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ijmicro

国际微生物学杂志

1687 - 9198 1687 - 918 x

Hindawi

10.1155 / 2021/5582615

5582615

研究文章

比较不同的表型和PCR检测Carbapenemase-Producing测试铜绿假单胞菌隔离在哈马丹,伊朗

https://orcid.org/0000 - 0003 - 1243 - 3164 当弗洛

Masoumeh

https://orcid.org/0000 - 0003 - 4128 - 8613 塔

默罕默德

https://orcid.org/0000 - 0001 - 9991 - 8193 Arabestani

Mohammad Reza

¹ ²

Chikere

Chioma布莱斯

^{1

微生物学系

哈马丹大学医学科学

哈马丹

伊朗

umsha.ac.ir} ^{2

营养健康研究中心

医学院的

哈马丹大学医学科学

哈马丹

伊朗

umsha.ac.ir}

2021年

19 7 2021年

2021年 25 2 2021年 23 4 2021年 8 7 2021年 19 7 2021年

2021年

这是一个开放的文章在知识共享归属许可下发布的,它允许无限制的使用,分布和繁殖在任何媒介,提供最初的工作是正确的引用。

近年来,特拉的患病率铜绿假单胞菌隔离已成为世界普遍关注的问题。carbapenemase-producing的快速、准确检测铜绿假单胞菌分离是如此重要。本研究的目的是评估等表型方法修改霍奇的性能测试(MHT) CarbaNP (CNPt),结合双盘协同测试(CDDT)和碳青霉烯失活方法(CIM)快速、准确检测临床"的生产铜绿假单胞菌隔离。本研究于97年进行铜绿假单胞菌菌株,从哈马丹医院的临床样本中分离出,西方的伊朗在2017 - 2018年。抗生素敏感性测试都使用磁盘扩散和最低抑制浓度(MIC)电性能测试方法。我们评估MHT的性能、CarbaNP CDDT, CIM测试相比,聚合酶链反应(PCR)检测carbapenemase-producing隔离。此外,特基因的存在使用PCR方法研究。我们的研究结果表明,最高的阻力是头孢西丁(94.8%)。此外,碳青霉烯抗生素中,阻力是imipenem最高(49.4%)。在49特隔离,42(85.7%)隔离麦克风是积极的。表型测试的结果表明,CarbaNP CIM, CDDT, MHT测试是积极的(48/49,97.95%)、(46/49,93.87%)、(27/49,57.44%)、分离(25/49,53.19%),分别为。CarbaNP和CIM测试显示,高灵敏度,特异性,阳性预测值(PPV)以及阴性预测值(NPV)相比,PCR 铜绿假单胞菌隔离。CarbaNP和CIM测试和具体测试识别carbapenemase-producing极为敏感铜绿假单胞菌隔离。哈马丹大学医学科学 9610126514 1。介绍<gydF4y2Ba/title> <p> <italic> 铜绿假单胞菌<gydF4y2Ba/italic>是一个投机取巧的病原体和全球是院内感染的主要原因<gydF4y2Baxref ref-type="bibr" rid="B1"> 1<gydF4y2Ba/xref>]。然而,碳青霉烯的最后一行被认为是治疗严重感染所致<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离(<gydF4y2Baxref ref-type="bibr" rid="B2"> 2<gydF4y2Ba/xref>]。在过去的十年里,特拉隔离的出现已成为一个主要问题在卫生保健系统。虽然耐碳青霉烯的多种机制报道,大部分的机制相关的流行"酶,属于Ambler甲级(组织),B类(VIMs IMP, SPM、SIM和GIM),和类D (OXA-48)<gydF4y2Baitalic> β<gydF4y2Ba/italic>-lactamases [<gydF4y2Baxref ref-type="bibr" rid="B3"> 3<gydF4y2Ba/xref>]。细菌分离,能产生"酶,有能力灭活的<gydF4y2Baitalic> β<gydF4y2Ba/italic>-lactams,包括青霉素、头孢菌素、碳青霉烯和monobactams [<gydF4y2Baxref ref-type="bibr" rid="B4"> 4<gydF4y2Ba/xref>]。<gydF4y2Ba/p> <p>这些隔离可以在医院环境中迅速传播引起院内感染死亡率高。所以,carbapenemase-producing的快速识别<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离是最重要的,及时发现、治疗和性能的感染控制措施,以防止这些耐药隔离的扩张<gydF4y2Baxref ref-type="bibr" rid="B5"> 5<gydF4y2Ba/xref>]。尽管分子识别的方法仍然是黄金标准carbapenemase-producing隔离和酶类型,"基因可以很容易地检测到PCR (<gydF4y2Baxref ref-type="bibr" rid="B6"> 6<gydF4y2Ba/xref>]。然而,高成本等原因,这种方法无法检测到新的"基因,各种表型方法如CarbaNP、CIM, MHT和CDDT已经开发的快速检测carbapenemase-producing隔离(<gydF4y2Baxref ref-type="bibr" rid="B6"> 6<gydF4y2Ba/xref>]。在我们的研究中,我们调查的诊断价值四个表型测试(CarbaNP、CIM MHT和CDDT) carbapenemase-producing的检测<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离。CarbaNP和CIM测试是两个表型测试,这可以用常规实验室设备(内部)和最近推荐的临床和实验室标准协会(CLSI)检测carbapenemase-producing指南<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离(<gydF4y2Baxref ref-type="bibr" rid="B7"> 7<gydF4y2Ba/xref>]。<gydF4y2Ba/p> </sec> <sec id="sec2"> <title>2。材料和方法<gydF4y2Ba/title> <sec id="sec2.1"> <title>2.1。分离和鉴定<斜体> P。绿脓杆菌< /斜体><gydF4y2Ba/title> <p>这种描述性的横断面研究是通过2017年11月至2018年5月进行的。总共有97<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离从住院病人通过不同临床标本收集包括尿液、伤口,血,气管和其他临床标本。他们在教育医院住院哈马丹大学医学科学,哈马丹,伊朗。最初,收集到的样本后转移到微生物实验室,他们在血琼脂培养基培养和纯粹的殖民地被孤立。革兰氏染色法和各种生化测试,包括氧化酶、过氧化氢酶、oxidative-fermentative测试,增长对媒体包括三糖铁琼脂(TSI),溴棕三甲铵琼脂,和增长42°C,进行识别<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离。最后,隔离是保存在脑心浸液(BHI)媒体含有20%甘油和储存在−70°C (<gydF4y2Baxref ref-type="bibr" rid="B8"> 8<gydF4y2Ba/xref>]。本研究大学的伦理委员会批准的医学科学,哈马丹,伊朗(代码。:IR.UMSHA.REC.1396.662)。<gydF4y2Ba/p> </sec> <sec id="sec2.2"> <title>2.2。抗菌药物敏感性试验<gydF4y2Ba/title> <p>抗菌药物敏感性检测<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离执行按照CLSI(2017)指令使用磁盘扩散法(Kirby-Bauer) Mueller-Hinton琼脂板各种抗生素(<gydF4y2Baxref ref-type="bibr" rid="B9"> 9<gydF4y2Ba/xref>]。所有磁盘,包括imipenem (10<gydF4y2Baitalic> μ<gydF4y2Ba/italic>meropenem (10 g)<gydF4y2Baitalic> μ<gydF4y2Ba/italic>doripenem (10 g)<gydF4y2Baitalic> μ<gydF4y2Ba/italic>g)、头孢他啶(30<gydF4y2Baitalic> µ<gydF4y2Ba/italic>g)、阿米卡星(30<gydF4y2Baitalic> μ<gydF4y2Ba/italic>g),四环素(75<gydF4y2Baitalic> µ<gydF4y2Ba/italic>g)、哌拉西林/ tazobactam (1000/10<gydF4y2Baitalic> μ<gydF4y2Ba/italic>哌拉西林(100克)<gydF4y2Baitalic> μ<gydF4y2Ba/italic>g),头孢曲松(30<gydF4y2Baitalic> µ<gydF4y2Ba/italic>g)、头孢噻肟(30<gydF4y2Baitalic> µ<gydF4y2Ba/italic>g)、头孢西丁(30<gydF4y2Baitalic> µ<gydF4y2Ba/italic>g)和环丙沙星(5<gydF4y2Baitalic> µ<gydF4y2Ba/italic>g),从英国购买桅杆集团(英国)。耐碳青霉烯为样本,麦克风测试是由imipenem电性能测试。<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>ATTC27853被用作标准菌株。<gydF4y2Ba/p> </sec> <sec id="sec2.3"> <title>2.3。选择<斜体> P。绿脓杆菌< /斜体>隔离表型和PCR测试<gydF4y2Ba/title> <p>临床分离株基于碳青霉烯耐概要文件被选中了表型和PCR测试。<gydF4y2Ba/p> </sec> <sec id="sec2.4"> <title>2.4。表型检测金属——<斜体>β< /斜体>内酰胺酶(MBL)结合双盘协同测试(CDDT)<gydF4y2Ba/title> <p>CDDT MBLs生产用于表型鉴定<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离。Imipenem (IMP) (10<gydF4y2Baitalic> μ<gydF4y2Ba/italic>g)和imipenem +乙二胺四乙酸(EDTA)光盘被用来检测MBL-producing<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离。18 - 24小时后的孵化35°C,如果增加的抑制区与imipenem-EDTA磁盘≥7毫米独自IMP磁盘相比,它被认为是MBL积极(<gydF4y2Baxref ref-type="bibr" rid="B10"> 10<gydF4y2Ba/xref>]。<gydF4y2Ba/p> </sec> <sec id="sec2.5"> <title>2.5。修改霍奇测试(MHT)<gydF4y2Ba/title> <p>这种表型测试建议CLSI(2017)检测carbapenemase-producing细菌。首先,0.5麦克法兰稀释<gydF4y2Baitalic> 大肠杆菌<gydF4y2Ba/italic>(写明ATCC 25922)在5毫升的肉汤或盐水。1:10稀释条纹是草坪上穆勒辛顿琼脂(尼古拉斯)板。一个10<gydF4y2Baitalic> µ<gydF4y2Ba/italic>克厄他培南磁盘(桅杆、英国)是放置在板的中心<gydF4y2Baxref ref-type="bibr" rid="B11"> 11<gydF4y2Ba/xref>]。<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离(测试隔离)都有四个不同的方向。<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>分离培养在直线从圆盘的边缘向外板的边缘。盘子被孵化在37°C 16到24小时。cloverleaf-like结构表示"的生产测试隔离。<gydF4y2Baitalic> 肺炎克雷伯菌<gydF4y2Ba/italic>(写明ATCC baa - 1705)作为一个积极的控制(<gydF4y2Baxref ref-type="bibr" rid="B12"> 12<gydF4y2Ba/xref>]。<gydF4y2Ba/p> </sec> <sec id="sec2.6"> <title>2.6。碳青霉烯失活方法(CIM)<gydF4y2Ba/title> <p>在该测试中,对于每一个隔离,10<gydF4y2Baitalic> µ<gydF4y2Ba/italic>L循环的文化是悬浮在一个2毫升大豆胰蛋白酶的肉汤(TSB)媒介。meropenem磁盘使用无菌添加到每个管循环。孵化后管2小时35°C±2°C (<gydF4y2Baxref ref-type="bibr" rid="B13"> 13<gydF4y2Ba/xref>),meropenem磁盘被暂停,然后放在Mueller-Hinton琼脂板,接种敏感<gydF4y2Baitalic> 大肠杆菌<gydF4y2Ba/italic>压力指示器(写明ATCC 29522),随后在35°C的环境18 - 24小时。疑似隔离产生"酶时,meropenem盘是灭活和应变敏感指标可以生长在不活跃的盘的存在(<gydF4y2Baxref ref-type="bibr" rid="B14"> 14<gydF4y2Ba/xref>]。<gydF4y2Ba/p> </sec> <sec id="sec2.7"> <title>2.7。CarbaNP测试(CNPt)<gydF4y2Ba/title> <p>首先,两个微型离心机管被标记为(a)和(b);然后,100年<gydF4y2Baitalic> µ<gydF4y2Ba/italic>l的细菌试剂添加到每个管。对于每个隔离,1<gydF4y2Baitalic> µ<gydF4y2Ba/italic>L的细菌在一夜之间从一个两管血琼脂板接种。然后,100年<gydF4y2Baitalic> µ<gydF4y2Ba/italic>l A和B的解决方案是添加到管分别“A”和“B”,并且涡。管被孵化的35°C(2小时<gydF4y2Baxref ref-type="bibr" rid="B12"> 12<gydF4y2Ba/xref>]。