[RAISUS S4抗菌敏感性试验对产碳青霉烯酶肠杆菌筛选性能及检测时间的评价]。

Yumiko Funashima, Hiroki Hanaiwa, Taeko Narita, Zenzo Nagasawa
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摘要

产碳青霉烯酶肠杆菌(CPE)的快速检测对感染控制具有重要意义,因为它传播携带抗性基因的质粒。在这里,我们评估了全自动抗菌药物敏感性试验系统“RAISUS S4”对CPE的快速检测。采用62株CPE菌株,包括耐碳青霉烯类肠杆菌和100株不产碳青霉烯类肠杆菌。RAISUS S4采用18小时和快速两种方法。用美罗培南的结果评价CPE检测的灵敏度和决策时间。结果表明,两种方法检测CPE的灵敏度均为100%,其中18小时法特异性为97%,快速法特异性为95%。18小时法检测CPE的平均时间为7.2小时,快速法为8.8小时。18小时法测定162株的平均MIC时间为17.2小时,快速法测定的平均MIC时间为8.8小时。此外,我们还分析了18hr法的吸光度值。在药物浓度为0.125µg/ml时检查生长曲线,吸光度达到0.8 Abs时判定为阳性,平均5.8 h即可检出CPE,灵敏度为100%,特异性为92%。RAISUS S4的18小时方法可以快速检测CPE,快速方法可以早期检测MIC,包括敏感分离株。这些结果表明,即使在CPE分离率较低的日本,RAISUS S4也能快速检测出CPE而不会遗漏CPE。
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[Evaluation of Screening Performance and Detection Time of Carbapenemase-Producing Enterobacterales Using RAISUS S4 in a Antimicrobial Sensitivity Test].

Rapid detection of carbapenemase-producing Enterobacterales (CPE) is important in infection control, since it transmits plasmids carrying resistance genes. Here, we evaluated the rapid detection of CPE using the fully automated antimicrobial susceptability testing system "RAISUS S4". Sixty-two CPE strains including carbapenem-resistant Enterobacterales and 100 carbapenemase-non-producing Enterobacterales strains were used. RAISUS S4 was performed using both 18 hr and rapid methods. The sensitivity of CPE detection and decision time were evaluated using Meropenem results. The results showed that the sensitivity for CPE detection was 100% for both methods, with specificity of 97% for the 18 hr method and 95% for the rapid method. The mean CPE detection time for the 18 hr method was 7.2 hrs and 8.8 hrs for the rapid method. The mean MIC determination time of the 18 hr method for all 162 strains was 17.2 hrs and 8.8 hrs for the rapid method. In addition, we analyzed the absorbance values of the 18 hr method. Checking the growth curve at a drug concentration of 0.125 µg/ml and determining it to be positive when its absorbance reached 0.8 Abs, CPE could be detected in an average of 5.8 hrs with in sensitivity of 100% and specificity of 92%. The 18 hr method of RAISUS S4 allowed rapid detection of CPE, and the rapid method allowed earlier MIC determination, including sensitive isolates. These results suggest that RAISUS S4 can detect CPE rapidly without missing CPE by routine test even in Japan where the frequency of CPE isolation is low.

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