恒温扩增芯片法在儿童下呼吸道感染性疾病中的应用价值评估  

Application of isothermal amplification chip method in lower respiratory tract pathogens detection in children

作　　者：王咏红[1] 郭雅洁[1] 陈玉莹 马琦 李洁琼[1] WANG Yong-hong;GUO Ya-jie;CHEN Yu-ying;MA Qi;LI Jie-qiong(Beijing Key Laboratory of Pediatric Respiratory Infection Diseases,Key Laboratory of Major Diseases in Children,Ministry of Education,National Clinical Research Center for Respiratory Diseases,National Key Discipline of Pediatrics(Capital Medical University),Beijing Pediatric Research Institute,B)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院,儿科学国家重点学科,国家呼吸系统疾病临床医学研究中心,教育部儿科重大疾病研究重点实验室,儿童呼吸道感染性疾病研究北京市重点实验室,北京市儿科研究所呼吸感染疾病研究室,北京100045

出　　处：《中国循证儿科杂志》2018年第3期176-179,共4页Chinese Journal of Evidence Based Pediatrics

基　　金：首都卫生发展科研专项资金:2016-1-2092;国家自然科学基金:81571950。

摘　　要：目的评价恒温扩增芯片法在儿童下呼吸道感染病原体检测中的应用价值。方法纳入2017年1~7月于首都医科大学附属北京儿童医院住院的下呼吸道感染患儿,入院当天采集痰液等分泌物标本,通过恒温扩增芯片法(芯片法)检测13种常见病原体,比较芯片法与痰培养和血清学方法的检出率。结果研究期间应用恒温扩增芯片法共检测230例下呼吸道感染住院患儿,共检出182例(79.1%)病原阳性。单一病原感染77例(33.5%),混合感染105例(45.6%)。芯片法检出的主要病原菌为耐甲氧西林葡萄球菌(33.8%)、流感嗜血杆菌(27.8%)和肺炎链球菌(22.6%),芯片法对流感嗜血杆菌、肺炎链球菌、金黄色葡萄球菌和肺炎克雷伯菌的阳性检出率明显高于培养法。两种方法对于铜绿假单胞菌、鲍曼不动杆菌和肺炎支原体等的检出率差异无统计学意义。结论对于儿童下呼吸道感染病原体检测,芯片法操作简便、快速,可同时检测13种病原体,且病原体检出率明显高于培养法。Objective To evaluate the effect of isothermal amplification chip method in lower respiratory tract pathogens detection.Methods A total of 230 qualified sputum samples were collected.The pathogens were detected by using the isothermal amplification chip method and bacterial culture method.Mycobacterium tuberculosis was tested by using the Ziehl-Neelsen staining.Results Pathogens were detected by using the isothermal amplification chip method in 182 specimens with the positive rate of 79.1%,which were mainly Methicillin-resistant staphylococcus aureus(33.8%),Haemophilus influenzae(27.7%),Streptococcus pneumoniae(22.5%).Of which,77(33.5%)were single pathogen infection,105(45.6%)were mixed infection and 48(20.9%)were pathogen negative.The positive rates of haemophilus influenzae,streptococcus pneumoniae,staphylococcus aureus and klebsiella pneumonia e detected using isothermal amplification chip were higher than culture.The total conformance rate of escherichia coli,klebsiella pneumoniae,pseudomonas aeruginosa,acinetobacter baumannii,and malt narrow-phagocytes by the two different methods were high.And the positive rate of mycoplasma pneumoniae detected by isothermal amplification chip(12.4%)was similar with that detected by argeted serological testing(11.8%).Conclusion Isothermal amplification chip method is conducive to the rapid diagnosis of low respiratory tract infection of children and timely targeted treatment.

关 键 词：环介导恒温扩增 下呼吸道感染 病原体 儿童 

分 类 号：R446.5[医药卫生—诊断学] R725.6[医药卫生—临床医学]