抗生素应用对16SrRNA基因芯片检测腹水细菌的影响

Influence of antibiotic treatment to the detection of ascites bacteria by 16S rRNA microarray

目的评价抗生素的应用是否影响基因芯片（寡核苷酸序列分析）检测腹水细菌16SrRNA基因在自发性细菌性腹膜炎（SBP）诊断中的应用。方法采用16SrRNAPCR-基因芯片检测76例临床疑似SBP肝病患者的腹水细菌16SrRNA基因，与同期患者的腹水细菌培养相比，分析两种不同检测方法对应用抗生素（31例）和未应用抗生素（45例）患者的细菌阳性率的差异。结果76份疑似SBP患者的腹水样本中，基因芯片检测阳性率22．37％（17份），明显高于腹水细菌培养阳性率的7．89％（6份），两种方法差异有统计学意义（Х^2=18．05，P〈0．01）。应用抗生素组腹水细菌基因芯片检测阳性率为19．35％（6份），略低于未应用抗生素组的24．44％（11份），但两组差异无统计学意义（Х^2=0．274，P〉0．05）。应用抗生素组腹水细菌培养阳性率为0（0／31），而未应用抗生素组阳性率为13．33％（6／45），两组差异有统计学意义（Х^2=4．488，P〈0．05）。结论16SrRNA PCR-基因芯片检测腹水细菌与腹水培养相比可能更少受抗牛素府用的影响。

Objective To evaluate the influence to detect ascites bacteria with 16S rRNA PCR-microarray in patients with spontaneous bacterial peritonitis（ SBP） after treated with antibiotics. Methods Compared to ascites bacterial culture, ascites bacterial 16S rRNA genes were detected by PCR-microarmy in 76 cases of suspected SBP with chronic liver diseases, and the difference of ascites bacteria positive rates between two groups with and without antibiotics were analyzed. Results Of the 76 ascites samples in SBP patients, there were 17 （22.37 % ） ascites bacteria positive detected by PCR-microarray, and 6（7.89% ） ascites bacteria positive detected by bacterial culture. The positive rates of former were much higher（ Х^2 = 18.05, P 〈 0.01）. In groups with and without antibiotics, the positive rates of bacterial detection with PCR-microarray were 19.35% and 24.44% respectirely, there was no statistical difference between the two groups（ Х^2 = 0.274, P 〉 0.05） ; and the positive rates of bacterial detection with bacterial cuhure were 0（0/31 ） and 13.33%（6/45） respectively, there was statistical difference between the two groups （Х^2= 4.488, P 〈 0.05）. Conclusions Compared to the ascites bacterial culture, less influence is found in ascites bacteria detection with 16S rRNA PCR-microarray in patients with SBP after treatment with antibiotics.