荧光PCR在百日咳病例实验室诊断中的应用

Application of real-time PCR in laboratory diagnosis of pertussis cases

目的为了解百日咳的真实感染状况,应用荧光PCR(Real-time Polymerase Chain Reaction)对监测医院的百日咳疑似病例进行实验室诊断。方法2019年1~12月,在河南省4家监测医院采集百日咳疑似病例的鼻咽拭子,应用荧光PCR检测百日咳鲍特菌特异性核酸片段。结果对545例百日咳疑似病例开展荧光PCR检测,共检测出阳性病例94例,阳性率为17.25%。0岁组阳性率最高(41.82%),15~29岁组阳性率最低(2.38%),不同年龄组检测阳性率的差异有统计学意义(P<0.05)。男性和女性检测阳性率的差异无统计学意义(P>0.05)。发病14 d内疑似病例的检测阳性率最高,随着病程的延长阳性率逐渐下降。阳性病例的病程中位数(Median,M)=18 d,阴性病例的病程M=24 d,两组病例病程的差异有统计学意义(P<0.05)。结论6岁以内婴幼儿是百日咳高发群体,荧光PCR适用于发病14 d内的百日咳疑似病例的实验室诊断。

Objective In order to understand the true infection status of pertussis,real-time polymerase chain reaction(real-time PCR)was used for laboratory diagnosis of suspected cases of pertussis in monitoring hospitals.Methods From January to December in 2019,nasopharyngeal swabs from suspected cases of pertussis were collected at 4 monitoring hospitals in Henan Province.Realtime Polymerase Chain Reaction(real-time PCR)was used to detect DNA of Bordetella pertussis.Results 545 suspected cases of pertussis were detected by real-time PCR,of which 94 cases were positive,and the positive rate was 17.25%.<1 year-old group had the highest positive rate(41.82%),and 15-29 year-old group had the lowest positive rate(2.38%).The difference of positive rates in different age groups was statistically significant(P<0.05).There was no statistically significant difference of positive rates between male and female(P>0.05).Real-time PCR had the highest positive rate when the illness duration was less than 14 days.The difference of illness duration between positive cases and negative cases was statistically significant(P<0.05).Conclusions Children younger than 6 year-old had a higher incidence for pertussis than other age groups.Real-time PCR was suitable for laboratory diagnosis of suspected cases of pertussis whose illness duration was less than 14 days.