2小时后,carbapenemase-producing隔离导致pH值变化和产生黄色,但隔离,不产生"酶保持相同的颜色解决方案(<gydF4y2Baxref ref-type="bibr" rid="B15"> 15<gydF4y2Ba/xref>]。<gydF4y2Ba/p> </sec> <sec id="sec2.8"> <title>2.8。DNA提取<gydF4y2Ba/title> <p>总dna的<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离被沸腾的提取方法。短暂,隔夜细菌培养3 - 5殖民地在500年再次被停职<gydF4y2Baitalic> µ<gydF4y2Ba/italic>l无菌蒸馏水,煮30分钟,然后离心,享年14000岁<gydF4y2Bainline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"> <mml:mi> g<gydF4y2Ba/mml:mi> </mml:math> </inline-formula>5分钟到颗粒细胞碎片。然后,提取的DNA是储存在−20°C (<gydF4y2Baxref ref-type="bibr" rid="B16"> 16<gydF4y2Ba/xref>,<gydF4y2Baxref ref-type="bibr" rid="B17"> 17<gydF4y2Ba/xref>]。DNA的数量和质量是决定使用纳米分光光度计(Biocompare NanoDrop nd - 1000年,旧金山,美国)和凝胶电泳。<gydF4y2Ba/p> </sec> <sec id="sec2.9"> <title>2.9。Carbapenemase-Encoding基因的PCR检测<gydF4y2Ba/title> <p>特拉<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离检测KPC,小鬼,VIM, SIM, GIM, SPM, OXA-48, AMPC基因PCR使用特定的引物(表<gydF4y2Baxref ref-type="table" rid="tab1"> 1<gydF4y2Ba/xref>)[<gydF4y2Baxref ref-type="bibr" rid="B18"> 18<gydF4y2Ba/xref>- - - - - -<gydF4y2Baxref ref-type="bibr" rid="B21"> 21<gydF4y2Ba/xref>]。<gydF4y2Ba/p> <table-wrap id="tab1"> <label>表1<gydF4y2Ba/label> <p>PCR引物"基因的检测。<gydF4y2Ba/p> <table> <thead> <tr> <th align="left">"基因<gydF4y2Ba/th> <th align="center">序列(5′3′)<gydF4y2Ba/th> <th align="center">底漆<gydF4y2Ba/th> <th align="center">预期扩增子大小(bp)<gydF4y2Ba/th> <th align="center">参考<gydF4y2Ba/th> </tr> </thead> <tbody> <tr> <td align="left" rowspan="2">小鬼<gydF4y2Ba/td> <td align="center">Imp-F<gydF4y2Ba/td> <td align="center">GGA ATA GAG TGG CTT AAY TCT C<gydF4y2Ba/td> <td rowspan="2" align="center">188年<gydF4y2Ba/td> <td rowspan="2" align="center">(<gydF4y2Baxref ref-type="bibr" rid="B18"> 18<gydF4y2Ba/xref>]<gydF4y2Ba/td> </tr> <tr> <td align="center">Imp-R<gydF4y2Ba/td> <td align="center">CCA AAC YAC助教GTT ATC T<gydF4y2Ba/td> </tr> <tr> <td align="left" rowspan="2">VIM<gydF4y2Ba/td> <td align="center">Vim-F<gydF4y2Ba/td> <td align="center">手枪GGT GTT TCG TGG猫<gydF4y2Ba/td> <td rowspan="2" align="center">390年<gydF4y2Ba/td> <td rowspan="2" align="center">(<gydF4y2Baxref ref-type="bibr" rid="B18"> 18<gydF4y2Ba/xref>]<gydF4y2Ba/td> </tr> <tr> <td align="center">Vim-R<gydF4y2Ba/td> <td align="center">海巡署ATG公司治理文化AGC ACC AG)<gydF4y2Ba/td> </tr> <tr> <td align="left" rowspan="2">GIM-1<gydF4y2Ba/td> <td align="center">GIM-1F<gydF4y2Ba/td> <td align="center">TCG ACA CAC CTT GGT CTG AA<gydF4y2Ba/td> <td rowspan="2" align="center">271年<gydF4y2Ba/td> <td rowspan="2" align="center">(<gydF4y2Baxref ref-type="bibr" rid="B18"> 18<gydF4y2Ba/xref>]<gydF4y2Ba/td> </tr> <tr> <td align="center">GIM-2R<gydF4y2Ba/td> <td align="center">AAC TTC CAA CTT TGC猫GC<gydF4y2Ba/td> </tr> <tr> <td align="left" rowspan="2">SPM-1<gydF4y2Ba/td> <td align="center">SPM-1F<gydF4y2Ba/td> <td align="center">AAA ATC TGG侠盗猎车手公司治理文化AAA CG<gydF4y2Ba/td> <td rowspan="2" align="center">477年<gydF4y2Ba/td> <td rowspan="2" align="center">(<gydF4y2Baxref ref-type="bibr" rid="B18"> 18<gydF4y2Ba/xref>]<gydF4y2Ba/td> </tr> <tr> <td align="center">SPM-1R<gydF4y2Ba/td> <td align="center">ACA TTA苑GCT GGA ACA GG<gydF4y2Ba/td> </tr> <tr> <td align="left" rowspan="2">SIM-1<gydF4y2Ba/td> <td align="center">Sim-1F<gydF4y2Ba/td> <td align="center">TAC亚美大陆煤层气有限公司GGA TTC GGC ATC G<gydF4y2Ba/td> <td rowspan="2" align="center">570年<gydF4y2Ba/td> <td rowspan="2" align="center">(<gydF4y2Baxref ref-type="bibr" rid="B18"> 18<gydF4y2Ba/xref>]<gydF4y2Ba/td> </tr> <tr> <td align="center">Sim-1R<gydF4y2Ba/td> <td align="center">TAA TGG有条件现金援助GTT CCC ATG TG<gydF4y2Ba/td> </tr> <tr> <td align="left" rowspan="2">KPC 1 - 5<gydF4y2Ba/td> <td align="center">KPC-1F<gydF4y2Ba/td> <td align="center">CATTCAAGGGCTTTCTTGCTGC<gydF4y2Ba/td> <td rowspan="2" align="center">538年<gydF4y2Ba/td> <td rowspan="2" align="center">(<gydF4y2Baxref ref-type="bibr" rid="B19"> 19<gydF4y2Ba/xref>]<gydF4y2Ba/td> </tr> <tr> <td align="center">KPC-1R<gydF4y2Ba/td> <td align="center">ACGACGGCATAGTCATTTGC<gydF4y2Ba/td> </tr> <tr> <td align="left" rowspan="2">AMPC<gydF4y2Ba/td> <td align="center">AMPC-F<gydF4y2Ba/td> <td align="center">CGGCTCGGTGAGCAAGACCTTC<gydF4y2Ba/td> <td rowspan="2" align="center">218年<gydF4y2Ba/td> <td rowspan="2" align="center">(<gydF4y2Baxref ref-type="bibr" rid="B20"> 20.<gydF4y2Ba/xref>]<gydF4y2Ba/td> </tr> <tr> <td align="center">AMPC-R<gydF4y2Ba/td> <td align="center">AGTCGCGGATCTGTGCCTGGTC<gydF4y2Ba/td> </tr> <tr> <td align="left" rowspan="2">OXA-48<gydF4y2Ba/td> <td align="center">OXA-48-F<gydF4y2Ba/td> <td align="center">GCTTGATCGCCCTCGATT<gydF4y2Ba/td> <td rowspan="2" align="center">281年<gydF4y2Ba/td> <td rowspan="2" align="center">(<gydF4y2Baxref ref-type="bibr" rid="B21"> 21<gydF4y2Ba/xref>]<gydF4y2Ba/td> </tr> <tr> <td align="center">OXA-48-R<gydF4y2Ba/td> <td align="center">GATTTGCTCCGTGGCCGAAA<gydF4y2Ba/td> </tr> </tbody> </table> </table-wrap> </sec> <sec id="sec2.10"> <title>2.10。统计分析<gydF4y2Ba/title> <p>SPSS成立于19日的分析收集到的数据(美国芝加哥,IL)。学生的<gydF4y2Baitalic> t<gydF4y2Ba/italic>以及用于分析数值数据。统计学意义是<gydF4y2Bainline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"> <mml:mi> P<gydF4y2Ba/mml:mi> <mml:mo> <<gydF4y2Ba/mml:mo> <mml:mn> 0.05<gydF4y2Ba/mml:mn> </mml:math> </inline-formula>。表型方法的敏感性和特异性进行了分析与PCR作为标准卡方检验的方法。<gydF4y2Ba/p> </sec> </sec> <sec id="sec3"> <title>3所示。结果<gydF4y2Ba/title> <sec id="sec3.1"> <title>3.1。药敏测试<斜体> P。绿脓杆菌< /斜体>隔离<gydF4y2Ba/title> <p>97年抗菌药物敏感性测试的结果<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离显示最高的阻力是头孢西丁(94.8%,<gydF4y2Baitalic> n<gydF4y2Ba/italic>= 92)和最低的阻力是哌拉西林/ tazobactam (39.2%,<gydF4y2Baitalic> n<gydF4y2Ba/italic>= 38)。此外,耐碳青霉烯抗生素中,最高的是imipenem (49.4%,<gydF4y2Baitalic> n<gydF4y2Ba/italic>= 48)和最低的阻力是meropenem (41.2%,<gydF4y2Baitalic> n<gydF4y2Ba/italic>= 40)。此外,在97年<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离,49个分离株耐药和48隔离容易碳青霉烯(表<gydF4y2Baxref ref-type="table" rid="tab2"> 2<gydF4y2Ba/xref>)。49(51.51%)特拉隔离,42例(85.7%)为麦克风(表隔离有积极的结果<gydF4y2Baxref ref-type="table" rid="tab3"> 3<gydF4y2Ba/xref>)。<gydF4y2Ba/p> <table-wrap id="tab2"> <label>表2<gydF4y2Ba/label> <p>抗菌谱测试的结果<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离。<gydF4y2Ba/p> <table> <thead> <tr> <th align="left">抗生素<gydF4y2Ba/th> <th align="center">不。