荧光定量16S rRNA基因检测诊断妇产科菌血症的应用价值

Applicability of PCR methods based on 16S rRNA genes to diagnosis of infections in gynecological and obstetric patients

目的评价荧光定量16S rRNA基因检测诊断妇产科患者菌血症的应用价值。方法 2013-01至2014-12对100例疑为全身感染处于菌血症状态的住院分娩孕产妇进行常规血液培养,同时行细菌16S rRNA基因检测,包括DNA提取、设计引物和探针、PCR扩增及对扩增产物荧光定量检测,以临床诊断及血液培养阳性菌血症作为对照,计算诊断阳性率、敏感性和特异性,数据采用SPSS11.0软件进行统计分析。结果荧光定量PCR方法检测发现菌血症阳性的患者44例,阳性率为44%,明显高于血液培养的15%,差异有统计学意义(P<0.05);以临床诊断及血液培养阳性菌血症作为对照,荧光PCR的诊断敏感性为87.9%,特异性为90.6%。结论荧光定量16S rRNA基因检测的阳性率远高于血液培养,可为孕产妇患者感染提供早期、敏感的病原学诊断依据。

Objective To develop a PCR method based on 16 S rRNA genes for the diagnosis of infections among gynecological and obstetric patients in order to improve the efficiency and accuracy of bacterial detection. Methods 100 patients suspected with blood infections had their blood cultured and bacterial 16 S r RNA genes were detected synchronously by extraction of DNA,primer and probe design,PCR amplification and fluorescent quantitative detection of amplified products. The positive rate,sensitivity and specificity of the two methods were compared. Results The positive rate of PCR was 44% by PCR,which was significantly higher than 15%by blood culture. Withg the criteria of positive blood culture and / or clinical diagnosis of blood infection as control,the sensitivity was87. 9% and the specificity was 90. 6% for PCR. Conclusions The positive rate of PCR was significantly higher than that of blood culture and can be used as an early and sensitive index in pathogenic diagnosis of blood infections among gynecological and obstetric patients.