16S rDNA文库构建技术辅助诊断长病程患者血流感染病原菌方面的应用

Application of 16S rDNA library construction technology in assisting the diagnosis of pathogenic bacteria causing bloodstream infections in patients with long disease course

目的探讨16S rDNA文库构建技术在长病程患者细菌血流感染病原学诊断中的应用价值。方法随机收集2023年脓毒血症患者的血浆以及静脉血样本各20例。利用血培养、16S rDNA文库构建技术与16S rDNA高通量测序技术同时检测样本中的病原菌,比较三种方法检测结果的一致性和性能指标。进一步比较疑似混合感染组(SMIG)和单一感染组(SIG)患者的预后情况。结果通过一致性评价和临床性能指标分析后发现,16S rDNA文库构建技术的结果一致率为80.00%,灵敏度为88.24%,特异性为33.3%。16S rDNA高通量测序技术的结果一致率为70.00%,灵敏度为82.35%。通过K⁃M生存曲线分析显示,疑似混合感染组患者的住院时长以及PCT恢复正常时长明显高于单一感染组且差异有统计学意义(P<0.05)。结论疑似混合细菌血流感染患者的住院时长与病程长于单一细菌血流感染患者,且利用16S rDNA文库构建技术能够有效辅助血培养技术诊断长病程血流感染病原菌,辅助临床医生针对长病程血流感染患者制定更加精准的诊疗方案。

Objective To explore the application value of 16S rDNA library construction technology in the etiological diagnosis of bacterial bloodstream infections in patients with long disease course.Methods In 2023,20 plasma and 20 venous blood samples were randomly collected from sepsis patients.Blood culture,16S rDNA library construction technology,and 16S rDNA high⁃throughput sequencing technology were used to simultaneously detect pathogens in the samples.The study aimed to compare the consistency and performance indicators of the three methods'detection results.Additionally,the prognosis of patients in the suspected mixed infection group(SMIG)was compared to those in the single infection group(SIG)Results After conducting a consistency evaluation and analyzing the clinical performance index,it was found that the consistency rate of the 16S rDNA library construction technology was 80.00%,with a sensitivity of 88.24%,and a specificity of 33.3%.The consistency rate of the 16S rDNA high⁃throughput sequencing technology was 70.00%,with a sensitivity of 82.35%.Based on the K⁃M survival curve analysis,it was determined that the length of hospital stay and PCT recovery time in the suspected mixed infection group were significantly longer than those in the single infection group,and the difference was statistically significant(P<0.05).Conclusion Patients suspected of having mixed bacterial bloodstream infections experience longer hospital stays and disease durations compared to those with single bacterial bloodstream infections.The utilization of 16S rDNA library construction technology can significantly aid blood culture technology in identifying pathogens associated with prolonged bloodstream infections.This assistance enables clinical doctors to formulate more precise diagnosis and treatment strategies for patients with extended bloodstream infections.