耐药(%)<gydF4y2Ba/th> <th align="center">中间<gydF4y2Ba/th> <th align="center">敏感的<gydF4y2Ba/th> <th align="center">总<gydF4y2Ba/th> </tr> </thead> <tbody> <tr> <td align="left">哌拉西林<gydF4y2Ba/td> <td align="center">42 (43.3)<gydF4y2Ba/td> <td align="center">13 (13.4)<gydF4y2Ba/td> <td align="center">42 (43.3)<gydF4y2Ba/td> <td align="center">97年<gydF4y2Ba/td> </tr> <tr> <td align="left">哌拉西林/ tazobactam<gydF4y2Ba/td> <td align="center">38 (39.2)<gydF4y2Ba/td> <td align="center">11 (11.3)<gydF4y2Ba/td> <td align="center">48 (49.4)<gydF4y2Ba/td> <td align="center">97年<gydF4y2Ba/td> </tr> <tr> <td align="left">头孢他啶<gydF4y2Ba/td> <td align="center">40 (41.2)<gydF4y2Ba/td> <td align="center">6 (6.2)<gydF4y2Ba/td> <td align="center">51 (52.6)<gydF4y2Ba/td> <td align="center">97年<gydF4y2Ba/td> </tr> <tr> <td align="left">Aztreonam<gydF4y2Ba/td> <td align="center">50 (51.5)<gydF4y2Ba/td> <td align="center">19日(19.5)<gydF4y2Ba/td> <td align="center">28日(28.9)<gydF4y2Ba/td> <td align="center">97年<gydF4y2Ba/td> </tr> <tr> <td align="left">阿米卡星<gydF4y2Ba/td> <td align="center">40 (41.2)<gydF4y2Ba/td> <td align="center">10 (10.3)<gydF4y2Ba/td> <td align="center">47 (48.5)<gydF4y2Ba/td> <td align="center">97年<gydF4y2Ba/td> </tr> <tr> <td align="left">环丙沙星<gydF4y2Ba/td> <td align="center">53 (54.6)<gydF4y2Ba/td> <td align="center">2 (2.1)<gydF4y2Ba/td> <td align="center">42 (43.3)<gydF4y2Ba/td> <td align="center">97年<gydF4y2Ba/td> </tr> <tr> <td align="left">Meropenem<gydF4y2Ba/td> <td align="center">40 (41.2)<gydF4y2Ba/td> <td align="center">5 (5.2)<gydF4y2Ba/td> <td align="center">52 (53.6)<gydF4y2Ba/td> <td align="center">97年<gydF4y2Ba/td> </tr> <tr> <td align="left">Doripenem<gydF4y2Ba/td> <td align="center">45 (46.4)<gydF4y2Ba/td> <td align="center">2 (2.1)<gydF4y2Ba/td> <td align="center">50 (51.5)<gydF4y2Ba/td> <td align="center">97年<gydF4y2Ba/td> </tr> <tr> <td align="left">头孢西丁<gydF4y2Ba/td> <td align="center">92 (94.8)<gydF4y2Ba/td> <td align="center">1 (1)<gydF4y2Ba/td> <td align="center">4 (4.1)<gydF4y2Ba/td> <td align="center">97年<gydF4y2Ba/td> </tr> <tr> <td align="left">四环素<gydF4y2Ba/td> <td align="center">53 (54.6)<gydF4y2Ba/td> <td align="center">5 (5.2)<gydF4y2Ba/td> <td align="center">39 (40.2)<gydF4y2Ba/td> <td align="center">97年<gydF4y2Ba/td> </tr> <tr> <td align="left">头孢曲松钠<gydF4y2Ba/td> <td align="center">65 (67)<gydF4y2Ba/td> <td align="center">18 (18.6)<gydF4y2Ba/td> <td align="center">14 (14.43)<gydF4y2Ba/td> <td align="center">97年<gydF4y2Ba/td> </tr> <tr> <td align="left">Imipenem<gydF4y2Ba/td> <td align="center">48 (49.4)<gydF4y2Ba/td> <td align="center">1 (1)<gydF4y2Ba/td> <td align="center">48 (49.4)<gydF4y2Ba/td> <td align="center">97年<gydF4y2Ba/td> </tr> </tbody> </table> </table-wrap> <table-wrap id="tab3"> <label>表3<gydF4y2Ba/label> <p>麦克风和不同的表型测试的结果为"基因。<gydF4y2Ba/p> <table> <thead> <tr> <th align="left">耐碳青霉烯相关基因<gydF4y2Ba/th> <th align="center">麦克风imipenem<gydF4y2Ba/th> <th align="center">CDDT<gydF4y2Ba/th> <th align="center">MHT<gydF4y2Ba/th> <th align="center">CIM<gydF4y2Ba/th> <th align="center">CarbaNP<gydF4y2Ba/th> </tr> </thead> <tbody> <tr> <td align="left">KPC<gydF4y2Ba/td> <td align="center">> 32<gydF4y2Ba/td> <td align="center">6/11<gydF4y2Ba/td> <td align="center">5/11<gydF4y2Ba/td> <td align="center">11/11<gydF4y2Ba/td> <td align="center">11/11<gydF4y2Ba/td> </tr> <tr> <td align="left">小鬼<gydF4y2Ba/td> <td align="center">8 > 32<gydF4y2Ba/td> <td align="center">13/20<gydF4y2Ba/td> <td align="center">15/20<gydF4y2Ba/td> <td align="center">20/20<gydF4y2Ba/td> <td align="center">20/20<gydF4y2Ba/td> </tr> <tr> <td align="left">VIM<gydF4y2Ba/td> <td align="center">8 > 32<gydF4y2Ba/td> <td align="center">10/19<gydF4y2Ba/td> <td align="center">14/19<gydF4y2Ba/td> <td align="center">19/19<gydF4y2Ba/td> <td align="center">19/19<gydF4y2Ba/td> </tr> <tr> <td align="left">AMPC<gydF4y2Ba/td> <td align="center">8 > 32<gydF4y2Ba/td> <td align="center">16/25<gydF4y2Ba/td> <td align="center">14/25<gydF4y2Ba/td> <td align="center">22/25<gydF4y2Ba/td> <td align="center">24/25<gydF4y2Ba/td> </tr> <tr> <td align="left">OXA-48<gydF4y2Ba/td> <td align="center">8 > 32<gydF4y2Ba/td> <td align="center">20/35<gydF4y2Ba/td> <td align="center">18/35<gydF4y2Ba/td> <td align="center">33/35<gydF4y2Ba/td> <td align="center">34/35<gydF4y2Ba/td> </tr> <tr> <td align="left">SIM卡<gydF4y2Ba/td> <td align="center">8 > 32<gydF4y2Ba/td> <td align="center">3/8<gydF4y2Ba/td> <td align="center">4/8<gydF4y2Ba/td> <td align="center">8/8<gydF4y2Ba/td> <td align="center">8/8<gydF4y2Ba/td> </tr> <tr> <td align="left">SPM<gydF4y2Ba/td> <td align="center">16<gydF4y2Ba/td> <td align="center">10/17<gydF4y2Ba/td> <td align="center">11/17<gydF4y2Ba/td> <td align="center">17/17<gydF4y2Ba/td> <td align="center">17/17<gydF4y2Ba/td> </tr> <tr> <td align="left">GIM<gydF4y2Ba/td> <td align="center">8<gydF4y2Ba/td> <td align="center">3/6<gydF4y2Ba/td> <td align="center">3/6<gydF4y2Ba/td> <td align="center">6/6<gydF4y2Ba/td> <td align="center">6/6<gydF4y2Ba/td> </tr> <tr> <td align="left">KPC + IMP + AMPC<gydF4y2Ba/td> <td align="center">8 > 32<gydF4y2Ba/td> <td align="center">2/2<gydF4y2Ba/td> <td align="center">2/2<gydF4y2Ba/td> <td align="center">2/2<gydF4y2Ba/td> <td align="center">2/2<gydF4y2Ba/td> </tr> <tr> <td align="left">KPC + AMPC + OXA-48<gydF4y2Ba/td> <td align="center">16<gydF4y2Ba/td> <td align="center">2/3<gydF4y2Ba/td> <td align="center">1/3<gydF4y2Ba/td> <td align="center">3/3<gydF4y2Ba/td> <td align="center">3/3<gydF4y2Ba/td> </tr> <tr> <td align="left">小鬼+ VIM + OXA-48<gydF4y2Ba/td> <td align="center">8<gydF4y2Ba/td> <td align="center">3/6<gydF4y2Ba/td> <td align="center">6/6<gydF4y2Ba/td> <td align="center">6/6<gydF4y2Ba/td> <td align="center">6/6<gydF4y2Ba/td> </tr> <tr> <td align="left">小鬼+ AMPC + OXA-48<gydF4y2Ba/td> <td align="center">> 32<gydF4y2Ba/td> <td align="center">3/5<gydF4y2Ba/td> <td align="center">4/5<gydF4y2Ba/td> <td align="center">4/5<gydF4y2Ba/td> <td align="center">5/5<gydF4y2Ba/td> </tr> <tr> <td align="left">小鬼+ KPC + OXA-48<gydF4y2Ba/td> <td align="center">> 32<gydF4y2Ba/td> <td align="center">1/1<gydF4y2Ba/td> <td align="center">1/1<gydF4y2Ba/td> <td align="center">1/1<gydF4y2Ba/td> <td align="center">1/1<gydF4y2Ba/td> </tr> <tr> <td align="left">VIM + KPC + AMPC<gydF4y2Ba/td> <td align="center">> 32<gydF4y2Ba/td> <td align="center">1/3<gydF4y2Ba/td> <td align="center">3/3<gydF4y2Ba/td> <td align="center">3/3<gydF4y2Ba/td> <td align="center">3/3<gydF4y2Ba/td> </tr> <tr> <td align="left">VIM + KPC + AMPC + OXA-48<gydF4y2Ba/td> <td align="center">8<gydF4y2Ba/td> <td align="center">0/1<gydF4y2Ba/td> <td align="center">1/1<gydF4y2Ba/td> <td align="center">1/1<gydF4y2Ba/td> <td align="center">1/1<gydF4y2Ba/td> </tr> <tr> <td align="left">小鬼+ VIM + AMPC<gydF4y2Ba/td> <td align="center">4 - 8<gydF4y2Ba/td> <td align="center">2/4<gydF4y2Ba/td> <td