RESUMEN
BACKGROUND/PURPOSE: To evaluate the ability of quadruple Taqman probe real-time PCR to the detection of vanA, vanB and vanM in enterococcal isolates. METHODS: A total of 343 strains, including 253 vancomycin-resistant enterococcus (VRE) strains and 90 non-VRE strains, were tested by both quadruple Taqman probe real-time PCR and gel-based PCR assay. RESULTS: When differentiating among three genotypes of vanA, vanB and vanM in VRE strains, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy and consistency of the quadruple Taqman probe real-time PCR were all 100%. Minimum. Inhibitory concentration (MIC) results showed that there was a wide MIC range of vancomycin and teicoplanin for the strains that harboring vanA/vanM gene respectively or harboring vanA and vanM genes simultaneously. However, the VRE strains with vanB genotype all were sensitive to teicoplanin. CONCLUSION: Considering the excellent PPV and low NPV, real-time PCR would be useful to monitor VRE-colonized or infected patients. However, further evaluation of the assay's performance in the clinical specimens is required, especially when considering that high level of PCR inhibitors present in these samples.
Asunto(s)
Proteínas Bacterianas/genética , Proteínas Bacterianas/aislamiento & purificación , Ligasas de Carbono-Oxígeno/genética , Ligasas de Carbono-Oxígeno/aislamiento & purificación , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Acinetobacter baumannii , Farmacorresistencia Microbiana/genética , Enterococcus/efectos de los fármacos , Enterococcus/genética , Enterococcus faecium/genética , Genotipo , Klebsiella pneumoniae/genética , Pruebas de Sensibilidad Microbiana , Pseudomonas aeruginosa , Staphylococcus aureus/genética , Teicoplanina/farmacología , Vancomicina/farmacología , Enterococos Resistentes a la Vancomicina/genéticaRESUMEN
Given the multiple terrorist attacks that have occurred in recent years in China, medical rescue teams and specialized incident assessment teams have been established by the government; however, medical rescue after nuclear, biological, and chemical incidents remains challenging and is often inefficient. In the present article, problems were analyzed regarding the assessment of responder countermeasures, training of professionals and the management of emergency medical incidents related to nuclear, biological and chemical attacks. Countermeasures, the establishment of response coordination, public education, practical training and exercise, and a professional consultant team or system should be the focus of emergency medical response facilities. Moreover, the government was offered professionals who are involved in managing nuclear, biological and chemical incidents.
