聚合酶链反应技术检测临床标本中军团病杆菌

Detection of Legionella spp in Clinical Spectimens by Polymerase Chain Reaction

探讨聚合酶链反应（ＰＣＲ）技术检测临床标本中军团病杆菌（ＬＤＢ）对军团菌病的诊断价值。用ＰＣＲ技术对３１例ＬＤＢ培养和（或）血清学阳性、临床诊断为军团菌病患者急性期的临床标本中，军团菌巨噬细胞感染增效基因（ｍｉｐｇｅｎｅ）的６３０ｂｐ片段进行ＤＮＡ扩增，并与军团菌培养和血清学诊断（间接荧光抗体检查法）比较。结果：ＰＣＲ技术诊断军团菌病的阳性率为９０．３％（２８／３１），比培养的阳性率（６２．６％，１７／２７）高（χ２＝８．２３，Ｐ＜０．００５），与血清学检测阳性率（８６．２％，２５／２９）之间无显著性差异（χ２＝０．８９，Ｐ＞０．２５）。在ＬＤＢ培养阴性、血清学阴性的４０例肺部感染患者中３例ＰＣＲ法检测结果阳性。

By using PCR, DNA amplification of a specific fragment of the macrophage infectivity potentiator (mip) gene from Legionella pneumophila was used to detect Legionella spp. in 31 patients with Legionnaires′ disease, and the diagnostic value of this method was compared with that of the Legionella culture and the serological diagnosis (indirect immunofluorescence test). Clinical specimens from 40 Legionella culturenegative and serologicalnegative patients with pulmonary infection were simultaneously detected by PCR. The diagnostic positive rate of Legionnaires′ diseases by PCR was 90.3% (28/31), and significantly higher than culture (17/27, positive rate 62.6%, P <0.005) and no statistical difference when compared with serological diagnosis (25/29, positive rate 86.2%, P >0.25). 3 specimens of 40 culture and serological negative patients were amplificationpositive by using PCR. PCR could be a promising and useful tool for the diagnosis of Legionnaires′ disease.