随着碳青霉烯类药物使用量的增加,耐碳青酶烯类革兰阴性菌逐渐增多,其耐药机制主要是产碳青霉烯酶,因此快速准确鉴定碳青霉烯酶及类型,对于及时有效地治疗和控制感染具有重要意义。早期的检测方法有显色培养基、改良霍奇试验和纸片协同试验,但所需时间长;生化方法耗时短且敏感性和特异性较高,但不能区分亚型;激光解吸电离时间飞行质谱(MALDI-TOF)目前可用于菌种鉴定、亚型分类以及耐药基因的检测。在各种碳青霉烯酶基因技术中,二代测序(NGS)技术不仅可以检测碳青霉烯酶基因,还可以检测整合子、转座子和质粒等,可同时完成菌株流行病学和耐药机制的研究。该文就目前碳青霉烯酶表型和基因检测方法的优缺点作了综述。
With increasing use of carbapenem antibiotics , carbapenems-resistant gram-negative bacteria are spreading, and carbapenemase-producing is the main mechanism of carbapenems resistance . Rapid and accurate identification of carbapenemase and its type is of great importance to timely and effective treatment and control of infections .Chromogenic /Fluorogenic culture media, modified Hodge test and double disk synergy test are traditional methods for carbapenemase detection , but all are time-consuming. Biochemical method is more time efficient and with high sensitivity and specificity , but cannot be used to identify subtypes.Now matrix-assisted laser desorption ionization -time-of-flight mass spectrometry (MALDI-TOF MS) has been successfully applied in the identification of species , subtypes and detection of drug -resistant genes.And among various carbapenemase gene detection techniques , next generation sequencing (NGS) can also be used for the detection of integrons , transposons and plasmids, which is important in both epidemiology and resistant mechanism studies .This article reviews the advantages and disadvantages of various methods for phenotype and gene detection of carbapenemase .