GICA在检测CRE引起的血流感染早期中的应用价值研究OA

Objective To evaluate the application value of gold immunochromatographic assay(GICA)in the detection of carbapenem resistant enterobacteriaceae(CRE)in the early stage of bloodstream infection,and provide laboratory basis for the precise treatment of CRE infection.Methods A total of 31 CRE samples and 20 carbapenem-sensitive enterobacteriaceae samples were collected from inpatients in Henan Provincial Chest Hospital from January to December 2020,and a simulated blood culture positive experimental scheme was established.A total of 51 positive blood culture products were pretreated by GICA to directly detect car-bapenemase,and the results of polymerase chain reaction sequencing were used as"the gold standard"to eval-uate the accuracy of GICA in directly detecting carbapenemase typing in positive blood culture samples.Results The positive results of 51 blood cultures showed that 13 strains carried blaKPC-2 genotype,14 strains carried blaNDM-1 genotype,two strains carried blaNDM-5 genotype,and two strains carried both blaKPC-2 and blaNDM-1 genotypes.No corresponding drug resistance genes were detected in the remaining 20 strains.The 31 carbap-enemase producing samples were detected by colloidal gold immunochromatography,of which 13 strains pro-duced blaKPC,16 strains produced blaNDM,and two strains produced blaKPC and blaNDM at the same time.The re-sults of the two methods were consistent(Kappa=1),and the sensitivity and specificity were 100%.Conclu-sion GICA has the advantages of convenient operation,short time consumption,high sensitivity and specifici-ty.This method can significantly shorten the diagnosis time of CRE in bloodstream infection,and provide ex-perimental basis for rational drug use for clinicians in the early stage.