多重聚合酶链式反应在脓毒血症病原体检测中的应用  

Application of multiplex polymerase-chain-reaction in detection of pathogens causing sepsis

作　　者：赖军华[1] 韦柳华[2] 杨柳光[2] 刘欢[1] 王承辉[1] 莫松[1] 莫小源[1] 

机构地区：[1]广西医科大学第四附属医院重症医学科,广西柳州545005 [2]广西医科大学第四附属医院检验科,广西柳州545005

出　　处：《中华医院感染学杂志》2014年第17期4409-4411,共3页Chinese Journal of Nosocomiology

基　　金：广西科学研究与技术开发基金项目(桂科攻1140003A-43)

摘　　要：目的探讨多重聚合酶链式反应(PCR)在脓毒血症病原体检测中的灵敏度、特异性及检测时间,为多重PCR在脓毒血症病原体检测中的应用提供理论依据。方法采用多重PCR和血培养检测医院40例脓毒血症患者血液中的病原体,并比较两种检测方法的灵敏度、特异性、检测速度、检测菌种的差异,并以同期40名健康体检者血标本作为对照;采用SPSS 15.0软件进行数据处理,检测阳性结果以率的形式表示,并进行χ2检验。结果对照组中两种方法的阳性率差异无统计学意义,脓毒血症组多重PCR检测的阳性率为55.0%,血培养为82.5%,两者比较差异有统计学意义(P<0.05),且血培养检测出18例脓血症患者中共有11例PCR检测为阳性,占61.1%;多重PCR特异性为80.7%,灵敏度为95.7%;脓毒血症组多重PCR的平均检测时间为(6±0.56)h,血培养法为(30.78±1.45)h,差异有统计学意义(P<0.05);从22份阳性血培养中共分离出4种病原菌,分别为金黄色葡萄球菌10株、铜绿假单胞菌7株、鲍氏不动杆菌3株、表皮葡萄球菌2株,多重PCR均能检测上述病原菌的DNA。结论在脓毒血症病原学的检测中,多重PCR较血培养具有更高的敏感性和特异性,检测时间也较血培养明显缩短,有利于脓毒血症病原体的快速检测,指导临床用药。OBJECTIVE To investigate the sensitivity, specificity, and detection time of multiplex polymerase-chainreaction （PCR） in the detection of pathogens causing sepsis so as to provide theoretical basis for application of multiples PCR in detection of the pathogens. METHODS By means of the multiplex PCR and blood culture, the pathogens isolated from the blood of 40 sepsis patients were detected, then the sensitivity, specificity, detection time, and species of detected pathogens were observed and compared between the two detection methods; mean- while, 40 healthy people who underwent the physical examination were assigned as the control group, the data were analyzed with the use of SPSS 15.0 software, the positive results were defined as rate, and the chi-square test was carried out. RESULTS In the control group, there was no significant difference in the positive rate between the two methods; in the sepsis group, the positive rate of the multiples PCR was 55.0%, the blood culture 82.5%, the difference was significant （P〈0.05）. Of 18 sepsis patients detected by the blood culture, 11 cases were positive for PCR, accounting for 61.1%. The specificity of the multiplex PCR was 80.7%, the sensitivity 95.7%. In the sepsis group, the average detection time of the multiples PCR was （6±0.56） hours, the blood culture （30. 78±1.45） hours, and there was significant difference （P〈0.05）. Totally 4 species of pathogens have been isolated from 22 blood specimens cultured positive, including 10 strains of Staphylococcus aureus 7 strains of Pseudomonas aeruginosa, 3 strains of Acinetobacter baumannii, and 2 strains of Staphylococcus epidermidis.The multiplex PCR could detect the DNA of the pathogens, CONCLUSION As compared with the blood culture, the multiplex PCR has higher sensitivity and specificity iti the deteetion of pathogens causing sepsis, with the deteetion time significantly shorter, it is conducive to the rapid detectlola of the pathogens causing sepsis as well as the reasonable clinical medication

关 键 词：多重聚合酶链式反应 血培养 脓毒血症 病原体检测 

分 类 号：R446[医药卫生—诊断学]