多重PCR检测在儿童肺炎细菌性病原中的临床应用

Clinical application of multiplex PCR detection in bacterial pathogens of children pneumonia

目的探讨多重PCR检测在儿童肺炎细菌性病原中的临床应用价值。方法选取2015年1~7月在我院就诊的300例肺炎患儿,收集患儿呼吸道分泌物,进行细菌培养并提取DNA,利用多重PCR扩增14种呼吸道病原菌靶基因,统计分析多重PCR检测儿童肺炎细菌性病原敏感性和特异性。结果从300例标本中,细菌培养出184株病原菌,阳性率为61.33%（184/300）。经多重PCR扩增检测118例样本呈阳性,阳性率为39.3%（118/300）。对14种病原菌多重PCR的敏感性为51.6%,特异性为68.6%,符合率为58.9%。多重PCR对SPN检出率（15.7%,47/300）高于培养（5.7%,17/300）（P〈0.05）;联合检测细菌性病原检出率为80.67%（242/300）,联合检测显著提高金黄色葡萄球菌、流感嗜血杆菌、肺炎链球菌、鲍曼不动杆菌和铜绿假单胞菌的检出率。结论多重PCR技术对肺炎链球菌检测的敏感性较高,联合检测能提高儿童肺炎细菌性病原检出率。

Objective To explore clinical applicative value of multiplex PCR detection in bacterial pathogens of children pneumonia. Methods 300 children with pneumonia who were admitted to our hospital from January 2015 to July 2015 were selected. Airway secretions of children were collected and received bacterial culture to extract DNA. 14 kinds of target genes of respiratory pathogenic bacteria were amplified by multiplex PCR. Sensitivity and specificity of bacterial pathogens of children pneumonia detected by multiplex PCR were analyzed. Results In 300 specimens, there were 184 strains of pathogenic bacteria and the positive rate was 61.33%（184/300）. By amplified detection of multiplex PCR, 118 specimens were positive and the positive rate was 39.3%（118/300）. Sensitivity, specificity and coincidence rate of multiplex PCR for 14 pathogenic bacteria was 51.6%, 68.6% and 58.9% respectively. Detection rate of multiplex PCR for SPN was 15.7%（47/300）, higher than culture 5.7%（17/300）（P〈0.05）. Detection rate of combined detection of pathogenic bacteria was 80.67%（242/300）. Combined detection can significantly improve detection rates of staphylococcus aureus, haemophilus influenza, streptococcus pneumonia, acinetobacter baumanii and pseudomonas aeruginosa. Conclusion Multiplex PCR has higher sensitivity for detection of staphylococcus aureus. Combined detection can improve detection rate of bacterial pathogens of children pneumonia.