PCR检测在血液病患儿血流感染细菌谱分析中的应用

Analysis of etiology of bloodstream infection in children with hematologic disease by using PCR

目的探讨聚合酶链式反应(PCR)技术在分析血流感染细菌菌谱中的应用,为血液病患儿细菌性血流感染的流行病学调查提供新的思路。方法从西安市儿童医院血液内科收集80例疑似血流感染患儿的外周静脉血标本进行血培养,同时扩增并测序细菌16SrDNA,对血培养和PCR结果进行比较。结果 80例血液标本中7例细菌培养阳性,阳性率为8.8%;PCR检测出16例阳性,阳性率为20.0%,二者差异有统计学意义(χ2=5.82,P<0.05);在16例PCR阳性标本中,革兰阳性菌占68.7%,其中表皮葡萄球菌最多[占31.3%(5/16)],革兰阴性菌占31.3%,以非发酵菌为主[占18.7%(3/16)]。结论 16SrDNA-PCR结合测序的方法可以很好地鉴定血流感染病原菌,可作为一种新的流行病学方法在临床应用;血液病儿童血流感染病原菌以革兰阳性球菌为主,尤以表皮葡萄球菌最常见。

Objective To explore the value of PCR for analyzing the pathogenic spectrum of bloodstream infection（BSI）in chil-dren with blood disease,and to provide a new thought for epidemiological survey of BSI.Methods A total of 80 children with blood disease in hematology department with suspected bacterial infections were recruited in the study,whose blood samples were collect-ed and detected by using blood cultivation（BC）and 16 S rDNA-PCR.The results obtained by the two methods were compared.Re-sults Among the 80 children,the positive rate of BC and PCR were 8.8% and 20.0%,respectively.There was significant differ-ence between the two methods（χ2 =5.82,P 〈0.05）.Gram-positive bacteria and Gram-negative bacteria accounted for 68.7% and 31.3% respectively in 16 bacteria.The predominant pathogen was Staphylococcus epidermidis （31.3%）.Conclusion Compared with BC,16 S rDNA-PCR and sequencing provide a new way for analyzing the pathogenic spectrum of BSI,which might be effective for epidemiological investigation.The pathogens of BSI are mainly Gram-positive bacteria in children of hematology department,and Staphylococcus epidermidis is the most common pathogen.