恒温扩增芯片法在ICU肺部感染患者下呼吸道感染病原体检测中的应用价值  

Clinical application value of isothermal amplification chip in the detection of pathogens in lower respiratory tract of pulmonary infection patiens in ICU

作　　者：刘佳佳[1] 孙静娜[1] 张征[1] 闫海洋 魏从真[1] 赵帅[1] LIU Jia-jia;SUN Jing-na;ZHANG Zheng(The First Hospital Inspection Center of Hebei Medical University,Shijiazhuang Hebei 050031,China.)

机构地区：[1]河北医科大学第一医院检验中心,河北石家庄050031

出　　处：《临床和实验医学杂志》2021年第15期1672-1676,共5页Journal of Clinical and Experimental Medicine

基　　金：2020年河北省卫健委医学科学研究课题(编号:20201163)。

摘　　要：目的评价恒温扩增芯片法(IAMP)在重症监护病房(ICU)肺部感染患者下呼吸道感染病原体检测中的应用效果。方法前瞻性收集2018年5月至2020年12月河北医科大学第一医院ICU病房155例肺部感染患者的合格痰标本,用IAMP法进行检测,同时进行细菌培养。比较病原体检出率,并对检测结果进行分析。结果155例痰标本中,IAMP法检出125例阳性标本,阳性率为80.6%。155例痰标本中,痰培养阳性108例,阳性率为69.8%。IAMP法的阳性检出率高于痰培养检出率,差异有统计学意义(P<0.05)。IAMP法对鲍曼不动杆菌(Ab)、耐甲氧西林金黄色葡萄球菌(MRS)、肺炎克雷伯菌(Kpn)、铜绿假单胞菌(Pae)、金黄色葡萄球菌(Sau)、嗜麦芽窄食单胞菌(Sm)、流感嗜血杆菌(Hi)、肺炎链球菌(Sp)检出率分别为43.2%、32.9%、31.6%、21.3%、20.0%、16.1%、10.3%和9.7%。而痰培养对象以上细菌的检出率分别为39.4%、0%、17.4%、13.5%、14.8%、5.8%、0%和0%。IAMP法的MRS、Kpn、Sm、Hi、Sp阳性检出率显著高于痰培养,差异均有统计学意义(P<0.05),而IAMP法和痰培养的Ab、Pae、Sau阳性检出率比较,差异无统计学意义(P>0.05)。IAMP法同时还检测到3例结核分枝杆菌复合群(Mtp)、1例嗜肺军团菌(Lpn)、1例肺炎支原体(Mp)和1例肺炎衣原体(Cpn),痰培养检测出3例奇异变形杆菌(Pmi)。结论IAMP法检测ICU病房肺部感染患者下呼吸道病原体检出阳性率高于痰培养,且检测简便、耗时短,为临床上肺部感染患者诊断提供更为快速且准确的新方法。Objective To evaluate the clinical application value of isothermal amplification chip(IAMP)in the detection of pathogens in lower respiratory tract in patients with pulmonary infection in ICU.Methods The qualified sputum specimens from 155 patients with lung infection in the ICU ward of the First Hospital of Hebei Medical University from May 2018 to December 2020 were prospectively collected and detected by IAMP method,and the bacteria culture were also used at the same time,and the physical examination rates of pathogens were compared,and the test results were analyzed.Results Among the 155 sputum samples,125 positive samples were detected by IAMP method,the positive rate was 80.6%.Among 155 sputum samples,108 were positive for sputum culture,the positive rate was 69.8%.The IAMP method was used to detect Acinetobacter baumannii(Ab),methicillin-resistant Staphylococcus aureus(MRS),Klebsiella pneumoniae(Kpn),Pseudomonas aeruginosa(Pae),Staphylococcus aureus(Sau),Stenotrophomonas maltophilia(Sm),Haemophilus influenzae(Hi),Streptococcus pneumoniae(Sp)positive rates were 43.2%,32.9%,31.6%,21.3%,20.0%,16.1%,10.3%and 9.7%.The detection rates of bacteria above sputum culture subjects were 39.4%,0%,17.4%,13.5%,14.8%,5.8%,0%and 0%,respectively.The positive detection rates of MRS,Kpn,Sm,Hi,and Sp of IAMP method were significantly higher than those of sputum culture,and the differences were statistically significant(P<0.05),while the positive detection rates of Ab,Pae,and Sau of IAMP method and sputum culture were compared,the differences were not statistically significant(P>0.05).At the same time,3 cases of Proteus mirabilis(Pmi)were detected in sputum culture of 3 cases of Mycobacterium tuberculosis complex(Mp),1 case of Legionella pneumophila(Lpn),1 case of Mycoplasma pneumoniae(Mp)and 1 case of Chlamydia pneumoniae(Cp),by IAMP method.Conclusion The positive rate of lower respiratory tract pathogen in patients with pulmonary infection in ICU detected by IAMP is higher than that of sputum culture,and the detection is simp

关 键 词：恒温扩增芯片法 细菌培养 肺部感染 下呼吸道感染 

分 类 号：R459.7[医药卫生—急诊医学] R446.5[医药卫生—治疗学]