下呼吸道六项病原菌多重核酸检测与传统细菌培养方法的比较  

Comparative study of multiple nucleic acid tests with conventional bacterial culture methods for detection of six kinds of pathogenic bacteria in lower respiratory tract

作　　者：刘庆[1] 李剑[2] 马挪亚 黄露萍[1] 李勇[1] 王思思 邹国英[1] 徐飞[1] LIU Qing;LI Jian;MA Nuoya;HUANG Luping;LI Yong;WANG Sisi;ZOU Guoying;XU Fei(Hunan Provincial Brain Hospital(The Second People’s Hospital of Hunan Province),Changsha,Hunan 410007,China;Hunan Provincial Center for Disease Control and Prevention,Changsha,Hunan 410153,China)

机构地区：[1]湖南省脑科医院(湖南省第二人民医院),湖南长沙410007 [2]湖南省疾病预防控制中心,湖南长沙410153

出　　处：《实用预防医学》2024年第7期872-875,共4页Practical Preventive Medicine

摘　　要：目的通过对多重核酸检测与传统细菌培养方法的比较,探讨多重核酸检测技术在下呼吸道病原菌感染早期诊断中的价值和应用。方法收集2022年7月12日—2023年7月26日所有行下呼吸道六项病原体核酸检测样本,同期行传统细菌培养,分析比较两种方法病原体检出率的差异。结果痰标本中对于荚膜型流感嗜血杆菌和肺炎链球菌的检出率,多重核酸检测方法高于传统培养方法(12.39%vs.4.42%,P=0.012;27.43%vs.0.00%),对于铜绿假单胞菌、金黄色葡萄球菌和肺炎克雷伯杆菌两种方法的检出率差异均无统计学意义(P>0.05),具有一般到中等的一致性(kappa=0.328&0.387&0.490,均P<0.001);在支气管肺泡灌洗液标本中对于肺炎克雷伯杆菌和肺炎链球菌的检出率,多重核酸检测方法高于传统培养方法(29.87%vs.14.29%,P<0.001,14.29%vs.0.00%),对于金黄色葡萄球菌和铜绿假单胞菌两种方法检出率差异均无统计学意义(P>0.05),二者具有一般到中等的一致性(kappa=0.252&0.490,均P<0.05)。多重核酸检测实验室内平均周转时间短于传统培养方法(χ^(2)=7905.733,P<0.001)。结论多重核酸检测方法在部分下呼吸道病原菌的检出中更具优势,部分细菌的检出与传统培养方法具有一定的一致性,此外具有更短的实验室内周转时间,可以快速准确地为临床提供诊疗信息,两种方法之间具有一定的互补性,二者结合可有效地避免漏诊和误诊。Objective To explore the value and application of multiple nucleic acid tests in the early diagnosis of lower respiratory tract infections caused by pathogenic bacteria through a comparative study of multiple nucleic acid tests and traditional bacterial culture methods.Methods We collected the specimens undergoing nucleic acid tests for six kinds of pathogens in the lower respiratory tract from July 12,2022 to July 26,2023,and the specimens underwent traditional bacterial cultures during the same period.The differences in the detection rates of pathogens between the two methods were analyzed and compared.Results The detection rates of Haemophilus influenzae and Streptococcus pneumoniae in sputum specimens undergoing multiple nucleic acid tests were higher than those in sputum specimens undergoing traditional bacterial cultures(12.39%vs.4.42%,P=0.012;27.43%vs.0.00%),but no statistically significant differences were found in the detection rates of Pseudomonas aeruginosa,Staphylococcus aureus,and Klebsiella pneumoniae between the two methods(all P>0.05),with a fair to moderate concordance(kappa=0.328&0.387&0.490,all P<0.001).As for Klebsiella pneumoniae and Streptococcus pneumoniae in specimens of bronchoalveolar lavage fluid,the detection rates based on multiple nucleic acid tests were higher than those based on traditional bacterial cultures(29.87%vs.14.29%,P<0.001;14.29%vs.0.00%),but no statistically significant differences were observed in the detection rates of Staphylococcus aureus and Pseudomonas aeruginosa between the two methods(P>0.05),with a fair to moderate concordance(kappa=0.252&0.490,both P<0.05).The intra-laboratory turnaround time based on multiple nucleic acid tests was less than that based on traditional bacterial cultures(χ2=7,905.733,P<0.001).Conclusion Multiple nucleic acid tests are more advantageous in the detection of some lower respiratory tract pathogens.The detection of some bacteria based on multiple nucleic acid tests has a certain degree of consistency with that based on traditional c

关 键 词：多重核酸检测 下呼吸道感染 病原菌检测 实验室内周转时间 

分 类 号：R446.5[医药卫生—诊断学]