探讨细菌16S rRNA基因检测对新生儿败血症早期诊断的意义

Research significance about the detection of 16SrRNA gene in the early diagnosis of neonatal septicemia

目的:探讨细菌16S核糖体核糖核酸(16S rRNA)基因检测对新生儿败血症早期诊断的意义。方法:对126例疑似新生儿败血症患儿的血标本进行16S r RNA基因聚合酶链反应(PCR)检测,并同时做血培养,比较分析两种方法检测细菌病原体的快速性、敏感性和特异性。结果:126例疑似新生儿败血症患儿的血标本经血培养检测阳性率为13.8%(17/126);经PCR检测阳性率为22.2%(28/126),PCR检测阳性率明显高于血培养检测阳性率,差异显著(x^2=10.234,P=0.004)。以血培养为"金标准",PCR检测灵敏度为88.2%(15/17)、特异度为88.1%(96/109)。从操作时间分析,血培养和PCR检测的平均时间分别为(28.9±4.3)h和(7.5±1.2)h,PCR检测速度明显快于血培养。结论:细菌16S r RNA基因PCR检测方法速度快、敏感性高且特异性强,不受抗生素的干扰,可为新生儿败血症的早期诊断提供可靠依据。

Objective： To study the significance about the detection of 16 SrRNA gene in the early diagnosis of neonatal septicemia. Methods： 126 cases with suspecting neonatal septicemia meningitis were collected. Every sample was detected with blood culture and 16 Sr RNA gene polymerase chain reaction（PCR） test, comparing testing rapidity, sensitivity and specificity of bacterial pathogens of two kinds of methods. Results： The tests positive rate of 126 cases suspecting neonatal septicemia with blood culture was 13.8%（17/126）. PCR detection positive rate was 22.2%（28/126）. PCR detection positive rate was significantly higher than blood culture positive rate, and the difference was statistically significant（Mc Nemar=10.234, P=0.004）. Taking blood culture as the ＂gold standard＂, the sensitivity of PCR detection was 88.2%（15/17） and specificity was 88.1%（96/109）. Analyzing the operating time, the average test time of blood culture and PCR detection was（28.9±4.3）h and（7.5±1.2）h respectively. The test speed of PCR detection was faster than blood culture. Conclusion： PCR detection method of the bacterial 16 SrRNA gene is fast, and has high sensitivity and strong specificity. It is not affected by the antibiotics, and can provide reliable basis for the early diagnosis of neonatal septicemia.