基于PCR的比传统的便测试在患有腹的儿童中,这些儿童接受了固体器官移植或造血干细胞移植
Seewalee Sidafong1, Pornthep Tanpowpong, Sophida Boonsathorn
1Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Medicine
|September 25, 2023
概括
基于聚合酶连锁反应 (PCR) 的便测试比传统方法在移植后的儿童中检测到更多的传染性腹原因. 这些先进的测试有助于指导适当的抗微生物治疗,以改善患者管理.
科学领域:
- 儿童传染病 儿童传染病
- 移植医学 移植医学 移植医学
- 临床微生物学 临床微生物学
背景情况:
- 传染性腹是儿科移植接受者的常见并发症.
- 传统的便检测在诊断感染性腹的致病原体方面存在局限性.
- 在这种人群中,高级诊断方法如聚合酶链反应 (PCR) 的有用性数据很少.
研究的目的:
- 在移植后的儿童中评估基于PCR的便测试的诊断产量.
- 为了比较PCR检测率与传统便检测率.
- 评估基于PCR的便检测结果对儿科移植受体腹管理的影响.
主要方法:
- 一项对68名儿科患者 (1-19岁) 的回顾性分析,这些患者接受了固体器官或造血干细胞移植.
- 纳入标准:2015年1月至2023年2月期间,免疫抑制和持续≥24小时的腹.
- 收集有关人口统计,临床特征和管理的数据,以及便检测结果 (PCR和常规).
主要成果:
- 基于PCR的测试在41.8%的腹发作中发现了病原体,明显高于传统测试 (16.5%).
- 通过PCR检测,可以更好地检测出沙门氏菌spp. 和病毒 (尤其是诺罗病毒),而常规测试对Clostridioides difficile.更好.
- 在58%的病例中,PCR结果影响了管理决策,特别是对于Campylobacter jejuni和C. difficile感染.
结论:
- 基于PCR的便测试提供了较高的诊断产量,与传统的方法相比,在儿科移植接受者的传染性腹.
- 这些先进的测试可以指导临床医生选择适当的抗微生物药物,从而有可能改善患者的治疗结果.
- 进一步的研究可能会阐明PCR便检测在这个脆弱的患者群体中的成本效益和更广泛的临床影响.
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