多重聚合酶链反应检测儿童常见下呼吸道感染细菌

Multiplex PCR assay for detection of common bacteria causing lower respiratory tract infections in children

目的探讨多重聚合酶链反应(PCR)检测儿童急性下呼吸道感染细菌的应用价值。方法对383例急性下呼吸道感染患儿的深部呼吸道吸引物进行细菌培养及多重PCR检测,检测肺炎链球菌、流感嗜血菌、金黄色葡萄球菌、肺炎克雷伯菌、大肠埃希菌、嗜肺军团菌、铜绿假单胞菌等9种病原菌。结果细菌培养的总检出率为42.04%,多重PCR检出率45.95%,两者差异无统计学意义;以细菌培养为标准,多重PCR检测的总敏感性为77.02%,特异性为76.58%,其中大肠埃希菌和表皮葡萄球菌的检出率明显高于培养法。结论多重PCR检测可作为下呼吸道致病菌快速检测的有用工具。

OBJECTIVE To explore the application of multiplex PCR assay for pneumonic bacterial etiologic diagnosis in children with lower respiratory tract infections.METHODS Totally 383 hospitalized children with lower respiratory tract infections were enrolled.The bacterial culture and multiplex PCR assay were used for rapid detection of 9 respiratory pathogens including Streptococcus pneumoniae,Haemophilus influenzae,Staphylococcus aureus,Klebsiella pneumoniae,Escherichia coli,Legionella pneumophila,Pseudomonas aeruginosa.RESULTS The total positive rate by bacterial culture was 42.04%,while the total positive rate by multiplex PCR was 45.95%,the difference between the two was not statistically significant.Taking the bacterial culture as the reference standard,the sensitivity and specificity of multiplex PCR were 77.02% and 76.58%,respectively.Multiplex PCR assay was more sensitive than culture method in the detection of E.coli and S.epidermidis.CONCLUSION Multiplex PCR is a useful tool for rapid detection of respiratory pathogens in clinical specimens.