Objective To investigate the feasibility of modified rapid Carba NP test for the detection of carbapenemase,and analyze the differences between the modified method and Carba NP test.Methods A total of 264 strains of gram-negative bacillus,including 164 carbapenem-resistant strains and 100 sensitive strains,were collected,and their carbapenemase were detected by Carba NP test and the modified rapid Carba NP test,respectively.The differences between the two tests were evaluated based on PCR as a reference.Results Among 164 carbapenem-resistant strains,carbapenemase gene was detected in 144 strains by PCR.The carbapenemase gene was negative in 100 sensitive strains.Among 164 carbapenem-resistant strains,135 were positive for the Carba NP test,while 130 for the modified rapid Carba NP test.One hundred of sensitive strains were negative for the two Carba NP tests.Compared with the results of PCR,the sensitivity,specificity and Kappa value of the Carba NP test were 91.7％ (132/144),97.5％ (117/120) and 0.886,respectively,while those of the modified rapid Carba NP test were 89.6％ (129/144),99.2％ (119/120) and 0.879,respectively.There was no significant difference in the positive rates between Carba NP test and the modified rapid Carba NP test (x2 =1.45,P ＞ 0.05).Conclusion The modified rapid Carba NP test which has high consistency with the PCR method,is faster and cheaper than the Carba NP test,and may be applied to epidemiologic survey and the early monitoring of nosocomial infections.%目的 探讨改良快速Carba NP试验用于检测碳青霉烯酶的可行性,并对比分析其与Carba NP试验的差异.方法 选取264株革兰阴性杆菌,其中耐药菌株164株,敏感菌株100株.分别采用Carba NP试验、改良快速Carba NP试验检测碳青霉烯酶表型,并以PCR检测结果为参比,评价上述检测方法的差异.结果 164株耐药菌株中,耐药基因阳性144株;100株敏感菌株耐药基因均为阴性.164株耐药菌株中Carba NP试验阳性135株;改良快速Carba NP试验阳性130株.100株敏感菌株中,2种方法均为阴性.与PCR检测结果相比,Carba NP试验的敏感性和特异性分别为91.7％ (132/144)和97.5％ (117/120),Kappa值0.886;改良快速Carba NP试验敏感性和特异性分别为89.6％ (129/144)和99.2％ (119/120),Kappa值0.879.Carba NP试验与改良快速Carba NP试验的阳性检出率差异无统计学意义(x2=1.45,P＞0.05).结论 改良快速Carba NP试验与PCR方法一致性高,较Carba NP试验更为快速、廉价,适用于流行病学调查和院内感染的早期监测.
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