因检测为金标准,自检验科菌库中传出已鉴定的VRE、万古霉素敏感肠球菌(VSE)各30株,MRSA、其他链球菌各20株,对两种培养基性能进行比较；同时采集临床患者便标本350份接种于两种培养基,进行VRE筛选.结果 对已知的VRE和非VRE两种筛选培养基符合率均达到100.0％；对临床便标本进行VRE的筛选中,ChromID VRE产色琼脂培养基符合率为100.0％,含万古霉素6 μg/ml血琼脂培养基筛选出1株假阳性菌株.结论 ChromID VRE产色琼脂培养基对VRE筛选和鉴定准确,可应用于临床；含万古霉素6μg/ml血琼脂培养基,更适合应用于基层医院进行大样本量筛查.

Application evaluation of media for selecting vancomycin-resistant Enterococcusisolates

OBJECTIVE To evaluate ChromID VRE agar and blood medium(containing 6 μg/ml vancomycin) for detecting and identifying vancomycin-resistant Enterococci(VRE).METHODS Thirty VRE strains,30 VSE strains,20 MRSA strains and 20 other Streptococci strains were inoculated in these two mediums separately.Moreover,350 stool specimens were cultured with these two mediums to select VRE strains.The VITEK2 Compact and PCR were used as standard methods for detecting resistant genes.RESULTS The sensitivity and specicity of the two mediums were all 100% when they were used to test the determined strains.To the 350 stool samples,the sensitivity and specificity of ChromID VRE medium were still 100%,but there was one false positive VRE strain isolated by the blood medium containing 6μg/ml vancomycin.CONCLUSION The sensitivity and specificity of ChromID VRE agar are high,and it can be used in clinical samples,and the blood medium containing 6μg/ml vancomycin can be used for selecting VREs in primary hospitals.