align="center">四四<gydF4y2Ba/td> <td align="center">四四<gydF4y2Ba/td> <td align="center">四四<gydF4y2Ba/td> </tr> <tr> <td align="left">KPC + OXA-48 + VIM + AMPC<gydF4y2Ba/td> <td align="center">> 32<gydF4y2Ba/td> <td align="center">1/1<gydF4y2Ba/td> <td align="center">1/1<gydF4y2Ba/td> <td align="center">1/1<gydF4y2Ba/td> <td align="center">1/1<gydF4y2Ba/td> </tr> <tr> <td align="left">小鬼+ AMPC<gydF4y2Ba/td> <td align="center">8<gydF4y2Ba/td> <td align="center">8/11<gydF4y2Ba/td> <td align="center">8/11<gydF4y2Ba/td> <td align="center">11/11<gydF4y2Ba/td> <td align="center">11/11<gydF4y2Ba/td> </tr> <tr> <td align="left">VIM + KPC<gydF4y2Ba/td> <td align="center">16<gydF4y2Ba/td> <td align="center">3/5<gydF4y2Ba/td> <td align="center">4/5<gydF4y2Ba/td> <td align="center">5/5<gydF4y2Ba/td> <td align="center">5/5<gydF4y2Ba/td> </tr> <tr> <td align="left">没有检测到<gydF4y2Ba/td> <td align="center">< 0.25 - 2<gydF4y2Ba/td> <td align="center">44/48<gydF4y2Ba/td> <td align="center">45/48<gydF4y2Ba/td> <td align="center">48/48<gydF4y2Ba/td> <td align="center">48/48<gydF4y2Ba/td> </tr> </tbody> </table> </table-wrap> </sec> <sec id="sec3.2"> <title>3.2。人口特征的评价<斜体> P。绿脓杆菌< /斜体>隔离和抗菌谱的抵抗力<gydF4y2Ba/title> <p>协会的人口学特征评估<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离和抗菌谱电阻表所示<gydF4y2Baxref ref-type="table" rid="tab4"> 4<gydF4y2Ba/xref>。<gydF4y2Ba/p> <table-wrap id="tab4"> <label>表4<gydF4y2Ba/label> <p>人口特征的评价<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离和抗菌谱与三个主要的抗生素的耐药性。<gydF4y2Ba/p> <table> <thead> <tr> <th align="left" rowspan="2">特征<gydF4y2Ba/th> <th align="center" rowspan="2">不。检查<gydF4y2Ba/th> <th align="center" colspan="2">Imipenem阻力<gydF4y2Ba/th> <th align="center" colspan="2">Meropenem阻力<gydF4y2Ba/th> <th align="center" colspan="2">Doripenem阻力<gydF4y2Ba/th> </tr> <tr> <th align="center">不。(%)<gydF4y2Ba/th> <th align="center"> <inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"> <mml:mi> P<gydF4y2Ba/mml:mi> </mml:math> </inline-formula>价值<gydF4y2Ba/th> <th align="center">不。(%)<gydF4y2Ba/th> <th align="center"> <inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"> <mml:mi> P<gydF4y2Ba/mml:mi> </mml:math> </inline-formula>价值<gydF4y2Ba/th> <th align="center">不。(%)<gydF4y2Ba/th> <th align="center"> <inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M5"> <mml:mi> P<gydF4y2Ba/mml:mi> </mml:math> </inline-formula>价值<gydF4y2Ba/th> </tr> </thead> <tbody> <tr> <td align="left"> <italic> 年龄<gydF4y2Ba/italic></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> </tr> <tr> <td align="left">清廉<gydF4y2Ba/td> <td align="center">9<gydF4y2Ba/td> <td align="center">5 (55.6)<gydF4y2Ba/td> <td align="center">0.308<gydF4y2Ba/td> <td align="center">5 (55.6)<gydF4y2Ba/td> <td align="center">0.441<gydF4y2Ba/td> <td align="center">5 (55.6)<gydF4y2Ba/td> <td align="center">0.346<gydF4y2Ba/td> </tr> <tr> <td align="left">11日至20日<gydF4y2Ba/td> <td align="center">9<gydF4y2Ba/td> <td align="center">5 (55.6)<gydF4y2Ba/td> <td align="center"></td> <td align="center">5 (55.6)<gydF4y2Ba/td> <td align="center"></td> <td align="center">5 (55.6)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">21 - 30<gydF4y2Ba/td> <td align="center">7<gydF4y2Ba/td> <td align="center">4 (57.1)<gydF4y2Ba/td> <td align="center"></td> <td align="center">3 (42.8)<gydF4y2Ba/td> <td align="center"></td> <td align="center">3 (42.8)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">31-40<gydF4y2Ba/td> <td align="center">7<gydF4y2Ba/td> <td align="center">3 (42.8)<gydF4y2Ba/td> <td align="center"></td> <td align="center">2 (28.6)<gydF4y2Ba/td> <td align="center"></td> <td align="center">2 (28.6)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">每周<gydF4y2Ba/td> <td align="center">21<gydF4y2Ba/td> <td align="center">9 (42.8)<gydF4y2Ba/td> <td align="center"></td> <td align="center">9 (42.8)<gydF4y2Ba/td> <td align="center"></td> <td align="center">9 (42.8)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">51-60<gydF4y2Ba/td> <td align="center">14<gydF4y2Ba/td> <td align="center">5 (35.7)<gydF4y2Ba/td> <td align="center"></td> <td align="center">4 (28.6)<gydF4y2Ba/td> <td align="center"></td> <td align="center">3 (21.4)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">61 - 70<gydF4y2Ba/td> <td align="center">19<gydF4y2Ba/td> <td align="center">13 (68.4)<gydF4y2Ba/td> <td align="center"></td> <td align="center">12 (63.1)<gydF4y2Ba/td> <td align="center"></td> <td align="center">13 (68.4)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">71 - 80<gydF4y2Ba/td> <td align="center">5<gydF4y2Ba/td> <td align="center">2 (40)<gydF4y2Ba/td> <td align="center"></td> <td align="center">2 (40)<gydF4y2Ba/td> <td align="center"></td> <td align="center">3 (60)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">81 - 90<gydF4y2Ba/td> <td align="center">5<gydF4y2Ba/td> <td align="center">2 (40)<gydF4y2Ba/td> <td align="center"></td> <td align="center">2 (40)<gydF4y2Ba/td> <td align="center"></td> <td align="center">3 (60)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">91 - 100<gydF4y2Ba/td> <td align="center">1<gydF4y2Ba/td> <td align="center">1 (100)<gydF4y2Ba/td> <td align="center"></td> <td align="center">1 (100)<gydF4y2Ba/td> <td align="center"></td> <td align="center">1 (100)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">总没有。<gydF4y2Ba/td> <td align="center"> <bold> 97年<gydF4y2Ba/bold></td> <td align="center"> <bold> 49 (50.5)<gydF4y2Ba/bold></td> <td align="center"></td> <td align="center"> <bold> 45 (46.4)<gydF4y2Ba/bold></td> <td align="center"></td> <td align="center"> <bold> 47 (48.5)<gydF4y2Ba/bold></td> <td align="center"></td> </tr> <tr> <td align="left" colspan="8"> <hr></td> </tr> <tr> <td align="left"> <italic> 性别<gydF4y2Ba/italic></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> </tr> <tr> <td align="left">男性<gydF4y2Ba/td> <td align="center">70年<gydF4y2Ba/td> <td align="center">34 (48.6)<gydF4y2Ba/td> <td align="center">0.232<gydF4y2Ba/td> <td align="center">33 (47.1)<gydF4y2Ba/td> <td align="center">0.488<gydF4y2Ba/td> <td align="center">34 (48.6)<gydF4y2Ba/td> <td align="center">0.345<gydF4y2Ba/td> </tr> <tr> <td align="left">女<gydF4y2Ba/td> <td align="center">27<gydF4y2Ba/td> <td align="center">15 (55.6)<gydF4y2Ba/td> <td align="center"></td> <td align="center">12 (44.4)<gydF4y2Ba/td> <td align="center"></td> <td align="center">13 (48.1)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">总没有。