脑炎/脑膜炎多重病原体核酸联合检测试剂盒在儿童疑诊中枢神经系统感染中的潜在应用价值

Potential application value of FilmArray^(R) meningitis/encephalitis panel in children with suspected central nervous system infections

目的评价脑炎/脑膜炎多重病原体核酸联合检测试剂盒(FilmArray ME panel)对儿童中枢神经系统感染病原的临床诊断效果及应用价值。方法分子生物学研究。前瞻性收集2019年5月至11月首都医科大学附属北京儿童医院感染内科收治的疑诊中枢神经系统感染患儿经腰椎穿刺获得的脑脊液标本,同时送检临床病原学和FilmArray ME panel检测,并对检测标本进行PCR验证,应用独立样本t检验或Mann-WhitneyU检验比较2种检测方法的结果及影响因素。结果共纳入113例中枢神经系统感染病例,临床常规送检阳性17例,阳性率15.0%,其中脑脊液培养阳性4例,阳性率3.5%,FilmArray ME panel检测阳性病例23例,阳性率20.4%。FilmArray ME panel检出细菌7例次,病毒13例次,真菌1例次,病毒及细菌同时阳性2例。共同检出病原中,FilmArray ME panel平均提前2.7 d得到病原结果。结论相比于脑脊液培养,FilmArray ME panel检测周期短、阳性率高,且病毒检出率高。

Objective To explore the clinical application and effect of FilmArray®meningitis/encephalitis(ME)panel in identifying pathogens of central nervous system(CNS)infections in children.Methods Molecular biology study.Cerebrospinal fluid(CSF)samples were prospectively obtained through lumbar puncture from children with suspected CNS infections admitted to the Department of Infectious Diseases at Beijing Children′s Hospital,Capital Medical University from May to November 2019.These samples were subjected to both routine clinical pathogen testing and FilmArray ME panel testing.Polymerase chain reaction was used to validate all samples.Independent sample t-test or Mann-Whitney U-test was used for comparative analysis of the results and influence factors obtained by the two detection methods.Results A total of 113 cases of suspected CNS infections were enrolled.Routine clinical testing yielded 17 cases,with a positive rate of 15.0%,including 4 positive CSF cultures,with a positivity rate of 3.5%.FilmArray ME panel detected 23 positive cases,with a positive rate of 20.4%.FilmArray ME panel detected bacteria in 7 cases,viruses in 13 cases,fungi in 1 case,and both viruses and bacteria in 2 cases.Among the common pathogens detected,FilmArray ME panel obtained the results on average 2.7 days in advance.Conclusions Compared with CSF culture,FilmArray ME panel has the advantages of shorter detection period,higher positive detection rate,and higher virus detection rate.