疑似中枢神经系统感染患者脑脊液病原体多重PCR检测结果的研究

Analysis and study of multiple PCR results of cerebrospinal fluid pathogens in patients with suspected central nervous system infection

目的分析脑膜炎/脑炎多重PCR(MEMP-19)检测技术检测疑似中枢神经系统(CNS)感染患者脑脊液病原体的结果。方法选取2019年10-11月于四川大学华西医院就诊的208例患者的脑脊液标本,提取核酸,使用MEMP-19技术进行检测并对结果进行分析,统计病历和临床治疗信息。结果208例脑脊液标本中,有43例检测出病原体,总检出率为20.67%。疑似CNS感染组病原体检出率为48.53%,其中EB病毒检出率最高(29.41%),新型隐球菌和结核分枝杆菌检出率分别为17.65%和10.29%。单一感染占63.64%(21/33),双重感染占30.30%(10/33),三重感染占6.06%(2/33)。非CNS感染组病原体检出率为7.14%,其中肠道病毒6例,EB病毒4例,均为单一感染。疑似CNS感染组MEMP-19阳性和阴性患者临床症状和脑脊液相关指标比较,差异均无统计学意义(P>0.05)。结论MEMP-19技术可以快速、准确地对脑脊液中的多种病原体进行筛查、检测,有助于实验室及时为临床提供CNS感染的病原学依据。

Objective To analyze the results of meningitis/encephalitis multiple PCR(MEMP-19)in the detection of cerebrospinal fluid pathogens in patients with suspected central nervous system(CNS)infection.Methods The cerebrospinal fluid samples of 208 patients in West China Hospital of Sichuan University from October to November 2019 were selected,nucleic acid was extracted and detected by MEMP-19,and the results were analyzed,and the medical records and clinical treatment information were counted.Results Pathogens were detected in 43 out of 208 cerebrospinal fluid samples,with a total detection rate of 20.67%.The detection rate of pathogens in suspected CNS infection group was 48.53%,among which EB virus detection rate was the highest(29.41%),cryptococcus and mycobacterium tuberculosis detection rates were 17.65%and 10.29%,respectively.Single infection accounted for 63.64%(21/33),double infection accounted for 30.30%(10/33),triple infection accounted for 6.06%(2/33).The pathogen detection rate of non CNS infection group was 7.14%,including 6 cases of enterovirus and 4 cases of EB virus,all of which were single infection.There was no significant difference in clinical symptoms and cerebrospinal fluid related indexes between MEMP-19 positive and negative patients in suspected CNS infection group(P>0.05).Conclusion MEMP-19 technology can quickly and accurately screen and detect a variety of pathogens in cerebrospinal fluid,which is helpful for the laboratory to provide etiological basis for central nervous system infection in time.