聚合酶链反应诊断细菌和真菌性中枢神经系统感染的临床价值

发布时间：2018-03-16 04:25

本文选题：感染　切入点：中枢神经系统　出处：《中国感染与化疗杂志》2017年06期 　论文类型：期刊论文

【摘要】：目的探讨聚合酶链反应(PCR)在细菌和真菌性中枢神经系统感染快速诊断中的临床价值。方法收集137例中枢神经系统感染患者留存的脑脊液进行DNA提取,采用细菌和真菌通用引物扩增病原体DNA并进行序列测定,对比同期脑脊液培养方法与PCR方法的检测结果。结果 137份脑脊液标本中PCR检测到细菌50株,真菌6株,脑脊液培养检测到细菌38株,真菌5株;PCR检测法灵敏度为40.9%,特异度为100%,阳性预测值为100%,阴性预测值为38.2%,诊断效率为56.7%;传统培养法则分别为31.4%、100%、100%、34.7%、44.4%。PCR的灵敏度、阴性预测值和诊断效率均明显优于传统培养方法,特异度和阳性预测值与培养法相当,两方法鉴定菌种的符合率为97.7%。结论通用引物PCR扩增法具有快速、特异、灵敏、准确等特点,对细菌和真菌性中枢神经系统感染的病原学快速诊断具有重要的应用价值。
[Abstract]:Objective to investigate the clinical value of polymerase chain reaction (PCR) in the rapid diagnosis of bacterial and fungal central nervous system infections. The pathogen DNA was amplified by bacterial and fungal universal primers and sequenced. The results of CSF culture method and PCR method were compared. Results 50 strains of bacteria and 6 strains of fungi were detected by PCR in 137 samples of cerebrospinal fluid. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic efficiency were 40.9, 100, 100, 38.2, 56.7, respectively, respectively. The negative predictive value and diagnostic efficiency were obviously superior to those of the traditional culture method. The specificity and positive predictive value of the two methods were similar to those of the culture method. The coincidence rate of the two methods for identifying the strains was 97.7.The conclusion the universal primer PCR amplification method is rapid, specific and sensitive. It has important application value for rapid etiological diagnosis of bacterial and fungal central nervous system infection.
【作者单位】：首都医科大学宣武医院检验科;江西卫生职业学院检验系;
【基金】：首都临床特色重点专项课题(Z141107002514012)
【分类号】：R440;R742.9

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