16SrRNA基因序列分析在感染性心内膜炎瓣膜内病原菌检测中的应用

Application of 16S rRNA gene sequencing in diagnosis of infective endocarditis

目的探讨16S rRNA基因序列法在感染性心内膜炎(IE)患者瓣膜赘生物内致病原检测中的应用价值。方法对129例IE患者术中赘生物进行DNA提取、PCR扩增及测序分析,并与传统血培养及赘生物培养进行比较分析。结果配对卡方检验显示16S rRNA基因序列分析法检测阳性率明显高于血培养[83.53%(71/85)vs 28.24%(24/85),P<0.05]和赘生物培养[77.5%(100/129)vs 18.6%(24/129),P<0.05],可检出苛养菌及立克次体、巴通体、支原体等特殊病原体。结论应用16S rRNA基因序列分析法可提高IE患者瓣膜赘生物致病原的检出率。

Objective To investigate the advantages of 16 S rRNA gene sequence method in detecting the pathogen in valve vegetations of patients with infective endocarditis（ IE）. Methods A total of 129 patients who underwent surgery for IE were enrolled. DNA extraction from vegetation and 16 S rRNA gene amplification were performed. The characteristics of blood culture and vegetation culture were compared. Results Mc Nemar chi-square test showed that the positive rate of PCR was higher than that of blood culture[83. 53%（ 71 /85） vs 28. 24%（ 24 /85）,P 〈 0. 05]and vegetation culture [77. 5%（ 100 /129） vs 18. 6%（ 24 /129）,P 〈 0. 05].The fastidious bacteria and Rickettsia,Bartonella,Mycoplasma could be detectable by 16 S rRNA gene sequence method. Conclusion16 S rRNA gene sequence method can be used to detect the pathogens in valve vegetations of the IE patients with high efficiency.