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Abstract：
Rapid detection of antimicrobial resistance is crucial for early initiation of appropriate therapy. The aim of this study was to investigate whether resistance to colistin, the last-resort antibiotic, in carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates can be detected accurately and rapidly by flow cytometry (FCM). The VITEK 2 automated system was used to identify 85 K. pneumoniae strains and to determine their resistance to carbapenems. The minimum inhibitory concentration (MIC) values for colistin in 85 CRKP strains were determined by broth microdilution (BMD), which is the reference method. In addition, FCM was used, combined with DiBAC4(3) fluorescent stain, to determine colistin susceptibility. The MIC₅₀ value of the strains, 80% of which were resistant to colistin by the BMD method, was 16 mg/L, and the MIC₉₀ value was 32 mg/L. When FCM was compared with the reference method, it was determined that the specificity was 94.1%, sensitivity was 100% of FCM, and Cohen\'s kappa value was 0.96. Colistin susceptibility results with FCM were obtained within an average of 2 h. These findings suggest that FCM holds great promise as a rapid and reliable alternative method for detecting colistin resistance in CRKP strains.
摘要：
快速检测抗生素耐药性对于早期启动适当的治疗至关重要。这项研究的目的是调查是否对粘菌素具有抗性，最后的抗生素，在耐碳青霉烯类肺炎克雷伯菌（CRKP）分离株中，流式细胞术（FCM）可以准确、快速地检测到。VITEK2自动化系统用于鉴定85株肺炎克雷伯菌，并确定其对碳青霉烯类抗生素的耐药性。通过肉汤微量稀释（BMD）确定85个CRKP菌株中粘菌素的最小抑制浓度（MIC）值，这是参考方法。此外,使用了FCM，结合DiBAC4（3）荧光染色剂，确定粘菌素敏感性。菌株的MIC0值，通过BMD方法，其中80％对粘菌素具有抗性，是16毫克/升，MIC值为32mg/L。当FCM与参考方法进行比较时，确定特异性为94.1%，灵敏度为FCM的100%，Cohen的kappa值为0.96。FCM的粘菌素敏感性结果平均在2小时内获得。这些发现表明，FCM作为检测CRKP菌株粘菌素耐药性的快速可靠的替代方法具有很大的前景。
