实时荧光PCR应用于临床血流感染的病原诊断价值

Diagnostic value of real-time fluorescence PCR detection of pathogens in clinical bloodstream infections

目的 分析实时荧光聚合酶链式反应(PCR)在临床血流感染中的诊断效能。方法 将2020年9月—2022年12月某医院收集的251份血培养物,同时采用实时荧光PCR、传统血培养法进行病原菌检测。结果 251份血培养物中,传统血培养法检测出阳性标本133份(52.99%),共检出17种病原菌。实时荧光PCR法检出149份(59.36%),共检出15种病原菌。实时荧光PCR法对铜绿假单胞菌、嗜麦芽寡单胞菌、肺炎链球菌具有更高的检出率。以传统血培养法为金标准,实时荧光PCR阴性预测值、敏感性、特异性分别为96.08%、86.58%、96.08%,2种方法相符样本227份,一致性为90.44%,Kappa值为0.807,一致性较好。结论 实时荧光PCR法应用于临床血流感染病原检测,具有较高的诊断效能,和血培养方法可以优势互补。

Objective This study analyzed the diagnostic efficiency of real-time fluorescence polymerase chain reaction(PCR) for clinical bloodstream infections.Methods A total of 251 blood cultures collected from a hospital between September 2020 and December 2022 were used for pathogen detection with real-time fluorescence PCR and a traditional blood culture method.Results Among 251 blood cultures,133 positive samples(52.99%) were detected with the traditional blood culture method,and a total of 17 pathogenic bacteria were detected.Real-time fluorescence PCR detected 149 samples(59.36%),with a total of 15 types of pathogens.The real-time fluorescence PCR method had a higher detection rate than the traditional method for Pseudomonas aeruginosa,Oligomonas maltophilia,and Streptococcus pneumoniae.With the traditional blood culture method as the gold standard,the negative predictive value,sensitivity,and specificity of real-time fluorescence PCR were 96.08%,86.58%,and 96.08%,respectively.The two methods showed good consistency for 227 samples,with a consistency of 90.44% and a Kappa value of 0.807.Conclusion Real-time fluorescence PCR detection of clinical bloodstream infections has high diagnostic efficiency;can avoid missed detections;and can achieve a better detection rate and pathogen detection rate than the blood culture method in patients with bloodstream infections.