黑龙江医学
黑龍江醫學
흑룡강의학
Heilongjiang Medical Journal
2015年
10期
1161-1162
,共2页
艰难梭菌%实验室鉴定方法%快速性%准确性
艱難梭菌%實驗室鑒定方法%快速性%準確性
간난사균%실험실감정방법%쾌속성%준학성
Clostridium difficile%Laboratory identification methods%Rapidity%Accuracy
目的：探讨3种艰难梭菌实验室鉴定方法的快速性及准确性。方法收集2014－04～2014－12间广东省第二人民医院118例ICU患者共234份标本进行24 h和48 h培养研究。并对培养结果进行鉴定。通过基因检测的方法对大便标本提取的DNA进行B毒素检测。然后以48 h培养标本的检测结果作为参考值，对24 h培养检测法和Pcr扩增B毒素基因检测法进行效能的评价，主要有特异度、灵敏度、阴性预测值和阳性预测值。结果对所有标本培养48 h后，9例患者共计10份艰难梭菌标本培养呈阳性，标本阳性率为4.27％，梭菌的感染率为7.62％。24 h培养法的效能对比值分别为：灵敏度76.00％、特异度100.00％、阴性预测值100.00％和阳性预测值97.00％；Pcr扩增tcdB基因检测法的效能对比值分别为：灵敏度82.30％、特异度99.15％、阴性预测值99.15％和阳性预测值82.30％。结论 Pcr扩增B毒素基因检测法用时最短，灵敏度和特异度均相对较高，24 h培养法灵敏度略低，可能导致漏诊，48 h培养法用时最长，但检测结果最可靠。
目的：探討3種艱難梭菌實驗室鑒定方法的快速性及準確性。方法收集2014－04～2014－12間廣東省第二人民醫院118例ICU患者共234份標本進行24 h和48 h培養研究。併對培養結果進行鑒定。通過基因檢測的方法對大便標本提取的DNA進行B毒素檢測。然後以48 h培養標本的檢測結果作為參攷值，對24 h培養檢測法和Pcr擴增B毒素基因檢測法進行效能的評價，主要有特異度、靈敏度、陰性預測值和暘性預測值。結果對所有標本培養48 h後，9例患者共計10份艱難梭菌標本培養呈暘性，標本暘性率為4.27％，梭菌的感染率為7.62％。24 h培養法的效能對比值分彆為：靈敏度76.00％、特異度100.00％、陰性預測值100.00％和暘性預測值97.00％；Pcr擴增tcdB基因檢測法的效能對比值分彆為：靈敏度82.30％、特異度99.15％、陰性預測值99.15％和暘性預測值82.30％。結論 Pcr擴增B毒素基因檢測法用時最短，靈敏度和特異度均相對較高，24 h培養法靈敏度略低，可能導緻漏診，48 h培養法用時最長，但檢測結果最可靠。
목적：탐토3충간난사균실험실감정방법적쾌속성급준학성。방법수집2014－04～2014－12간광동성제이인민의원118례ICU환자공234빈표본진행24 h화48 h배양연구。병대배양결과진행감정。통과기인검측적방법대대편표본제취적DNA진행B독소검측。연후이48 h배양표본적검측결과작위삼고치，대24 h배양검측법화Pcr확증B독소기인검측법진행효능적평개，주요유특이도、령민도、음성예측치화양성예측치。결과대소유표본배양48 h후，9례환자공계10빈간난사균표본배양정양성，표본양성솔위4.27％，사균적감염솔위7.62％。24 h배양법적효능대비치분별위：령민도76.00％、특이도100.00％、음성예측치100.00％화양성예측치97.00％；Pcr확증tcdB기인검측법적효능대비치분별위：령민도82.30％、특이도99.15％、음성예측치99.15％화양성예측치82.30％。결론 Pcr확증B독소기인검측법용시최단，령민도화특이도균상대교고，24 h배양법령민도략저，가능도치루진，48 h배양법용시최장，단검측결과최가고。
Objective To discuss the rapidity and accuracy of laboratory studies of three kinds of methods for identification of Clostridium difficile.Methods Selecting 118 ICU patients from April , 2014 to December , 2014.A total of 234 specimens were collected to conduct 24h and 48h culture studies.Then the results were identified and cultured , followed by a method of genetic testing stool samples DNA was extracted from B toxin detection.Then 48h culture samples test results were as reference value of 24h culture assays and Pcr toxin B gene amplification assay was done to evaluate the efficacy , main specificity , sensitivity , negative predictive value and positive predictive value.Results All specimens were cultured after 48h.Among 9 patients, a total of 10 copies of Clostridium difficile specimen culture were posi-tive, and the specimens positive rate was 4.27%.Clostridium infection rate was 7.62%.24h culture of effectiveness ratios were as follows:76.00%sensitivity and 100.00%specificity, 100.00%negative predictive value and 97.00%positive predictive value.Pcr efficacy tcdB gene amplification assay ratios were as follows:82.30%sensitivity and 99.15%specificity degree , 99.15%negative predictive value and 82.30%positive predictive value.Conclusion Pcr toxin B gene amplification assay has the shortest time , sensitivity and specificity are relatively high, 24h culture sensitivity is slightly lower , and it may lead to misdiagnosis;48h culture has the longest time , but it has the most reliable test results.
