發(fā)布時間：2018-11-13 13:24

【摘要】：目的分析靶序列富集多重聚合酶鏈?zhǔn)椒磻?yīng)(Tem-PCR)在兒童細(xì)菌性肺炎病原體檢測中的價值,為臨床診治工作提供客觀研究依據(jù)。方法選取2015年6月-2016年6月212例社區(qū)獲得性肺炎(CAP)患兒作為研究對象,采集所有納入患兒的呼吸道深部吸引物,分別對其進(jìn)行細(xì)菌培養(yǎng)和Tem-PCR檢測。結(jié)果有123例患兒的呼吸道分泌物標(biāo)本細(xì)菌培養(yǎng)檢出病原菌,檢出率為58.0%,共檢出病原菌127株,其中,革蘭陰性菌和革蘭陽性菌分別占76.4%和23.6%,主要病原菌為流感嗜血菌、大腸埃希菌、金黃色葡萄球菌,分別占20.5%、14.2%、12.6%;有85例患兒的呼吸道分泌物標(biāo)本Tem-PCR檢測呈陽性,陽性率為40.1%,共檢出105株病原菌靶基因,其中,流感嗜血菌、肺炎鏈球菌、鮑氏不動桿菌的比例最高,分別占40.0%、38.1%、10.5%;Tem-PCR檢測對流感嗜血菌、肺炎鏈球菌、鮑氏不動桿菌、金黃色葡萄球菌等的診斷特異度均較高,對肺炎鏈球菌、銅綠假單胞菌的診斷敏感度和Youden指數(shù)均較高。結(jié)論 Tem-PCR檢測在兒童CAP特定病原菌的早期診斷中具有一定的應(yīng)用價值,可作為細(xì)菌感染性CAP病原學(xué)診斷的輔助手段。
[Abstract]:Objective to analyze the value of target sequence enriched multiplex polymerase chain reaction (Tem-PCR) in the detection of pathogens of bacterial pneumonia in children and to provide an objective basis for clinical diagnosis and treatment. Methods from June 2015 to June 2016, 212 children with community-acquired pneumonia (CAP) were selected as the study subjects. All the respiratory tract deep aspirates were collected, and their bacterial culture and Tem-PCR detection were performed. Results A total of 127 strains of pathogenic bacteria were detected in 123 samples of respiratory secretions, the positive rate was 58.0. Among them, gram-negative bacteria and gram-positive bacteria accounted for 76.4% and 23.6%, respectively. The main pathogenic bacteria were Haemophilus influenzae, Escherichia coli and Staphylococcus aureus, accounting for 20.5g / 14.2% and 12.6cm respectively. The positive rate of Tem-PCR was 40.1 in the respiratory secretions of 85 children. A total of 105 pathogenic bacteria target genes were detected, among which, Haemophilus influenzae, Streptococcus pneumoniae and Acinetobacter baumannii were the highest. 40.0% and 38.1%, 10.5%; The diagnostic specificity of Tem-PCR was higher for Haemophilus influenzae, Streptococcus pneumoniae, Acinetobacter baumannii and Staphylococcus aureus. The diagnostic sensitivity and Youden index of Streptococcus pneumoniae and Pseudomonas aeruginosa were higher than those of Streptococcus pneumoniae and Pseudomonas aeruginosa. Conclusion Tem-PCR detection is valuable in the early diagnosis of specific pathogens of CAP in children, and can be used as an auxiliary method for the etiological diagnosis of bacterial infectious CAP.
【作者單位】： 湖北省婦幼保健院兒童腎臟風(fēng)濕免疫科;武漢市武昌醫(yī)院兒科;荊州市監(jiān)利縣人民醫(yī)院兒科;
【基金】：湖北省衛(wèi)生計生科研基金資助項目(WJ2017M132) 湖北省婦幼保健院科研基金資助項目(2016-07)
【分類號】：R440;R725.6

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