靶序列富集多重聚合酶链式反应在儿童细菌性肺炎病原体检测中的应用

发布时间：2018-11-13 13:24

【摘要】：目的分析靶序列富集多重聚合酶链式反应(Tem-PCR)在儿童细菌性肺炎病原体检测中的价值,为临床诊治工作提供客观研究依据。方法选取2015年6月-2016年6月212例社区获得性肺炎(CAP)患儿作为研究对象,采集所有纳入患儿的呼吸道深部吸引物,分别对其进行细菌培养和Tem-PCR检测。结果有123例患儿的呼吸道分泌物标本细菌培养检出病原菌,检出率为58.0%,共检出病原菌127株,其中,革兰阴性菌和革兰阳性菌分别占76.4%和23.6%,主要病原菌为流感嗜血菌、大肠埃希菌、金黄色葡萄球菌,分别占20.5%、14.2%、12.6%;有85例患儿的呼吸道分泌物标本Tem-PCR检测呈阳性,阳性率为40.1%,共检出105株病原菌靶基因,其中,流感嗜血菌、肺炎链球菌、鲍氏不动杆菌的比例最高,分别占40.0%、38.1%、10.5%;Tem-PCR检测对流感嗜血菌、肺炎链球菌、鲍氏不动杆菌、金黄色葡萄球菌等的诊断特异度均较高,对肺炎链球菌、铜绿假单胞菌的诊断敏感度和Youden指数均较高。结论 Tem-PCR检测在儿童CAP特定病原菌的早期诊断中具有一定的应用价值,可作为细菌感染性CAP病原学诊断的辅助手段。
[Abstract]:Objective to analyze the value of target sequence enriched multiplex polymerase chain reaction (Tem-PCR) in the detection of pathogens of bacterial pneumonia in children and to provide an objective basis for clinical diagnosis and treatment. Methods from June 2015 to June 2016, 212 children with community-acquired pneumonia (CAP) were selected as the study subjects. All the respiratory tract deep aspirates were collected, and their bacterial culture and Tem-PCR detection were performed. Results A total of 127 strains of pathogenic bacteria were detected in 123 samples of respiratory secretions, the positive rate was 58.0. Among them, gram-negative bacteria and gram-positive bacteria accounted for 76.4% and 23.6%, respectively. The main pathogenic bacteria were Haemophilus influenzae, Escherichia coli and Staphylococcus aureus, accounting for 20.5g / 14.2% and 12.6cm respectively. The positive rate of Tem-PCR was 40.1 in the respiratory secretions of 85 children. A total of 105 pathogenic bacteria target genes were detected, among which, Haemophilus influenzae, Streptococcus pneumoniae and Acinetobacter baumannii were the highest. 40.0% and 38.1%, 10.5%; The diagnostic specificity of Tem-PCR was higher for Haemophilus influenzae, Streptococcus pneumoniae, Acinetobacter baumannii and Staphylococcus aureus. The diagnostic sensitivity and Youden index of Streptococcus pneumoniae and Pseudomonas aeruginosa were higher than those of Streptococcus pneumoniae and Pseudomonas aeruginosa. Conclusion Tem-PCR detection is valuable in the early diagnosis of specific pathogens of CAP in children, and can be used as an auxiliary method for the etiological diagnosis of bacterial infectious CAP.
【作者单位】：湖北省妇幼保健院儿童肾脏风湿免疫科;武汉市武昌医院儿科;荆州市监利县人民医院儿科;
【基金】：湖北省卫生计生科研基金资助项目(WJ2017M132) 湖北省妇幼保健院科研基金资助项目(2016-07)
【分类号】：R440;R725.6

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