CAJ | 학술논문

目的：观察real time PCR在血流感染病原体检测中的敏感性和特异性，并与常规血培养对比，探讨其临床应用价值。方法以该院各临床科室收集的108份脓毒血症患者血液标本进行real time PCR检测，同时进行常规血培养，比较两种方法的特异性和敏感性。结果108份标本当中，两种方法检测出12种病原微生物。 Real time PCR共检测出阳性标本25份，阴性标本83份。其中与血培养共同阳性标本9份，共同阴性标本78份。两方法的一致性为80.6%。Real time PCR的阴性预测值是0.94，敏感性64%，特异性83%。16例标本real time PCR阳性而血培养阴性，5例标本血培养阳性而real time PCR阴性。同时，有2病标超出real time PCR的检测范围，而血培养阳性。此外，real time PCR无法检测光滑念珠菌。结论real time PCR虽然能快速检测血液感染中病原微生物，但依然不能完全替代血培养。
목적：관찰real time PCR재혈류감염병원체검측중적민감성화특이성，병여상규혈배양대비，탐토기림상응용개치。방법이해원각림상과실수집적108빈농독혈증환자혈액표본진행real time PCR검측，동시진행상규혈배양，비교량충방법적특이성화민감성。결과108빈표본당중，량충방법검측출12충병원미생물。 Real time PCR공검측출양성표본25빈，음성표본83빈。기중여혈배양공동양성표본9빈，공동음성표본78빈。량방법적일치성위80.6%。Real time PCR적음성예측치시0.94，민감성64%，특이성83%。16례표본real time PCR양성이혈배양음성，5례표본혈배양양성이real time PCR음성。동시，유2병표초출real time PCR적검측범위，이혈배양양성。차외，real time PCR무법검측광활념주균。결론real time PCR수연능쾌속검측혈액감염중병원미생물，단의연불능완전체대혈배양。
Objective To observe the sensitivity and specificity of real-time PCR in the detection of unknown pathogen in blood-stream infection, and compare that with conventional blood culture, and thus to investigate its clinic application value in pathogen detection. Methods A total of 108 blood samples of patients with sepsis from the clinic departments in our hospital were collected for real-time PCR detection and conventional blood culture. And the sensitivity and specificity of these two methods were compared. Results Of the 108 samples, 12 kinds of pathogens were detected. 25 positive and 83 negative samples were detected by real-time PCR. 9 samples were positive, and 78 samples were negative in both real-time PCR and blood culture assays. The agreement rate of blood culture system and real-time PCR was 80.6%. The negative predictive value of real-time PCR was 0.94, sensitivity was 64%, and specificity 83%. In 16 samples where a positive real-time PCR and a negative blood culture system result were obtained. In 5 samples, the blood culture assay was positive whereas the real-time PCR yielded negative results. In 2 of these cases, the pathogens involved were not included in the real-time PCR detection list but positive in blood culture assay. In addition, real-time PCR failed to detect Candida glabrata. Conclusion Real-time PCR is a rapid and valuable tool for rapid diagnosis of pathogens in the blood-stream, but it cannot be recommended as the replacement for the blood culture test.