环介导等温扩增技术对慢性阻塞性肺疾病急性加重期机械通气患者病原菌检测的研究

Study on detection of pathogenic bacteria in mechanically ventilated patients with acute exacerbation of chronic obstructive pulmonary disease by loop-mediated isothermal amplification technology

目的:分析环介导等温扩增(LAMP)技术对慢性阻塞性肺疾病急性加重期(AECOPD)机械通气患者病原菌检测的价值。方法:选取2017年1月-2019年12月AECOPD机械通气患者的下呼吸道痰标本65份,均进行动态采样监测,分析下呼吸道感染病原菌的构成,并与传统培养方法进行比较。结果:65例患者中,传统培养法阳性25例(38.4%);LAMP技术检测判定为阳性40例(61.5%),混合细菌检出率18.3%。LAMP技术检测主要致病菌依次为铜绿假单胞菌、鲍曼不动杆菌、肺炎链球菌、肺炎克雷伯菌及嗜麦芽窄食单胞菌,对混合感染的检出率为39.0%。结论:利用含LAMP技术的基因芯片进行核酸扩增,能够快速检测出病原菌,使患者及早得到有效治疗,控制病情,提早拔管,缩短ICU住院治疗时间。

Objective:To analyze the value of loop-mediated isothermal amplification(LAMP)technique in the detection of pathogenic bacteria in mechanically ventilated patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:From January 2017 to December 2019,65 sputum samples from lower respiratory tract of COPD patients with acute exacerbation of mechanical ventilation were collected and monitored dynamically.The composition of pathogenic bacteria in lower respiratory tract infection was analyzed and compared with traditional culture method.Results:Of 65 patients,25(38.4%)were positive by culture method,40(61.5%)cases were positive by LAMP technique and 18.3% were mixed bacteria.The main pathogenic bacteria detected by LAMP technology were pseudomonas aeruginosa,Acinetobacter baumannii,streptococcus pneumoniae,Klebsiella pneumoniae and stenotrophomonas maltophilia.The detection rate of mixed infection was 39.0%.Conclusion:The use of gene chips with LAMP technology for nucleic acid amplification can quickly detect pathogenic bacteria,make patients get effective treatment as soon as possible,control their condition,extubate the tube earlier,it can also shorten the length of ICU stays.