摘要
目的分析细菌耐药基因检测结果与药敏试验结果的一致性,以指导临床合理用药。方法选取2020年2月至2021年4月医院临床各科送检的住院患者的标本,包括痰液、血液、尿液等,以聚合酶链反应(PCR)法检测大肠埃希菌、肺炎克雷伯菌、粪肠球菌、屎肠球菌的基因型[头孢噻肟酶(CTX-M型)]分布情况,并比较细菌耐药基因检测结果与药敏试验结果的一致性。结果354株大肠埃希菌中,CTX-M型339株,占比95.76%(339/354),未检测出基因型13株,占比3.67%(13/354),≥2种基因型2株,占比0.56%(2/354);大肠埃希菌耐药基因检测结果与药敏试验结果一致性良好(Kappa=0.778,P=0.000)。82株肺炎克雷伯菌中,CTX-M型74株,占比90.24%(74/82),未检测出基因型1株,占比1.22%(1/82),≥2种基因型7株,占比8.54%(7/82);肺炎克雷伯菌耐药基因检测结果与药敏试验结果一致性较为尚可(Kappa=0.491,P=0.000)。24株粪肠球菌均未检测出基因型;粪肠球菌耐药基因检测结果与药敏试验结果一致性不佳(Kappa=0.188,P=0.122)。12株屎肠球菌均未检测出基因型;屎肠球菌耐药基因检测结果与药敏试验结果一致性不佳(Kappa=0.143,P=0.593)。结论大肠埃希菌、肺炎克雷伯菌对头孢塞肟的耐药性较为严重,且耐药基因检测结果与药敏试验结果具有良好的一致性,临床可根据细菌耐药基因检测结果选择最佳的抗菌药物。
Objective In order to guide clinical rational drug use,the results consistency of bacterial resistance gene detection and drug sensitivity test was analyzed.Methods With the selection of patient samples from various clinical departments of the hospital from February 2020 to April 2021,including sputum,blood,urine and other samples,the genotype[Cefotaxime(CTX-M type)]distribution of Escherichia coli,Klebsiella pneumoniae,Enterococcus faecalis and Enterococcus faecium was detected by polymerase chain reaction(PCR).Meanwhile,the consistency between the results of bacterial resistance gene detection and drug sensitivity test was compared.Results Among the 354 Escherichia coli strains,339 strains were CTX-M type,accounting for 95.76%(339/354),13 strains were undetected genotype,accounting for 3.67%(13/354),and 2 strains were≥2 genotypes,accounting for 0.56%(2/354).There was good consistency in the results of drug resistance gene detection and drug sensitivity test of Escherichia coli(Kappa=0.778,P=0.000).Among 82 strains of Klebsiella pneumoniae,74strains were CTX-M type,accounting for 90.24%(74/82),1 strains were undetected,accounting for 1.22%(1/82),and 7 strains were≥2 genotypes,accounting for 8.54%(7/82).The results of drug resistance gene detection and drug sensitivity test of Klebsiella pneumoniae were in good agreement(Kappa=0.491,P=0.000).No genotypes were detected in 24 strains of Enterococcus faecalis.The results of resistance gene detection of Enterococcus faecalis were in poor agreement with the results of drug sensitivity test(Kappa=0.188,P=0.122).No genotypes were detected in 12 strains of Enterococcus faecium.The consistency between the results of resistance gene test and drug sensitivity test was poor(Kappa=0.143,P=0.593).Conclusions The resistance of Escherichia coli and Klebsiella pneumoniae to cefasexime is more serious.In addition,the results of drug resistance gene testing were in good agreement with the drug sensitivity test.The best antimicrobial agents can be selected according to the results of bacterial resistance gene detection.
作者
李纯
叶俊琴
黎四平
LI Chun;YE Junqin;LI Siping(Guangdong Medical University,Dongguan Guangdong 523808,China;Dongguan Children's Hospital Affiliated to Guangdong Medical University,Dongguan Guangdong 523325,China)
出处
《医疗装备》
2022年第21期46-49,共4页
Medical Equipment
关键词
耐药基因
药敏试验
大肠埃希菌
肺炎克雷伯菌
Drug resistance gene
Drug sensitivity test
Escherichia coli
Klebsiella pneumoniae