<gydF4y2Ba/td> <td align="center"> <bold> 97年<gydF4y2Ba/bold></td> <td align="center"> <bold> 49 (50.5)<gydF4y2Ba/bold></td> <td align="center"></td> <td align="center"> <bold> 45 (46.4)<gydF4y2Ba/bold></td> <td align="center"></td> <td align="center"> <bold> 47 (48.5)<gydF4y2Ba/bold></td> <td align="center"></td> </tr> <tr> <td align="left" colspan="8"> <hr></td> </tr> <tr> <td align="left"> <italic> 医院病房<gydF4y2Ba/italic></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> </tr> <tr> <td align="left">燃烧<gydF4y2Ba/td> <td align="center">28<gydF4y2Ba/td> <td align="center">19日(67.8)<gydF4y2Ba/td> <td align="center">0.223<gydF4y2Ba/td> <td align="center">19日(67.8)<gydF4y2Ba/td> <td align="center">0.170<gydF4y2Ba/td> <td align="center">18 (64.3)<gydF4y2Ba/td> <td align="center">0.154<gydF4y2Ba/td> </tr> <tr> <td align="left">手术<gydF4y2Ba/td> <td align="center">5<gydF4y2Ba/td> <td align="center">2 (40)<gydF4y2Ba/td> <td align="center"></td> <td align="center">1 (20)<gydF4y2Ba/td> <td align="center"></td> <td align="center">0 (0)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">肺<gydF4y2Ba/td> <td align="center">11<gydF4y2Ba/td> <td align="center">5 (45.4)<gydF4y2Ba/td> <td align="center"></td> <td align="center">4 (36.4)<gydF4y2Ba/td> <td align="center"></td> <td align="center">3 (27.3)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">神经学<gydF4y2Ba/td> <td align="center">3<gydF4y2Ba/td> <td align="center">0 (0)<gydF4y2Ba/td> <td align="center"></td> <td align="center">1 (33.3)<gydF4y2Ba/td> <td align="center"></td> <td align="center">1 (33.3)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">整形外科<gydF4y2Ba/td> <td align="center">1<gydF4y2Ba/td> <td align="center">0 (0)<gydF4y2Ba/td> <td align="center"></td> <td align="center">0 (0)<gydF4y2Ba/td> <td align="center"></td> <td align="center">1 (100)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">创伤<gydF4y2Ba/td> <td align="center">13<gydF4y2Ba/td> <td align="center">7 (53.8)<gydF4y2Ba/td> <td align="center"></td> <td align="center">5 (38.4)<gydF4y2Ba/td> <td align="center"></td> <td align="center">6 (46.1)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">NICU<gydF4y2Ba/td> <td align="center">8<gydF4y2Ba/td> <td align="center">2 (25)<gydF4y2Ba/td> <td align="center"></td> <td align="center">1 (12.5)<gydF4y2Ba/td> <td align="center"></td> <td align="center">1 (12.5)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">加护病房<gydF4y2Ba/td> <td align="center">14<gydF4y2Ba/td> <td align="center">9 (64.3)<gydF4y2Ba/td> <td align="center"></td> <td align="center">8 (57.1)<gydF4y2Ba/td> <td align="center"></td> <td align="center">10 (71.4)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">血液学<gydF4y2Ba/td> <td align="center">2<gydF4y2Ba/td> <td align="center">1 (50)<gydF4y2Ba/td> <td align="center"></td> <td align="center">0 (0)<gydF4y2Ba/td> <td align="center"></td> <td align="center">1 (50)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">受感染的<gydF4y2Ba/td> <td align="center">12<gydF4y2Ba/td> <td align="center">4 (33.3)<gydF4y2Ba/td> <td align="center"></td> <td align="center">6 (50)<gydF4y2Ba/td> <td align="center"></td> <td align="center">6 (50)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">总没有。<gydF4y2Ba/td> <td align="center"> <bold> 97年<gydF4y2Ba/bold></td> <td align="center"> <bold> 49 (50.5)<gydF4y2Ba/bold></td> <td align="center"></td> <td align="center"> <bold> 45 (46.4)<gydF4y2Ba/bold></td> <td align="center"></td> <td align="center"> <bold> 47 (48.5)<gydF4y2Ba/bold></td> <td align="center"></td> </tr> <tr> <td align="left" colspan="8"> <hr></td> </tr> <tr> <td align="left"> <italic> 样本来源<gydF4y2Ba/italic></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> </tr> <tr> <td align="left">公元前<gydF4y2Ba/td> <td align="center">22<gydF4y2Ba/td> <td align="center">14 (63.6)<gydF4y2Ba/td> <td align="center"></td> <td align="center">12 (54.5)<gydF4y2Ba/td> <td align="center"></td> <td align="center">12 (54.5)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">加州大学<gydF4y2Ba/td> <td align="center">12<gydF4y2Ba/td> <td align="center">3 (25)<gydF4y2Ba/td> <td align="center">0.082<gydF4y2Ba/td> <td align="center">4 (33.3)<gydF4y2Ba/td> <td align="center">0.401<gydF4y2Ba/td> <td align="center">4 (33.3)<gydF4y2Ba/td> <td align="center">0.243<gydF4y2Ba/td> </tr> <tr> <td align="left">TC<gydF4y2Ba/td> <td align="center">33<gydF4y2Ba/td> <td align="center">16 (48.5)<gydF4y2Ba/td> <td align="center"></td> <td align="center">14 (42.4)<gydF4y2Ba/td> <td align="center"></td> <td align="center">15 (45.4)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">助教<gydF4y2Ba/td> <td align="center">5<gydF4y2Ba/td> <td align="center">3 (60)<gydF4y2Ba/td> <td align="center"></td> <td align="center">3 (60)<gydF4y2Ba/td> <td align="center"></td> <td align="center">4 (80)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">伤口<gydF4y2Ba/td> <td align="center">15<gydF4y2Ba/td> <td align="center">9 (60)<gydF4y2Ba/td> <td align="center"></td> <td align="center">7 (46.7)<gydF4y2Ba/td> <td align="center"></td> <td align="center">8 (53.3)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">痰<gydF4y2Ba/td> <td align="center">6<gydF4y2Ba/td> <td align="center">2 (33.3)<gydF4y2Ba/td> <td align="center"></td> <td align="center">3 (50)<gydF4y2Ba/td> <td align="center"></td> <td align="center">2 (33.3)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">脑脊液<gydF4y2Ba/td> <td align="center">2<gydF4y2Ba/td> <td align="center">0 (0)<gydF4y2Ba/td> <td align="center"></td> <td align="center">0 (0)<gydF4y2Ba/td> <td align="center"></td> <td align="center">0 (0)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">流体<gydF4y2Ba/td> <td align="center">1<gydF4y2Ba/td> <td align="center">1 (100)<gydF4y2Ba/td> <td align="center"></td> <td align="center">1 (100)<gydF4y2Ba/td> <td align="center"></td> <td align="center">1 (100)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">TT<gydF4y2Ba/td> <td align="center">1<gydF4y2Ba/td> <td align="center">1 (100)<gydF4y2Ba/td> <td align="center"></td> <td align="center">1 (100)<gydF4y2Ba/td> <td align="center"></td> <td align="center">1 (100)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">总没有。