两种检测方法对MRSA阳性病例检测临床效能评价

Clinical evaluation of the detection and monitoring of MRSA positive cases by two methods

目的:探讨深圳市第二人民医院通过聚合酶链式反应(PCR)检测技术和微生物细菌鉴定仪法对耐甲氧西林金黄色葡萄球菌(MRSA)检测的阳性情况和两种检测方法的相符性,以及此两种方法检测对确诊MRSA阳性患者治疗过程监测的临床价值。方法:收集2016年1月至2016年12月深圳市第二人民医院临床科室送检标本中测得金黄色葡萄球菌阳性标本,对同时进行了PCR检测和细菌鉴定仪检测的病例进行数据的整理、统计和分析。结果:在同时进行了两种方法检测的98例标本中,PCR检测技术与细菌鉴定仪法的符合率为64.29%;以PCR法为标准,微生物鉴定法检测结果的灵敏度为33.33%,特异度为84.75%,符合率为64.29%,阳性预测值为59.09%,阴性预测值为65.79%。PCR检测技术在患者治疗过程中多次检测的阳性率为66.67%,细菌鉴定仪法为33.33%。结论:微生物细菌鉴定仪法特异性高,可以和PCR检测技术联合使用,从而降低临床检测过程中出现的假阳性率,正确地指导临床用药;PCR检测技术的灵敏度高,提高了阳性检出率,对于治疗过程的监测效果PCR检测技术更加优于细菌鉴定仪法。

Objective To explore the coincidence of the positive situation of methicillin-resistant Staphylococcus aureus（MRSA） and the two detection methods by polymerase chain reaction（PCR） detection technology and microbial bacteria identification method in Shenzhen Second People＇s Hospital, and the clinical value of these two methods in the monitoring of MRSA-positive patients. Methods Collected from January 2016 to December 2016 Shenzhen Second People＇s Hospital clinical departments to send specimens of positive samples measured in Staphylococcus aureus, the same time on the PCR detection and bacterial identification of the data for the detection of cases, statistics and analysis. Results The coincidence rate of PCR detection technique was 64.29% in 98 samples, and the sensitivity of the microbiological method was 33.33% and the specificity was 84.75%. The sensitivity of the PCR method was 64.29% %. The coincidence rate was 64.29%, the positive predictive value was 59.09%, and the negative predictive value was 65.79%. The positive rate of PCR detection was 66.67% and 33.33% in the course of treatment. Conclusion Microbial bacteria identification method specific high, and PCR detection technology can be used in combination to reduce the clinical detection process in the false positive rate, the correct guidance of clinical medication; PCR detection technology has high sensitivity, improved positive detection rate. For the treatment of the monitoring effect of PCR detection technology is better than bacterial identification method.