FilmArray脑炎/脑膜炎多重病原体核酸联检试剂盒在中枢神经系统感染病原学诊断中的价值

Clinical value of FilmArray meningitis/encephalitis Panel in detecting the etiology of infection in central nervous system

目的:探讨FilmArray脑炎/脑膜炎多重病原体核酸联检试剂盒(FilmArray ME Panel)在中国儿童中枢神经系统感染病原学诊断方面的应用价值。方法:收集2019年3月至11月上海交通大学医学院附属上海儿童医学中心收治的145例疑诊中枢神经系统感染患儿的经腰椎穿刺获得的脑脊液标本,对所有患儿的脑脊液标本行培养的同时,行FilmArray ME Panel检测,比较脑脊液培养与FilmArray ME Panel检测的结果。结果:在145例患儿中,脑脊液培养阳性3例,阳性率2.1%;FilmArry ME Panel检测阳性30例,阳性率20.7%,明显高于脑脊液培养阳性率( χ^(2)=24.927, P<0.05)。在FilmArry ME Panel检测阳性的标本中,病毒阳性26例,占17.9%,其中肠道病毒(15.2%)是首要病原体。在142例脑脊液培养为阴性的标本中,FilmArray ME Panel检测阳性28例,占19.7%(28/142)。 结论:FilmArray ME Panel检测具有阳性率高,耗时短的特点,可实现病原学的快速诊断,且提高了病毒的检出率。

Objective To explore the value of FilmArray meningitis/encephalitis(ME)Panel in etiological diagnosis of infection in central nervous system(CNS)in Chinese children.Methods Cerebrospinal fluid(CSF)obtained through lumbar puncture was collected from 145 patients with suspected CNS infection at Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine from March 2019 to November 2019.All specimens were cultured simultaneously,which were detected by FilmArray ME Panel,and the results of cerebrospinal fluid culture and FilmArray ME Panel were compared.Results Among 145 patients with suspected CNS infection,three samples were found to be positive after cerebrospinal fluid culture,and the positive rate was 2.1%(3/145).For the FilmArray ME Panel,30 specimens were found to be positive,with a positive rate of 20.7%(30/145),and the difference of positive rate between the two methods was statistically significant(χ^(2)=24.927,P<0.05).Among the samples FilmArray ME Panel tested positive with pathogen,26 specimens were positive with virus making up 17.9%(26/145)and enterovirus(15.2%)was the primary pathogen.In addition,of the 142 specimens cerebrospinal fluid culture negative,28 samples were tested positive by the FilmArray ME Panel,accounting for 19.7%(28/142).Conclusion FilmArray ME Panel has the characteristics with high positive rate and could be time-saving.Meanwhile,FilmArray ME Panel has significant advantage in the detection of virus and improves the positive detection rate of virus.