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Triton X-100 对Hodge和Carba NP试验检测产碳青霉烯鲍曼不动杆菌复合群效能影响

Triton X-100 Enhanced the Detection of Hodge Test and Carba NP Test for Carbapenemase-producing Acinetobacter baumannii Complex

  • 摘要: 目的 探索快速、准确、简单、经济的表型检测方法,为产碳青霉烯酶鲍曼不动杆菌复合群流行病学调查及临床诊疗提供更好的手段和依据。方法 纳入四川大学华西医院分离的110株鲍曼不动杆菌复合群,以多重PCR扩增结果为金标准,比较Hodge试验、Carba NP试验与加入Triton X-100后改良的Triton Hodge试验及Carba NP-direct试验在检测鲍曼不动杆菌复合群是否产碳青霉烯酶中的敏感度、特异度及阳性效果。结果 Hodge试验在检测产碳青霉烯酶鲍曼不动杆菌复合群中敏感度和特异度分别为71.1%、100%,高于Carba NP试验(35.0%、86.7%,P<0.05)。加了Triton X-100试剂后改良试验的敏感度和阳性效果明显增高,Triton Hodge试验敏感度由71.1%提高到98.8%,Carba NP-direct试验敏感度由35.0%提高到85.5%,差异有统计学意义(P<0.001),但特异性差异无统计学意义(P>0.05)。结论 改良后的Triton Hodge试验及Carba NP-direct试验在检测产碳青霉烯酶鲍曼不动杆菌复合群中具有更高的敏感性及阳性检测判断效果,特异度不变,因此更适用于临床常规操作。

     

    Abstract: Objective To find out highly effective phenotypic methods to detect carbapenemase-producing Acinetobacter baumannii (A. baumannii complex) so as to support the epidemiological investigation and clinical application. Methods We included 113 A. baumannii complex and compared the detection performance of modified Hodge test, Carba NP test, Triton Hodge test, and the simplified Carba NP-direct test with Tritont X-100. Results We tested 83 carbapenemase-producing A. baumannii complex and 30 non-carbapenemase producers. The sensitivity and specificity of Hodge test were significantly higher than those of Carba NP test (71.1% versus 35.0%,100% versus 86.7%,P<0.05, respectively). The sensitivity of Triton Hodge test and Carba NP-direct test was respectively significantly higher than Hodge test and Carba NP test (98.8% versus 71.1%, 85.5% versus 35.0%,P<0.001, respectively ). However, the specificities were comparable (P>0.05). The positive additive effects of the two methods with Triton X-100 were more obvious than those of the methods without Triton X-100 (P<0.001). Conclusions Triton X-100 could increase the sensitivity and positive additive effect on phenotypic detection of A. baumannii complex. Triton Hodge test and Carba NP-direct test were more applicable for clinical routine procedure.

     

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