肺炎支原体液体培养法的实验诊断学评价
发布时间：2019-06-20 10:19
【摘要】：目的以血清颗粒凝集试验(particle agglutination test,PA)为标准,研究肺炎支原体(MP)液体培养法检测结果的实验诊断学价值,并探索液体培养法的优化方法。方法 2014年5月至2014年9月从我院收集2991例检查患者,采用液体培养法对患者咽拭子标本进行MP检测,得到结果(liquid culture,LC)1。将液体培养法阳性液采用平板分离培养,鉴定培养出的细菌后与其标准菌株定量接种于MP液体培养基,判断污染可能性,筛除假阳性后得到LC2。PA法检测同一患者血清中肺炎支原体的滴度。与PA比较,采用三维配对卡方算液体培养法(LC1,LC2)的敏感度、特异度、准确度等指标;采用Kruskal-Wallis秩和检验分析各年龄组分布与干扰细菌分布的差异;采用t检验比较标本分离菌与同种标准菌株引起MP液体培养假阳性差别。结果三维配对卡方检验得到CL1和CL2的灵敏度、特异度、误诊率、漏诊率、约登指数分别为82.2%、90.2%、9.8%、17.8%、0.724和82.2%、96.4%、3.6%、17.8%、0.786;CL2的特异度较CL1有明显的提高,差异有统计学意义(P0.05);CL1具有比CL2较高的误诊率;12岁以下年龄组与13~50岁、50岁以上年龄组的干扰细菌分布差异有统计学意义(P=0.01);各种分离菌使MP液体培养基产生假阳性的最低浓度较标准菌株低,差异有统计学意义(P0.05)。结论 MP液体培养法(CL1)与改进后的液体培养法(CL2)均具有较高的临床诊断价值,但是需排除口咽部分离菌的干扰;CL2比CL1具有更高的特异性;咽部细菌较标准菌对MP液体培养法的影响更为明显;咽部细菌对MP液体培养法影响与年龄阶段分布相关,较高年龄组(12岁以上)因具有较多的分离菌容易对MP液体培养基产生干扰。
[Abstract]:Objective to study the diagnostic value of (MP) liquid culture method for mycoplasma pneumoniae according to the standard of serum particle aggregation test (particle agglutination test,PA), and to explore the optimization method of liquid culture method. Methods from May 2014 to September 2014, 2991 patients were collected from our hospital. MP was detected by liquid culture method in throat swabs of patients, and the results (liquid culture,LC) were obtained. The positive solution of liquid culture method was isolated and cultured by plate. The cultured bacteria and their standard strains were quantitatively inoculated in MP liquid medium to judge the possibility of contamination. After screening false positive, the titer of Mycoplasma pneumoniae in serum of the same patient was detected by LC2.PA method. Compared with PA, three-dimensional matched chi-square method was used to calculate the sensitivity, specificity and accuracy of liquid culture (LC1,LC2), Kruskal-Wallis rank sum test was used to analyze the difference between the distribution of different age groups and interfering bacteria, and t test was used to compare the false positive difference of MP liquid culture between isolated bacteria and the same standard strain. Results the sensitivity, specificity, misdiagnosis rate and missed diagnosis rate of CL1 and CL2 were 82.2%, 90.2%, 8.8%, 17.8%, 96.4%, 3.6% and 17.8%, respectively, and the specificity of 0.786 鈮，
本文编号：2503143
[Abstract]:Objective to study the diagnostic value of (MP) liquid culture method for mycoplasma pneumoniae according to the standard of serum particle aggregation test (particle agglutination test,PA), and to explore the optimization method of liquid culture method. Methods from May 2014 to September 2014, 2991 patients were collected from our hospital. MP was detected by liquid culture method in throat swabs of patients, and the results (liquid culture,LC) were obtained. The positive solution of liquid culture method was isolated and cultured by plate. The cultured bacteria and their standard strains were quantitatively inoculated in MP liquid medium to judge the possibility of contamination. After screening false positive, the titer of Mycoplasma pneumoniae in serum of the same patient was detected by LC2.PA method. Compared with PA, three-dimensional matched chi-square method was used to calculate the sensitivity, specificity and accuracy of liquid culture (LC1,LC2), Kruskal-Wallis rank sum test was used to analyze the difference between the distribution of different age groups and interfering bacteria, and t test was used to compare the false positive difference of MP liquid culture between isolated bacteria and the same standard strain. Results the sensitivity, specificity, misdiagnosis rate and missed diagnosis rate of CL1 and CL2 were 82.2%, 90.2%, 8.8%, 17.8%, 96.4%, 3.6% and 17.8%, respectively, and the specificity of 0.786 鈮，
本文编号：2503143
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