DNA Microarray for Genotyping Antibiotic Resistance Determinants in Acinetobacter baumannii Clinical Isolates
DNA Microarray for Genotyping Antibiotic Resistance Determinants in Acinetobacter baumannii Clinical Isolates
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DOI：
10.1128/aac.00863-13
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发表时间：
2013-10-01
影响因子：
4.9
通讯作者：
Weile, Jan
中科院分区：
文献类型：
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作者：
Dally, Simon;Lemuth, Karin;Weile, Jan
近几十年来，鲍曼不动杆菌因其积累抗生素耐药性的能力而成为一种备受关注的微生物。为了提高鲍曼不动杆菌耐药基因诊断的提前期和准确性，我们研制了一种微阵列，可以在从细菌培养到结果的4h内检测91个与抗生素耐药相关的靶序列。在一项盲法前瞻性研究中，该阵列用60株多重耐药鲍曼不动杆菌进行了验证。将结果与自动药敏测试系统VITEK2确定的表型结果进行比较。被考虑的抗生素有哌拉西林-他唑巴坦、头孢他啶、亚胺培南、美罗培南、甲氧普林-磺胺甲恶唑、阿米卡星、庆大霉素、妥布霉素、环丙沙星和替吉环素。平均阳性预测值为98%，阴性预测值为98%，灵敏度为99%，特异度为94%。对于碳青霉烯酶基因，将阵列结果与德国国家革兰氏阴性病原体参考中心提供的单链PCR结果进行比较，结果完全一致。该阵列能够并行检测鲍曼不动杆菌的所有相关抗性决定因素。从培养到结果的短短4小时的处理时间有助于提供快速的结果，以便为危重患者启动足够的抗感染治疗。另一个应用将是用于流行病学监测的数据获取。
In recent decades, Acinetobacter baumannii has emerged as an organism of great concern due to its ability to accumulate antibiotic resistance. In order to improve the diagnosis of resistance determinants in A. baumannii in terms of lead time and accuracy, we developed a microarray that can be used to detect 91 target sequences associated with antibiotic resistance within 4 h from bacterial culture to result. The array was validated with 60 multidrug-resistant strains of A. baumannii in a blinded, prospective study. The results were compared to phenotype results determined by the automated susceptibility testing system VITEK2. Antibiotics considered were piperacillin-tazobactam, ceftazidime, imipenem, meropenem, trimethoprim-sulfamethoxazole, amikacin, gentamicin, tobramycin, ciprofloxacin, and tigecycline. The average positive predictive value, negative predictive value, sensitivity, and specificity were 98, 98, 99, and 94%, respectively. For carbapenemase genes, the array results were compared to singleplex PCR results provided by the German National Reference Center for Gram-Negative Pathogens, and results were in complete concordance. The presented array is able to detect all relevant resistance determinants of A. baumannii in parallel. The short handling time of 4 h from culture to result helps to provide fast results in order to initiate adequate anti-infective therapy for critically ill patients. Another application would be data acquisition for epidemiologic surveillance.