实时定量PCR在血流感染病原体快速检测中的应用

Application of real-time PCR in rapid detection of bloodstream infection pathogens

目的探讨实时定量PCR在血流感染病原体检测中的临床应用价值。方法选取收治的80例患者共92份血液标本进行实时定量PCR检测,同时进行血液培养,比较两种方法的特异度和敏感度。结果在92份标本当中,两种方法共同阴性标本66份(71.7%),两种方法共检测出病原体10种。实时定量PCR和血培养共同检出阳性标本7例,两种方法的一致性为79.3%。实时定量PCR的阴性预测值是0.94,敏感度是0.64,特异度是0.82。其中15份标本实时定量PCR阳性而血培养阴性,4份标本血培养阳性而实时定量PCR阴性。其中2份标本所培养出的病原体不在实时定量PCR的检测范围内,且实时定量PCR也不能检测光滑念珠菌。结论实时定量PCR是快速检测血液感染标本的有价值方法,但不能完全替代血培养。

Objective To investigate the clinical application value of real‐time PCR in the detection of bloodstream infection pathogens .Methods A total of 92 blood samples from 80 patients in our hospital were collected for conducting real time PCR de‐tection and conventional blood culture .The sensitivity and specificity were compared between the two methods .Results Among 92 samples ,66 samples （71 .7% ） were negative in both assays .Ten different pathogens were detected by either blood culture system or real‐time PCR or by both methods .Seven positive samples were detected by both assays .The consistence of the two methods was 79 .3% .The negative predictive value of real‐time PCR was 0 .94 ,the sensitivity was 0 .64 and the specificity was 0 .82 .Among them ,15 samples were positive in real‐time PCR ,while negative in blood culture system ,4 samples were positive in the blood cul‐ture ,whereas were negative in the real‐time PCR .The pathogens cultured in 2 samples were not in the detection range of real time PCR ,moreover real time pCR could not detect Candida glabrata .Conclusion Real time PCR is a valuable method for rapidly detec‐tion the sample of bloodstream infection ,but cannot completely replace the blood culture test .