<gydF4y2Ba/td> <td align="center"> <bold> 97年<gydF4y2Ba/bold></td> <td align="center"> <bold> 49 (50.5)<gydF4y2Ba/bold></td> <td align="center"></td> <td align="center"> <bold> 45 (46.4)<gydF4y2Ba/bold></td> <td align="center"></td> <td align="center"> <bold> 47 (48.5)<gydF4y2Ba/bold></td> <td align="center"></td> </tr> <tr> <td align="left" colspan="8"> <hr></td> </tr> <tr> <td align="left"> <italic> 住院期间<gydF4y2Ba/italic></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> </tr> <tr> <td align="left">清廉的日子<gydF4y2Ba/td> <td align="center">56<gydF4y2Ba/td> <td align="center">20 (35.7)<gydF4y2Ba/td> <td align="center"></td> <td align="center">18 (32.1)<gydF4y2Ba/td> <td align="center"></td> <td align="center">14 (25)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">11-29天<gydF4y2Ba/td> <td align="center">25<gydF4y2Ba/td> <td align="center">16 (64)<gydF4y2Ba/td> <td align="center"></td> <td align="center">13 (52)<gydF4y2Ba/td> <td align="center"></td> <td align="center">18 (72)<gydF4y2Ba/td> <td align="center"></td> </tr> <tr> <td align="left">1 - 2个月<gydF4y2Ba/td> <td align="center">16<gydF4y2Ba/td> <td align="center">13 (81.2)<gydF4y2Ba/td> <td align="center">0.433<gydF4y2Ba/td> <td align="center">14 (87.5)<gydF4y2Ba/td> <td align="center">0.455<gydF4y2Ba/td> <td align="center">15 (93.7)<gydF4y2Ba/td> <td align="center">0.601<gydF4y2Ba/td> </tr> <tr> <td align="left">总没有。<gydF4y2Ba/td> <td align="center"> <bold> 97年<gydF4y2Ba/bold></td> <td align="center"> <bold> 49 (50.5)<gydF4y2Ba/bold></td> <td align="center"></td> <td align="center"> <bold> 45 (46.4)<gydF4y2Ba/bold></td> <td align="center"></td> <td align="center"> <bold> 47 (48.5)<gydF4y2Ba/bold></td> <td align="center"></td> </tr> </tbody> </table> </table-wrap> </sec> <sec id="sec3.3"> <title>3.3。包含不同类型的隔离"的结果<gydF4y2Ba/title> <p>从49 carbapenems-resistant<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离被分成不同Ambler组包括KPC (11/49), B (40/49), AmpC(25/49),和OXA-48(35/49), 48隔离容易这个抗生素家族,这49个特隔离测试不同的表型和PCR测试。<gydF4y2Ba/p> </sec> <sec id="sec3.4"> <title>3.4。Beta-Lactamase表型检测的测试类<gydF4y2Ba/title> <p>最高的敏感性和特异性表型测试KPC基因的检测是CarbaNP和CIM测试(100%),尽管MHT和CDDT测试检测的敏感性和特异性较低KPC基因(表<gydF4y2Baxref ref-type="table" rid="tab5"> 5<gydF4y2Ba/xref>和<gydF4y2Baxref ref-type="table" rid="tab6"> 6<gydF4y2Ba/xref>)。<gydF4y2Ba/p> <table-wrap id="tab5"> <label>表5<gydF4y2Ba/label> <p>结果的敏感性,特异性,NPV, PPV CarbaNP与CIM测试。<gydF4y2Ba/p> <table> <thead> <tr> <th align="left" rowspan="2"></th> <th align="center" rowspan="2">不。<gydF4y2Ba/th> <th align="center" colspan="4">CarbaNP<gydF4y2Ba/th> <th align="center" rowspan="2">不。<gydF4y2Ba/th> <th align="center" colspan="4">CIM<gydF4y2Ba/th> <th align="center" rowspan="2">麦克风<gydF4y2Ba/th> </tr> <tr> <th align="center">灵敏度(%)<gydF4y2Ba/th> <th align="center">特异性(%)<gydF4y2Ba/th> <th align="center">PPV<gydF4y2Bainline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M6"> <mml:msup> <mml:mrow></mml:mrow> <mml:mi> ∗<gydF4y2Ba/mml:mi> </mml:msup> </mml:math> </inline-formula>(%)<gydF4y2Ba/th> <th align="center">净现值<gydF4y2Bainline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M7"> <mml:msup> <mml:mrow></mml:mrow> <mml:mi> ∗<gydF4y2Ba/mml:mi> </mml:msup> </mml:math> </inline-formula>(%)<gydF4y2Ba/th> <th align="center">灵敏度(%)<gydF4y2Ba/th> <th align="center">特异性(%)<gydF4y2Ba/th> <th align="center">PPV (%)<gydF4y2Ba/th> <th align="center">NPV (%)<gydF4y2Ba/th> </tr> </thead> <tbody> <tr> <td align="left">一个<gydF4y2Ba/td> <td align="center">11/11<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">11/11<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">> 32<gydF4y2Ba/td> </tr> <tr> <td align="left">B<gydF4y2Ba/td> <td align="center">40/40<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">39/40<gydF4y2Ba/td> <td align="center">97年<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">88年<gydF4y2Ba/td> <td align="center">8 to.32<gydF4y2Ba/td> </tr> <tr> <td align="left">C<gydF4y2Ba/td> <td align="center">24/25<gydF4y2Ba/td> <td align="center">96年<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">96年<gydF4y2Ba/td> <td align="center">22/25<gydF4y2Ba/td> <td align="center">89年<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">88年<gydF4y2Ba/td> <td align="center">8 to.32<gydF4y2Ba/td> </tr> <tr> <td align="left">D<gydF4y2Ba/td> <td align="center">34/35<gydF4y2Ba/td> <td align="center">97年<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">93年<gydF4y2Ba/td> <td align="center">33/35<gydF4y2Ba/td> <td align="center">94年<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">87年<gydF4y2Ba/td> <td align="center">8 to.32<gydF4y2Ba/td> </tr> <tr> <td align="left">小鬼<gydF4y2Ba/td> <td align="center">20/20<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">20/20<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">8 to.32<gydF4y2Ba/td> </tr> <tr> <td align="left">VIM<gydF4y2Ba/td> <td align="center">19/19<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">19/19<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">8 to.32<gydF4y2Ba/td> </tr> <tr> <td align="left">SIM卡<gydF4y2Ba/td> <td align="center">8/8<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">8/8<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">8 to.32<gydF4y2Ba/td> </tr> <tr> <td align="left">SPM<gydF4y2Ba/td> <td align="center">17/17<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">17/17<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">8 to.32<gydF4y2Ba/td> </tr> <tr> <td align="left">GIM<gydF4y2Ba/td> <td align="center">21/21<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">21/21<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">One hundred.<gydF4y2Ba/td> <td align="center">8 to.32<gydF4y2Ba/td> </tr> </tbody> </table> <table-wrap-foot> <fn> <p> <inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M8"> <mml:msup> <mml:mrow></mml:mrow> <mml:mi> ∗<gydF4y2Ba/mml:mi> </mml:msup> </mml:math> </inline-formula>净现值:负面预测值。<gydF4y2Bainline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M9"> <mml:msup> <mml:mrow></mml:mrow> <mml:mi> ∗<gydF4y2Ba/mml:mi> </mml:msup> </mml:math> </inline-formula>PPV:积极的预测值。<gydF4y2Ba/p> </fn> </table-wrap-foot> </table-wrap> <table-wrap id="tab6"> <label>表6<gydF4y2Ba/label> <p>结果的敏感性,特异性,NPV, PPV MHT和IMP.EDTA测试。<gydF4y2Ba/p> <table> <thead> <tr> <th align="left" rowspan="2"></th> <th align="center" rowspan="2">不。<gydF4y2Ba/th> <th align="center" colspan="4">MHT<gydF4y2Ba/th> <th align="center" rowspan="2">不。