Giá trị xét nghiệm mCIM, eCIM so với CARBA-5, multiplex PCR trong sàng lọc Enterobacteriales sinh carbapenemase=The diagnostic value of mCIM and eCIM compared to CARBA-5 and multiplex PCR in screening for carbapenemase-producing Enterobacteriales

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Tác giả: Thị Hoa Hà, Duy Nhất Lê, Sĩ Tuấn Nguyễn, Thị Thuỳ Linh Nguyễn, Nguyễn Trường Duy Trần, Thị Trinh Võ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.98-107

Bộ sưu tập: Metadata

ID: 478197

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This study aims to verify the diagnostic value, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), of the mCIM and eCIM tests compared to CARBA-5 and multiplex PCR in screening for carbapenemaseproducing Enterobacterales at Thong Nhat General Hospital, Dong Nai Province, from 4/2020 to 9/2024. Methods: This is a descriptive crosssectional study. The case group includes 147 strains of Carbapenemase gene-harboring Enterobacterales, and the control group consists of 1,516 strains of non-Carbapenemase geneharboring Enterobacterales. The diagnostic utility of mCIM and eCIM was compared with the CARBA-5 standard. The value of the mCIM and eCIM tests was also compared to an optimized multiplex PCR based on the publication by Poirel 2011. Results: The mCIM test showed an accuracy of 95%, with a sensitivity of 90% and a specificity of 100% compared to the CARBA-5 gold standard. The eCIM test demonstrated an accuracy of 100%, with both a sensitivity and specificity of 100% compared to the CARBA-5 gold standard. Both mCIM and eCIM tests exhibited 100% reproducibility (repeatability and reproducibility) in concordance with the CARBA-5 test. When compared to multiplex PCR, the values for the mCIM/eCIM tests were as follows: sensitivity of 100%, specificity of 96.7%, positive predictive value (PPV) of 64.6%, and negative predictive value (NPV) of 100%. Conclusion: The first study estimating sensitivity in Vietnam aimed at determining the value of mCIM and eCIM tests on 1,663 bacterial strains shows that mCIM and eCIM have high value in screening and classifying Carbapenemase in Enterobacterales.Xác nhận giá trị sử dụng, độ nhạy, độ đặc hiệu, giá trị tiên đoán dương, giá trị tiên đoán âm của xét nghiệm mCIM, eCIM so với CARBA-5, multiplex PCR trong sàng lọc trực khuẩn Gram âm đường ruột (Enterobacterales) sinh Carbapenemase tại Bệnh viện Đa khoa Thống Nhất tỉnh Đồng Nai từ 4/2020 đến 9/2024. Phương pháp: Nghiên cứu cắt ngang mô tả. Nhóm bệnh gồm 147 chủng Enterobacterales mang gen mã hoá Carbapenemase và nhóm chứng gồm 1.516 chủng Enterobacterales không mang gen mã hoá Carbapenemase. Xác nhận giá trị sử dụng xét nghiệm mCIM, eCIM so với phương pháp tiêu chuẩn CARBA-5. Xác định giá trị xét nghiệm mCIM, eCIM so với phương pháp multiplex PCR được tối ưu dựa trên công bố của Poirel 2011. Kết quả: Xét nghiệm mCIM có độ chính xác là 95%, độ nhạy là 90% và độ đặc hiệu là 100% so với phương pháp tiêu chuẩn là CARBA-5. Xét nghiệm eCIM có độ chính xác là 100%, độ nhạy là 100% và độ đặc hiệu là 100% so với phương pháp tiêu chuẩn là CARBA-5. Cả 2 xét nghiệm mCIM và eCIM có độ chụm (độ lặp và độ tái lặp) đồng thuận loại tương đồng 100% với xét nghiệm CARBA-5. Giá trị của xét nghiệm mCIM/ eCIM so với multiplex PCR lần lượt như sau: độ nhạy là 100%
độ đặc hiệu là 96,7%
giá trị tiên đoán dương là 64,6%
giá trị tiên đoán âm là 100%. Kết luận: Nghiên cứu ước lượng một độ nhạy đầu tiên tại Việt Nam nhằm xác định giá trị xét nghiệm mCIM, eCIM trên 1663 chủng vi khuẩn cho thấy mCIM và eCIM có giá trị cao trong sàng lọc và phân nhóm carbapenemase ở Enterobacterales.

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