关节假体周围感染早期诊断中的eno和sar A基因检测

Application of eno and sar A gene testing in early diagnosis of periprosthetic joint infection

目的探讨eno和sar A基因检测应用于关节假体周围感染(PJI)早期诊断的效率和价值。方法选择5种最常见PJI致病菌,通过37℃培养、单克隆TSB肉汤扩增;盖玻片置入并37℃恒温摇床48 h培养成膜,建立体外PJI人体关节模型,并提取经过超声波裂解的RNA洗脱液样本41个进行eno和sar A基因的PCR检测,根据检测结果分析诊断的敏感性、特异性、阳性和阴性预测值、准确性并比较差异。结果eno检测具有较高的敏感性(83.33%),但较多假阳性结果影响其检测特异性(47.06%);sar A检测没有出现假阳性结果,检测特异性较高(100%),但敏感性偏低(41.67%)。结论eno和sar A基因检测用于早期诊断PJI有很高的使用价值,合理设计并序贯应用eno的检测敏感性初步诊断和sarA的特异性筛除假阳性结果能够更好地实现早期诊断葡萄球菌致病PJI。

Objective To investigate the efficiency and value of gene detection of eno and sar A in the early diagnosis of periprosthetic joint infection(PJI).Methods Five most common PJI pathogens were cultured under 37℃and amplified by monoclonal TSB broth;A PJI human joint model in vitro was estabilshed by placing cover glass into a constant temperature shaking table at 37℃for 48 hours,41 RNA eluent samples were extracted for PCR detection of eno and sar A genes after ultrasonic lysis.The sensitivity,specificity,positive and negative predictive values and accuracy of the four genes were analyzed and compared according to the detection results.Results The sensitivity of eno was 83.33%,but the specificity of eno was affected by many false positive results(47.06%);The specificity of sar A was 100%,but the sensitivity was 41.67%.Conclusion The detection of eno and sar A gene has high value in the early diagnosis of PJI.The reasonable design and sequential application of the sensitivity of eno and the specificity of sar A to screen out false positive results are better for early diagnosis of staphylococcal caused PJI.