安徽省儿童医院急诊科,安徽,合肥,230051
网络首发:2020-11-20,
纸质出版:2020
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徐卫华, 田克印, 李小双. 数字PCR 和血培养检测儿童MRSA 血流感染应用价值比较[J]. 中山大学学报(医学科学版), 2020,41(6).
XU Wei-hua, TIAN Ke-yin, LI Xiao-shuang. Comparison of Digital PCR and Blood Culture for Detection of MRSA Bloodstream Infection in Children[J]. Journal of Sun Yat-sen University (Medical Sciences), 2020, 41(6).
【目的】比较数字PCR 法和血培养法在检测儿童耐甲氧西林金黄色葡萄球菌血流感染中的应用效果。【方法】收集2017 年10 月到2019 年9 月在我院住院患儿的血液,同步进行数字PCR 方法检测和血培养法检测患儿的耐甲氧西林金黄色葡萄球菌感染情况。统计学分析采用SPSS18.0 软件统计分析。【结果】收集到246 例患儿血液标本,检测为耐甲氧西林金黄色葡萄球菌感染阳性的69 份,其中血培养和数字PCR 均为阳性的53 份,仅PCR 阳性的11 份,仅血培养阳性的5 份,血培养和数字PCR 均阴性的177 份。数字PCR 和血培养结果相符合的占93.50%(230/246);血培养平均阳性培养周期为48h,数字PCR 检测的平均时间为2.5 h;血培养为金标准,数字PCR 的敏感性为91.40%(53/58),特异性为94.15%(177/188),阳性预测值82.81%(53/64),阴性预测值97.25%(177/182)。结果显示数字PCR 的曲线下面积达93%,诊断价值较高,相比血培养法平均耗时需48 h,而数字PCR 法检测时间平均2.5 h,明显比培养法耗时少。【结论】在诊断儿童耐甲氧西林金黄色葡萄球菌血流感染时,数字PCR 法方法简单、快捷、灵敏度高、特异性好,有望提高耐甲氧西林金黄色葡萄球菌感染的快速诊断能力,为早期精准治疗赢取时间。
To compare the effectiveness of digital PCR and blood culture for detecting methicillin-resis⁃ tant Staphylococcus aureus(MRSA)bloodstream infection in children.【Methods】Blood samples from 246 child patients from October 2017 to September 2019 were obtained simultaneously for digital PCR and blood culture to detect MRSA infection. SPSS 18.0 software was used for statistical analysis.【Results】Among the 246 blood samples,69 were found positive,with 53 positive by both digital PCR and blood culture ,11 positive by digital PCR and 5 positive by blood culture. Another 177 blood samples were identified as negative by both methods. The overall agreement between the two tests was 93.50%(230/246). The average time-to-positivity(TTP)of blood culture was 48 h and time to obtain test results for digital PCR averaged 2.5 h. Considering the blood culture as the gold standard,the sensitivity,specificity,positive predictive value and negative predictive value of digital PCR were 91.40%(53/58),94.15%(177/188),82.81%(53/64), 97.25%(177/182),respectively. ROC curve showed that the area under the curve of the digital PCR was 93% ,which revealed higher diagnostic value. 【Conclusion】In the diagnosis of MRSA bloodstream infection in children,compared with blood culture,digital PCR is simpler,more rapid,more sensitive and more specific. Digital PCR helps rapid diagnosis and early precise treatment for MRSA infection.
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