<gydF4y2Ba/th> <th align="center" colspan="4">IMP.EDTA<gydF4y2Ba/th> </tr> <tr> <th align="center">灵敏度(%)<gydF4y2Ba/th> <th align="center">特异性(%)<gydF4y2Ba/th> <th align="center">PPV<gydF4y2Bainline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M10"> <mml:msup> <mml:mrow></mml:mrow> <mml:mi> ∗<gydF4y2Ba/mml:mi> </mml:msup> </mml:math> </inline-formula>(%)<gydF4y2Ba/th> <th align="center">净现值<gydF4y2Bainline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M11"> <mml:msup> <mml:mrow></mml:mrow> <mml:mi> ∗<gydF4y2Ba/mml:mi> </mml:msup> </mml:math> </inline-formula>(%)<gydF4y2Ba/th> <th align="center">灵敏度(%)<gydF4y2Ba/th> <th align="center">特异性(%)<gydF4y2Ba/th> <th align="center">PPV (%)<gydF4y2Ba/th> <th align="center">NPV (%)<gydF4y2Ba/th> </tr> </thead> <tbody> <tr> <td align="left">一个<gydF4y2Ba/td> <td align="center">5/11<gydF4y2Ba/td> <td align="center">64年<gydF4y2Ba/td> <td align="center">95年<gydF4y2Ba/td> <td align="center">84年<gydF4y2Ba/td> <td align="center">86年<gydF4y2Ba/td> <td align="center">6/11<gydF4y2Ba/td> <td align="center">68年<gydF4y2Ba/td> <td align="center">88年<gydF4y2Ba/td> <td align="center">68年<gydF4y2Ba/td> <td align="center">88年<gydF4y2Ba/td> </tr> <tr> <td align="left">B<gydF4y2Ba/td> <td align="center">23/40<gydF4y2Ba/td> <td align="center">70年<gydF4y2Ba/td> <td align="center">97年<gydF4y2Ba/td> <td align="center">97年<gydF4y2Ba/td> <td align="center">34<gydF4y2Ba/td> <td align="center">22/40<gydF4y2Ba/td> <td align="center">68年<gydF4y2Ba/td> <td align="center">90年<gydF4y2Ba/td> <td align="center">97年<gydF4y2Ba/td> <td align="center">33<gydF4y2Ba/td> </tr> <tr> <td align="left">C<gydF4y2Ba/td> <td align="center">14/25<gydF4y2Ba/td> <td align="center">69年<gydF4y2Ba/td> <td align="center">96年<gydF4y2Ba/td> <td align="center">96年<gydF4y2Ba/td> <td align="center">68年<gydF4y2Ba/td> <td align="center">16/25<gydF4y2Ba/td> <td align="center">73年<gydF4y2Ba/td> <td align="center">88年<gydF4y2Ba/td> <td align="center">89年<gydF4y2Ba/td> <td align="center">72年<gydF4y2Ba/td> </tr> <tr> <td align="left">D<gydF4y2Ba/td> <td align="center">18/35<gydF4y2Ba/td> <td align="center">67年<gydF4y2Ba/td> <td align="center">93年<gydF4y2Ba/td> <td align="center">97年<gydF4y2Ba/td> <td align="center">45<gydF4y2Ba/td> <td align="center">20/35<gydF4y2Ba/td> <td align="center">70年<gydF4y2Ba/td> <td align="center">87年<gydF4y2Ba/td> <td align="center">94年<gydF4y2Ba/td> <td align="center">48<gydF4y2Ba/td> </tr> <tr> <td align="left">小鬼<gydF4y2Ba/td> <td align="center">15/20<gydF4y2Ba/td> <td align="center">80年<gydF4y2Ba/td> <td align="center">93年<gydF4y2Ba/td> <td align="center">90年<gydF4y2Ba/td> <td align="center">85年<gydF4y2Ba/td> <td align="center">13/20<gydF4y2Ba/td> <td align="center">74年<gydF4y2Ba/td> <td align="center">87年<gydF4y2Ba/td> <td align="center">83年<gydF4y2Ba/td> <td align="center">80年<gydF4y2Ba/td> </tr> <tr> <td align="left">VIM<gydF4y2Ba/td> <td align="center">14/19<gydF4y2Ba/td> <td align="center">79年<gydF4y2Ba/td> <td align="center">93年<gydF4y2Ba/td> <td align="center">90年<gydF4y2Ba/td> <td align="center">85年<gydF4y2Ba/td> <td align="center">10/19<gydF4y2Ba/td> <td align="center">67年<gydF4y2Ba/td> <td align="center">88年<gydF4y2Ba/td> <td align="center">82年<gydF4y2Ba/td> <td align="center">76年<gydF4y2Ba/td> </tr> <tr> <td align="left">SIM卡<gydF4y2Ba/td> <td align="center">4/8<gydF4y2Ba/td> <td align="center">66年<gydF4y2Ba/td> <td align="center">95年<gydF4y2Ba/td> <td align="center">80年<gydF4y2Ba/td> <td align="center">91年<gydF4y2Ba/td> <td align="center">3/8<gydF4y2Ba/td> <td align="center">61年<gydF4y2Ba/td> <td align="center">87年<gydF4y2Ba/td> <td align="center">57<gydF4y2Ba/td> <td align="center">89年<gydF4y2Ba/td> </tr> <tr> <td align="left">SPM<gydF4y2Ba/td> <td align="center">11/17<gydF4y2Ba/td> <td align="center">73年<gydF4y2Ba/td> <td align="center">93年<gydF4y2Ba/td> <td align="center">89年<gydF4y2Ba/td> <td align="center">84年<gydF4y2Ba/td> <td align="center">10/17<gydF4y2Ba/td> <td align="center">70年<gydF4y2Ba/td> <td align="center">88年<gydF4y2Ba/td> <td align="center">80年<gydF4y2Ba/td> <td align="center">82年<gydF4y2Ba/td> </tr> <tr> <td align="left">GIM<gydF4y2Ba/td> <td align="center">11/21<gydF4y2Ba/td> <td align="center">67年<gydF4y2Ba/td> <td align="center">93年<gydF4y2Ba/td> <td align="center">91年<gydF4y2Ba/td> <td align="center">73年<gydF4y2Ba/td> <td align="center">12/21<gydF4y2Ba/td> <td align="center">70年<gydF4y2Ba/td> <td align="center">87年<gydF4y2Ba/td> <td align="center">84年<gydF4y2Ba/td> <td align="center">75年<gydF4y2Ba/td> </tr> </tbody> </table> <table-wrap-foot> <fn> <p> <inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M12"> <mml:msup> <mml:mrow></mml:mrow> <mml:mi> ∗<gydF4y2Ba/mml:mi> </mml:msup> </mml:math> </inline-formula>净现值:负面预测值。<gydF4y2Bainline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M13"> <mml:msup> <mml:mrow></mml:mrow> <mml:mi> ∗<gydF4y2Ba/mml:mi> </mml:msup> </mml:math> </inline-formula>PPV:阳性预测值。<gydF4y2Ba/p> </fn> </table-wrap-foot> </table-wrap> </sec> <sec id="sec3.5"> <title>3.5。表型测试乙级Beta-Lactamase的检测<gydF4y2Ba/title> <p>最高的表型检测的敏感性和特异性检测的小鬼,VIM, SIM, SPM, GIM基因相关CarbaNP和CIM测试(100%)(表<gydF4y2Baxref ref-type="table" rid="tab5"> 5<gydF4y2Ba/xref>和<gydF4y2Baxref ref-type="table" rid="tab6"> 6<gydF4y2Ba/xref>)。<gydF4y2Ba/p> </sec> <sec id="sec3.6"> <title>3.6。C Beta-Lactamase表型检测的测试类<gydF4y2Ba/title> <p>最高的敏感性和特异性表型测试的检测<gydF4y2Baitalic> AmpC<gydF4y2Ba/italic>相关基因CarbaNP测试(100%)(表<gydF4y2Baxref ref-type="table" rid="tab5"> 5<gydF4y2Ba/xref>和<gydF4y2Baxref ref-type="table" rid="tab6"> 6<gydF4y2Ba/xref>)。<gydF4y2Ba/p> </sec> <sec id="sec3.7"> <title>3.7。D Beta-Lactamase表型检测的测试类<gydF4y2Ba/title> <p>最高的敏感性和特异性表型测试CarbaNP OXA-48基因检测的相关测试(分别为97%和100%)(表<gydF4y2Baxref ref-type="table" rid="tab5"> 5<gydF4y2Ba/xref>和<gydF4y2Baxref ref-type="table" rid="tab6"> 6<gydF4y2Ba/xref>)。<gydF4y2Ba/p> </sec> <sec id="sec3.8"> <title>3.8。Carbapenemase-Encoding基因的PCR检测<gydF4y2Ba/title> <p>PCR方法的结果表明,11个隔离生产类(KPC), 40隔离B类(IMP, VIM, SIM, SPM和GIM), 25隔离类C (AmpC)和35隔离类D (OXA-48) "。<gydF4y2Ba/p> </sec> <sec id="sec3.9"> <title>3.9。表型检测相结合的类的测试,B, C, D Beta-Lactamases<gydF4y2Ba/title> <p>四个不同的表型测试变量的表现为35<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离携带类D " (OXA-48)。一般来说,最高的正面检测有关CarbaNP(34/35, 97%),与一个失踪OXA-48-producing隔离以及一个应变窝藏OXA-48和AmpC基因。35的铜绿假单胞菌分离株携带类D " (OXA-48), 20例(70%)检测到CDDT测试;从25隔离携带AmpC cephalosporinase基因,16隔离(73%)检测到CDDT测试,这个测试无法检测15隔离携带OXA-48基因和9隔离携带AmpC基因。在这方面,MHT测试最令人不快的结果;35只发现18隔离的隔离携带OXA-48基因(67%)和14分离出25隔离携带AmpC cephalosporinase基因(69%)和错过检测11隔离携带AmpC基因。49 carbapenemase-producing隔离,同时5隔离了VIM + KPC基因。成功地识别了这些隔离CarbaNP和CIM测试(5/5,100%),但这些隔离可以检测到的MHT测试(4/5,80%)和CDDT测试(3/5,60%)(表<gydF4y2Baxref ref-type="table" rid="tab5"> 5<gydF4y2Ba/xref>和<gydF4y2Baxref ref-type="table" rid="tab6"> 6<gydF4y2Ba/xref>)。<gydF4y2Ba/p> <p>表中列出的表型方法的性能<gydF4y2Baxref ref-type="table" rid="tab3"> 3<gydF4y2Ba/xref>。CarbaNP和CIM测试导致敏感性(97%比94%,<gydF4y2Bainline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M14"> <mml:mi> P<gydF4y2Ba/mml:mi> <mml:mo> =<gydF4y2Ba/mml:mo> <mml:mn> 0.02<gydF4y2Ba/mml:mn> </mml:math> </inline-formula>),高于MHT和CDDT测试(<gydF4y2Bainline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M15"> <mml:mi> P<gydF4y2Ba/mml:mi> <mml:mo> <<gydF4y2Ba/mml:mo> <mml:mn> 0.003<gydF4y2Ba/mml:mn> </mml:math> </inline-formula>)。