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홍승복 ( Seung-bok Hong ),신경아 ( Kyung-a Shin ),손재철 ( Jae-cheol Son ),신경섭 ( Seob-kyeong Shin ) 대한임상검사과학회 2010 대한임상검사과학회지(KJCLS) Vol.42 No.2
We evaluated the performance of a novel screening test, PBP2a MRSA rapid kit (Dinona Inc., Iksan, Korea), for methicillin-resistant Staphylococcus aureus (MRSA) based on a immunochromatographic assay. The test is able to detect penicillin-binding protein 2a (PBP2a) using the nasal specimens from health care workers. The nasal specimens were obtained from 69 healthcare workers and were incubated in enrichment broth followed eight hours incubatin in BHI with cefoxitin 4 μg/mL. These broth were tested by PBP2a Rapid Kit. The enrichment broths were also directly tested for tube coagulase using the conventional identification method. 19 of 22 MRSA showed positive results by PBP2a rapid test and direct coagulase test (the sensitivity for detection of MRSA, 86.36%). While, 8 of 47 non-MRSA showed false positive results for the two tests. All of the 8 non-MRSA which showed false positive were co-colonizing isolates with MRCNS and MSSA. In addition, 46 of 49 methicillin-resistant staphylococci (MRS) showed positive results for PBP2a MRSA rapid kit (the sensitivity for detection of MRS, 93.8%), and all of 20 non-MRS showed negative results (specificity, 100%). The combination of PBP2a MRSA rapid kit and direct coagulase test showed the good sensitivity for detection of MRSA from anterior nares but frequently showed false positive results from the co-colonizing carrier with MRCNS and MSSA.
Metallo-β-lactamase 생성 Pseudomonas aeruginosa 및 포도당 비발효그람음성간균의 검출방법에 관한 연구
신경섭,김원식,손재철,홍승복,최재운,형성민 충북대학교 의과대학 충북대학교 의학연구소 2003 忠北醫大學術誌 Vol.13 No.2
연구목적: Metallo-β-lactamse (MBL)는 carbepenem를 포함하는 대부분의 β-lactam 항균제를 가수분해할 수 있으므로 MBL 생성균의 확산은 이들 균에 의한 감염의 치료에 큰 문제를 야기할 수 있다. 따라서 MBL 생성균에 의한 감염의 확산을 막기 위해 이들 균의 조기 검출이 필요하다. 저자들은 MBL 생성균을 검출할 수 있는 세 가지 방법을 PCR 방법과 비교하여 보았다. 재료 및 방법: Imipenem의 MIC가 8 μg/mL 이상인 50개의 포도당 비발효 그람음성 간균을 대상으로 EDTA-double disk synergy test (EDTA-DDS), Etest MBL, Hodge 변법을 시행하였으며 대조 검사로 IMP-1, VIM-1, VIM-2에 대한 PCR을 시행하였다. 결과: 총 50 균주 중 MBL 생성균은 Pseudomonas aeruginosa 1 균주, Alcaligenens xylosxidans 7 균주 등 8 균주(16%)가 검출되었다. 이들 균주는 모두 VIM-2 형이었으며, EDTA-DDS, Etest MBL은 PCR 방법과 100% 일치하였다. Hodge 변법은 8 MBL 생성균주 중 2 균주를 검출하지 못했다. 결론: 50 균주 중 8 균주가 MBL 생성균이었고 모두 VIM-2 형이었다. Etest MBL은 가격이 비싸 검사실에서는 EDTA-DDS가 적당할 것으로 사료된다. Purpose: Because metallo-β-lactamase (MBL) has activity to hydrolysls against most β-lactam drugs, dissemination of MBL producing bacteria may cause problems of treatment of infection by their microorganisms. Early detection or screening for MBLs will contribute to prevent further spread of resistance. Authors compared three MBL detection methods with PCR for MBLs. Materials and Methods: For 50 isolates of g1ucose nonfermentative gram negative bacilli with reduced susceptability against imipenem (MIC≥8 μg/mL), EDTA-double disk synergy (EDTA-DDS), Etest MBL and modified Hodge test were compared with PCR detection method for MBLs. Results: Among 50 isolates of glucose nonfermentative microorganisms, eight MBL producers including a Pseudomonas aeruginosa and 7 Alcaligenes xylosoxidans were detected. Those isolates were VIM-2 producer. The results of EDTA-DDS and Etest MBL completely agreed with PCR for MBL detection. Two isolates among eight MBL Producers were not detected in modified Hodge test. Conclusion: All of MBL producing bacteria were VIM-2 genotype. In conclusion, EDTA-DDS may be useful method for MBL detection in clinical laboratory due to high cost of Etest MBL strip.