CAJ | 학술논문

目的：对GeneXpert实时荧光定量聚合酶链反应（PCR）在快速检测临床粪便标本中艰难梭菌的应用进行评估。方法采用双拭子蘸取临床未成形粪便标本，一支拭子用于GeneXpert实时荧光定量PCR检测艰难梭菌毒素基因tcdB，另一支用于常规厌氧菌培养检测；对GeneXpert实时荧光定量PCR检测结果与常规厌氧菌培养结果的一致性进行统计学分析，并计算GeneXpert实时荧光定量PCR的敏感性、特异性、阳性预测值和阴性预测值等参数。结果临床收集到141例未成形粪便标本，GeneXpert实时荧光定量PCR检出艰难梭菌毒素基因tcdB阳性42例，其中常规厌氧菌培养阳性34例，两者一致性较好（Kappa＝0．7750，P＜0．01），GeneXpert实时荧光定量PCR的敏感性、特异性、阳性预测值和阴性预测值分别为87．2％、92．2％、81．0％和94．9％。结论GeneXpert实时荧光定量PCR直接检测粪便标本中的艰难梭菌具有检测快速、操作简便等优点，有重要的临床应用价值。
목적：대GeneXpert실시형광정량취합매련반응（PCR）재쾌속검측림상분편표본중간난사균적응용진행평고。방법채용쌍식자잠취림상미성형분편표본，일지식자용우GeneXpert실시형광정량PCR검측간난사균독소기인tcdB，령일지용우상규염양균배양검측；대GeneXpert실시형광정량PCR검측결과여상규염양균배양결과적일치성진행통계학분석，병계산GeneXpert실시형광정량PCR적민감성、특이성、양성예측치화음성예측치등삼수。결과림상수집도141례미성형분편표본，GeneXpert실시형광정량PCR검출간난사균독소기인tcdB양성42례，기중상규염양균배양양성34례，량자일치성교호（Kappa＝0．7750，P＜0．01），GeneXpert실시형광정량PCR적민감성、특이성、양성예측치화음성예측치분별위87．2％、92．2％、81．0％화94．9％。결론GeneXpert실시형광정량PCR직접검측분편표본중적간난사균구유검측쾌속、조작간편등우점，유중요적림상응용개치。
Objective To evaluate the clinical application of GeneXpert real-time fluorescence quantitation polymerase chain reaction (PCR)in rapid detection of Clostridium difficile from stool.Methods Two-head swab was dipped in clinical stool specimens,one-head swab was used for GeneXpert real-time fluorescence quantitation PCR in detecting toxity gene tcdB ,and the other was used for anaerobic culture.The results of these 2 methods were compared and analyzed statistically,and the sensitivity,specificity,positive predictive value and negative predictive value of GeneXpert real-time fluorescence quantitation PCR were calculated.Results Totally 1 41 clinical stool specimens were collected,and GeneXpert real-time fluorescence quantitation PCR revealed that Clostridium difficile was positive in 42 cases,among which Clostridium difficile was cultured in 34 cases.GeneXpert real-time fluorescence quantitation PCR was well consistent with the culture method (Kappa=0.775 0,P<0.01 ),and the sensitivity,specificity,positive predictive value and negative predictive value of GeneXpert real-time fluorescence quantitation PCR were 87.2%, 92.2%,81 .0% and 94.9%,respectively.Conclusions GeneXpert real-time fluorescence quantitation PCR could detect Clostridium difficile from stool specimens directly and accurately,and it has a prospective potential for clinical application.