微生物培养检测在小儿肺炎支原体感染中的临床价值分析

Analysis of the Clinical Value of Microbial Culture Testing in Pediatric Mycoplasma Pneumoniae Infection

目的:分析快速微生物培养检测在小儿肺炎支原体感染中的临床价值,为临床诊断提供依据。方法:选取2020年10月-2021年12月襄城县人民医院收治的160例经初筛疑似支原体肺炎的患儿作为研究对象。所有患儿均接受常规肺部超声及查体检查初筛,并采用血清学检验与微生物培养检测进行进一步筛查,以综合诊断(影像学+病原学+查体+血清学)结果为金标准进行患儿分组,分为支原体肺炎组(支原体肺炎患儿)与对照组(非支原体肺炎患儿),并对比两组患儿临床特征及基线资料,计算血清学检验与微生物培养诊断的灵敏/特异度并分析诊断效能。结果:诊断显示,160例疑似患儿中确诊支原体肺炎98例(支原体肺炎组),非支原体肺炎患儿62例(对照组);两组患儿临床特征比较,差异无统计学意义(t=0.433、0.178、0.211、0.074、0.158、0.469、0.135,P>0.05);灵敏度81.63%、特异度72.58%、符合率78.13%;经微生物培养检测正确检出支原体肺炎(真阳性)89例,灵敏度90.82%、特异度85.48%、符合率88.75%;快速微生物培养诊断支原体肺炎的效能(95%CI:0.872~0.936,AUC:0.893)高于血清学检测的诊断效能(95%CI:0.863~0.931,AUC:0.842)。结论:快速微生物培养检测操作快速简单且准确率高,对小儿支原体肺炎肺炎具有较高诊断价值,与常规方式进行联合诊断可进一步提高临床支原体肺炎的诊断效能。

Objective:To analyze the clinical value of rapid microbial culture in children with Mycoplasma pneumoniae infection.Methods:160 pediatric patients admitted to the hospital from October 2020 to December 2021 with suspected mycoplasma pneumonia after initial screening were selected as the study population.All children received routine pulmonary ultrasound and physical examination for initial screening and were further screened using serologic testing and microbiological culture testing.The children were grouped into mycoplasma pneumonia group(children with mycoplasma pneumonia)and control group(children with non-mycoplasma pneumonia)using the comprehensive diagnostic(imaging+pathogenic+physical examination+serology)results as the gold standard,and the clinical characteristics and baseline data of the two groups were compared,and the sensitivity/specificity of the serological tests and microbiological culture were calculated and the diagnostic efficacy was analyzed.Results:The diagnosis showed that 98 of 160 suspected children were diagnosed with mycoplasma pneumonia(mycoplasma pneumonia group)and 62 children with non-mycoplasma pneumonia(control group),and the differences in clinical characteristics between the two groups were not statistically significant(t=0.433,0.178,0.211,0.074,0.158,0.469,0.135,P>0.05).The sensitivity was 81.63%,the specificity 72.58%,and the compliance rate 78.13%.Mycoplasma pneumoniae(true positive)was correctly detected by microbiological culture testing in 89 cases,with a sensitivity of 90.82%,specificity of 85.48%,and compliance rate of 88.75%.The efficacy of rapid microbiological cultures for the diagnosis of mycoplasma pneumonia(95%CI:0.872-0.936,AUC:0.893)was higher than that of serological tests(95%CI:0.863-0.931,AUC:0.842).Conclusion:The rapid microbiological culture test is fast,simple and accurate,and has high diagnostic value for pediatric mycoplasma pneumoniae pneumonia,and the combined diagnosis with conventional methods can further improve the diagnostic efficacy of clinical mycoplasma pneumoniae.