多重降落PCR检测血流感染产ESBLs肠杆菌科细菌与MRSA方法的建立和应用
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宋宇

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R446.5

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Establishment and application of multiplex touchdown PCR for detection of extendedspectrum βlactamasesproducing Enterobacteriaceae and methicillinresistant Staphylococcus aureus  in bloodstream infection
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    摘要:

    目的探索一种可同时检测产超广谱β内酰胺酶(ESBLs)的肠杆菌科细菌与耐甲氧西林金黄色葡萄球菌(MRSA)的多重降落PCR方法。方法收集某院20l3年3月—2014年9月102份住院患者血培养阳性标本,针对产ESBLs肠杆菌科细菌的SHV、TEM、OXA基因和MRSA的MecA基因设计4对特异性引物,分别采用单一降落PCR和多重降落PCR对各耐药基因进行扩增,并将结果与药敏纸片法进行比较。结果各单一PCR均可扩增出特异性条带,并用多重降落PCR同时检测了4种耐药基因;建立的多重降落PCR对4种耐药基因(MecA、SHV、TEM、OXA)DNA的检测下限分别为4.37、2.19、4.53和3.59 ng。与药敏纸片法相比,多重降落PCR总灵敏度与特异性分别为100.00%、88.24%,检测ESBLs的灵敏度达100.00%,特异性为87.23%,检测MRSA的灵敏度和特异度均为100.00%。结论该实验建立的多重降落PCR具有高灵敏度与特异性,可用于产ESBLs肠杆菌科细菌和MRSA所致血流感染的快速诊断与流行病学调查,有利于指导临床使用抗菌药物。

    Abstract:

    ObjectiveTo develop a multiplex touchdown PCR for simultaneous detection of extendedspectrum βlactamases (ESBLs)producing Enterobacteriaceae and methicillinresistant Staphylococcus aureus (MRSA).MethodsBlood culture positive specimens from 102 hospitalized patients were collected between March 2013 and  September 2014, four pairs of specific primers were designed based on SHV,TEM, and OXA genes of ESBLsproducing Enterobacteriaceae and MecA gene of MRSA,  drugresistant genes were amplified with single touchdown PCR and multiplex touchdown PCR, the results were compared with KirbyBauer disk diffusion method.ResultsEach single PCR amplified a specific band, four drugresistant genes were also detected by multiplex touchdown PCR;the lower detection limits of multiplex touchdown PCR for DNA of  MecA,SHV, TEM, and  OXA were 4.37 ng, 2.19 ng, 4.53 ng, and 3.59 ng, respectively. Compared with KirbyBauer disk diffusion method, the overall sensitivity and  specificity of multiplex touchdown PCR were 100.00% and 88.24% respectively, for ESBLs were 100.00% and  87.23% respectively,for  MRSA were both 100.00%.ConclusionA higher sensitivity and specificity multiple touchdown PCR assay has been developed, and it can be used in the rapid diagnosis and epidemiology investigation of  bloodstream infection caused by ESBLsproducing Enterobacteriaceae and  MRSA, and is helpful for guiding antimicrobial use in clinic.

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毕艳妮,隋振耿,宋宇,等.多重降落PCR检测血流感染产ESBLs肠杆菌科细菌与MRSA方法的建立和应用[J]. 中国感染控制杂志,2015,14(10):663-667. DOI:10.3969/j. issn.1671-9638.2015.10.004.
BI Yanni, SUI Zhengeng, SONG Yu, et al. Establishment and application of multiplex touchdown PCR for detection of extendedspectrum βlactamasesproducing Enterobacteriaceae and methicillinresistant Staphylococcus aureus  in bloodstream infection[J]. Chin J Infect Control, 2015,14(10):663-667. DOI:10.3969/j. issn.1671-9638.2015.10.004.

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  • 收稿日期:2015-03-02
  • 最后修改日期:2015-05-12
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  • 在线发布日期: 2015-10-30
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