新型16SrRNA基因芯片在新生儿败血症病原检测中的价值研究

The value of new 16S rRNA gene chip in pathogen detection of neonatal sepsis

目的探讨新型16S rRNA基因芯片在新生儿败血症病原检测中的价值。方法选择2015年1月至2017年12月北京大学深圳医院新生儿科收治的疑似败血症新生儿为研究对象，对所有新生儿抽取静脉血分别用血培养和基因芯片法进行病原检测，比较两种方法检测的阳性率、检测所需时间和检测所需血量。结果共纳入306例疑似败血症新生儿，其中血培养阳性34例（11.1%），基因芯片法阳性54例（17.6%）；98例诊断为新生儿败血症，其中血培养阳性34例（34.7%），基因芯片法阳性52例（53.1%），基因芯片法阳性率均高于血培养（P〈0.05）；基因芯片法对新生儿败血症5种常见病原的检出率高于血培养。血培养报阳时间为（14.6±5.5）h，鉴定病原时间为（72.9±19.0） h，基因芯片法报阳时间和鉴定病原时间均为3 h，基因芯片法检测病原所需时间明显短于血培养（P〈0.001）。血培养耗血量1～2 ml，基因芯片法耗血量0.5 ml，基因芯片法耗血量少于血培养。结论与传统血培养相比，基因芯片法能快速检测血中病原菌，有较高的阳性率，并可减少采血量，通过不断改进与完善，在新生儿败血症诊断中有较大的应用价值。

ObjectiveTo study the value of new 16S rRNA gene chip in pathogen detection of neonatal sepsis.MethodNewborns with suspected sepsis hospitalized in Peking University Shenzhen Hospital from January 2015 to December 2017 were chosen as the subjects. Blood culture and gene chip were both used to detect the pathogens of these infants. The positive rate, the detection time, and the blood volume needed for detection were compared between the two methods.ResultA total of 306 cases of suspected neonatal sepsis were included in the study. Among them, 34 （11.1%） were positive for blood culture and 54 （17.6%） were positive for gene chip. 98 cases were diagnosed as neonatal sepsis, 34 （34.7%） were positive for blood culture, and 52 （53.1%） were positive for gene chip. The positive rate of gene chip was higher than that of blood culture （P〈0.05）. For the 5 common pathogens of neonatal sepsis, the positive rate of gene chip was higher than that of blood culture. Time to positivity （TTP） and pathogen identification time of blood culture were （14.6±5.5） h and （72.9±19.0） h, respectively. TTP and pathogen identification time of gene chip were both 3 h. The detection time of gene chip was significantly less than that of blood culture （P〈0.001）. The blood volume needed for detection of blood culture and gene chip was 1~2 ml and 0.5 ml. Gene chip needs less blood volume than blood culture.ConclusionCompared with the traditional blood culture, gene chip can quickly detect the pathogens in the blood with higher positive rate and less blood volume. Gene chip is of great value in the diagnosis of neonatal sepsis.