由于OXA-48基因载体的改进检测隔离,CarbaNP测试的敏感性显著高于MHT和CDDT测试(97% vs . 67%和70%,<gydF4y2Bainline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M16"> <mml:mi> P<gydF4y2Ba/mml:mi> <mml:mo> <<gydF4y2Ba/mml:mo> <mml:mn> 0.001<gydF4y2Ba/mml:mn> </mml:math> </inline-formula>)。同样,CarbaNP和CIM的敏感性测试,增加到96%和89%,这是由于改进的检测AmpC基因载体分离。特异性的CarbaNP CDDT, MHT和CIM测试AmpC基因的检测是100%,100%,88%,特异性96%。综上所述,CarbaNP和CIM测试拥有最佳性能的有效检测Carbapenemase-producing隔离,在四个评估方法。<gydF4y2Ba/p> </sec> <sec id="sec3.10"> <title>3.10。统计分析的结果<gydF4y2Ba/title> <p>在<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离,有明显的磁盘扩散法和表型结果之间的相关性对碳青霉烯抗生素(<gydF4y2Bainline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M17"> <mml:mi> P<gydF4y2Ba/mml:mi> <mml:mo> ≤<gydF4y2Ba/mml:mo> <mml:mn> 0.001<gydF4y2Ba/mml:mn> </mml:math> </inline-formula>PCR和表型之间)和结果(<gydF4y2Bainline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M18"> <mml:mi> P<gydF4y2Ba/mml:mi> <mml:mo> ≤<gydF4y2Ba/mml:mo> <mml:mn> 0.001<gydF4y2Ba/mml:mn> </mml:math> </inline-formula>)。<gydF4y2Ba/p> </sec> </sec> <sec id="sec4"> <title>4所示。讨论<gydF4y2Ba/title> <p>增加之间的碳青霉烯抗生素耐药性<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>分离已经成为一个公共卫生问题。"生产的准确、快速检测<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离是必要的适当的治疗,预防传播和感染的控制。在过去的十年中,表型方法广泛应用于临床实验室的一线检测隔离生产" (<gydF4y2Baxref ref-type="bibr" rid="B22"> 22<gydF4y2Ba/xref>]。这些表型的检测方法有不同的敏感性和特异性carbapenemase-producing<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离。在目前的研究中,97人之上<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离,49隔离被认定为"生产者和48隔离noncarbapenemase生产商。四个表型方法包括MHT CDDT CarbaNP和CIM测试进行的检测carbapenemase-producing隔离。MHT测试是执行一个简单的测试来检测carbapenemase-producing隔离。一些研究表明,MHT测试假阴性和假阳性结果<gydF4y2Baxref ref-type="bibr" rid="B23"> 23<gydF4y2Ba/xref>]。在最近的研究中,MHT的敏感性和NPV测试检测MBL的生产商,有17个丢失的检测,分别是(23/40,70%)和34%。此外,MHT测试(18/35,67%)敏感性和45% NPV的检测类D (OXA-48) "。Pasteran等人研究的结果表明,MHT测试低敏感性(78%)和特异性(57%)MBL的检测和KPC-producing<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离(<gydF4y2Baxref ref-type="bibr" rid="B24"> 24<gydF4y2Ba/xref>]。Carvalhaes 2010年93%的敏感性MHT测试和显示假阳性结果的可能性在MHT测试(<gydF4y2Baxref ref-type="bibr" rid="B25"> 25<gydF4y2Ba/xref>]。这些假阳性结果可能是因为孔蛋白损失在细菌的细胞壁<gydF4y2Baxref ref-type="bibr" rid="B26"> 26<gydF4y2Ba/xref>]。此外,NPV价值最低的是有关MBL生产,所以这个测试不是一个合适的方法识别MBL-producing隔离。在我们的研究中,作为Varaiya et al。<gydF4y2Baxref ref-type="bibr" rid="B27"> 27<gydF4y2Ba/xref>)和基于et al。<gydF4y2Baxref ref-type="bibr" rid="B28"> 28<gydF4y2Ba/xref>)研究,CarbaNP的敏感性和CIM测试检测的B组"是100%。快速测试中用于识别MBL-producing<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离,选择简单的筛选测试像CDDT测试是一个关键阶段的监测新兴抗性决定因素。在一项研究中,147年<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离MBL基因,CDDT测试与高灵敏度快速测试介绍了B类ambler [<gydF4y2Baxref ref-type="bibr" rid="B29"> 29日<gydF4y2Ba/xref>]。自患病率IMP基因在特拉隔离高,这个测试可以用于这些耐药隔离的早期筛查。由于MHT的NPV价值低,灵敏度测试,这个方法不建议carbapenemase-producing隔离的识别。<gydF4y2Ba/p> <p>CDDT测试用于检测KPC, MBL, AmpC,和OXA-48基因,有68%,68%,73%,和70%的敏感性,分别。最低灵敏度CDDT测试有关的MBL的检测,所以不推荐的检测B类carbapenemase-producing隔离。<gydF4y2Ba/p> <p>CDDT可能是非常有用的在日常工作的实验室中实现快速检测<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离生产KPC和MBL "酶。的NPV CDDT测试的结果检测MBL生产商MHT测试。<gydF4y2Ba/p> <p>CIM的性能和CarbaNP测试MBL的识别,KPC AmpC, OXA-48基因生产商也被评估。总体敏感性,特异性,PPV和NPV KPC-producing CIM测试的隔离是100%。<gydF4y2Ba/p> <p>在目前的研究中,CIM的敏感性测试MBL的检测,OXA-48,和AmpC基因为97%,94%,和89%,分别。此外,CIM的特异性检测MBL的检测,OXA-48, AmpC基因是100%。在一项由Elif Aktaşet al ., CIM测试的敏感性和特异性分别为78%和100%,分别。Elif Aktaş等人还显示,孵化时间没有显著差异(<gydF4y2Baxref ref-type="bibr" rid="B30"> 30.<gydF4y2Ba/xref>]。因此,CIM测试可以是一个不错的选择测试的识别carbapenemase-producing隔离(<gydF4y2Baxref ref-type="bibr" rid="B31"> 31日<gydF4y2Ba/xref>]。<gydF4y2Ba/p> <p>除了CIM, CarbaNP测试推荐CLSI为流行病学或感染控制的目的,具有广阔的应用由于高敏感性和特异性<gydF4y2Baxref ref-type="bibr" rid="B7"> 7<gydF4y2Ba/xref>]。然而,该方法的一些缺点的检测carbapenemase-producing隔离不仅仅是imipenem粉的制备成本高,而且该方法的低灵敏度的检测OXA-type ",尤其是OXA-48阳性菌株(<gydF4y2Baxref ref-type="bibr" rid="B7"> 7<gydF4y2Ba/xref>]。它已经表明,蛋白质提取缓冲用于CarbaNP防止变色的反应称为缓冲效应,这是主要原因的识别OXA生产商。<gydF4y2Ba/p> <p>CIM测试是在2017年首次CLSI推荐的。这个测试有一些优势,包括低成本、高灵敏度和特异性,易于解释的结果,使它成为一个合适的表型方法carbapenemase-producing隔离的识别。<gydF4y2Ba/p> <p>根据这项研究的结果,在四个表型方法,CarbaNP和CIM方法可用于微生物的快速检测和适当carbapenemase-producing隔离控制感染和防止这些隔离的患病率。它也可以用于常规临床微生物实验室。<gydF4y2Ba/p> </sec> <sec id="sec5"> <title>5。结论<gydF4y2Ba/title> <p>这项研究的结果表明,CarbaNP和CIM测试有很高的敏感性和特异性识别"<gydF4y2Babold> - - - - - -<gydF4y2Ba/bold>生产<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离。由于其易用性和这些方法的速度,这些可以作为非常适合检测"的方法<gydF4y2Babold> - - - - - -<gydF4y2Ba/bold>生产<gydF4y2Baitalic> 铜绿假单胞菌<gydF4y2Ba/italic>隔离在临床实验室和医疗诊断。<gydF4y2Ba/p> </sec> <back> <glossary> <title>缩写<gydF4y2Ba/title> <def-list> <def-item> <term> MHT:<gydF4y2Ba/term> <def> <p>霍奇修改测试<gydF4y2Ba/p> </def> </def-item> <def-item> <term> CDDT:<gydF4y2Ba/term> <def> <p>结合双盘协同测试<gydF4y2Ba/p> </def> </def-item> <def-item> <term> CIM:<gydF4y2Ba/term> <def> <p>碳青霉烯失活方法<gydF4y2Ba/p> </def> </def-item> <def-item> <term> 麦克风:<gydF4y2Ba/term> <def> <p>最小抑制浓度<gydF4y2Ba/p> </def> </def-item> <def-item> <term> 聚合酶链反应:<gydF4y2Ba/term> <def> <p>聚合酶链反应<gydF4y2Ba/p> </def> </def-item> <def-item> <term> SIM卡:<gydF4y2Ba/term> <def> <p>硫化吲哚能动性<gydF4y2Ba/p> </def> </def-item> <def-item> <term> TSI:<gydF4y2Ba/term> <def> <p>三糖铁琼脂<gydF4y2Ba/p> </def> </def-item> <def-item> <term> 嗨:<gydF4y2Ba/term> <def> <p>脑心浸液媒体<gydF4y2Ba/p> </def> </def-item> <def-item> <term> EDTA:<gydF4y2Ba/term> <def> <p>乙二胺四乙酸<gydF4y2Ba/p> </def> </def-item> <def-item> <term> 尼古拉斯:<gydF4y2Ba/term> <def> <p>Muller-Hinton琼脂。<gydF4y2Ba/p> </def> </def-item> </def-list> </glossary> <sec sec-type="data-availability"> <title>数据可用性<gydF4y2Ba/title> <p>可用的数据和材料。<gydF4y2Ba/p> </sec> <sec> <title>伦理批准<gydF4y2Ba/title> <p>本研究伦理委员会批准哈马丹大学医学科学(没有代码。:IR.UMSHA.REC.1396.662)。<gydF4y2Ba/p> </sec> <sec> <title>同意<gydF4y2Ba/title> <p>书面知情同意被从所有参与者。<gydF4y2Ba/p> </sec> <sec sec-type="COI-statement"> <title>的利益冲突<gydF4y2Ba/title> <p>作者宣称没有利益冲突。<gydF4y2Ba/p> </sec> <sec> <title>作者的贡献<gydF4y2Ba/title> <p>MB执行测试,并收集和分析数据。太是一个贡献者在写作和编辑稿件。MRA设计项目,在整个项目的步骤。所有作者阅读和批准最后的手稿。<gydF4y2Ba/p> </sec> <ack> <title>确认<gydF4y2Ba/title> <p>这篇文章的作者是感激哈马丹大学医学科学的金融支持进行研究。这项工作是支持的副校长和研究哈马丹大学医学科学技术批准号9610126514。这项工作是支持的副校长哈马丹大学医学科学和研究技术。<gydF4y2Ba/p> </ack> <ref-list> <ref id="B1" content-type="article"> <label>1<gydF4y2Ba/label> <element-citation publication-type="journal"> <person-group person-group-type="author"> <name> <surname> 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