摘要
       神经外科后脑膜炎（PNM）是世界范围内最严重的医院获得性感染（HAI）之一，大量病原体，尤其是那些拥有多重耐药基因的病原体，与这些感染有关。现有的检测细菌和测量抗生素反应的方法缺乏灵敏度和稳定性，实验室检测方法不方便，至少需要24小时才能完成。迫切需要快速鉴定细菌并确定它们对抗生素的敏感性，以对抗多重耐药菌株的出现。在这项研究中，我们评估了一种新颖，快速且易于使用的微/纳流控芯片平台（MNCP），该平台克服了诊断神经外科细菌感染的困难。该平台可以在1小时内鉴定出10个属或种目标和13个遗传抗性决定子，操作简单。使用MNCP测试总共108个含细菌的脑脊液（CSF）培养物用于鉴定细菌和遗传抗性的决定因素。结果与常规鉴定和药敏试验方法进行比较108个CSF培养物中，MNCP与常规鉴定方法的一致率为94.44％，其中6个物种的一致性为100％。对于产生碳青霉烯酶和广谱β内酰胺酶（ESBL-）相关抗生素耐药基因，MNCP检测的敏感性和特异性均高（> 90.0％），完全可以满足临床诊断的要求。总之，MNCP快速，准确，易于使用，在神经外科后脑膜炎的治疗中具有很大的临床潜力。

       Post-neurosurgical meningitis (PNM) is one of the most severe hospital-acquired infections (HAI) worldwide, and a large number of pathogens, especially those possessing multi-resistance genes, are related to these infections. Existing methods for detecting bacteria and measuring their response to antibiotics lack sensitivity and stability, and laboratory-based detection methods are inconvenient, which require at least 24h to complete. Rapid identification of bacteria and the determination of their susceptibility to antibiotics are urgently needed, in order to combat the emergence of multi-resistant bacterial strains. In this study, we evaluated a novel, fast, and easy-to-use micro/nanofluidic chip platform (MNCP), which overcomes the difficulties of diagnosing bacterial infections in neurosurgery. This platform can identify 10 genus or species targets and 13 genetic resistancedeterminants within 1h, and it is very simple to operate. A total of 108 bacterium-containing cerebrospinal fluid (CSF) cultures were tested using the MNCP for identifying bacteria and determinants of genetic resistance. The results were compared to those with conventional identification and antimicrobial susceptibility test methods Among the 108 CSF cultures, the concordance rate between the MNCP and the conventional identification method was 94.44%, and 6 species attainted 100% consistency. For the production of carbapenemase- and extended spectrum beta lactamase- (ESBL-) related antibiotic resistance genes, both the sensitivity and specificity of the MNCP tests were high (> 90.0%) and could fully meet the requirements of clinical diagnosis. In conclusion, the MNCP is fast, accurate, and easy to use, and has great clinical potential in the treatment of post-neurosurgical meningitis.

https://www.ncbi.nlm.nih.gov/pubmed/29559366