广泛的聚合酶连锁反应和测序用于诊断传染病
Nicole E Putnam1,2, Drew W Charles3,4, James B Doub3
1Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Microbiology spectrum
|March 5, 2025
概括
广泛的聚合酶连锁反应 (BR-PCR) 补充了标准培养来检测难以识别的生物体,在6%的病例中改变了临床护理. 最好在怀疑细菌存在或培养结果为阴性时使用.
科学领域:
- 临床微生物学 临床微生物学
- 分子诊断学 分子诊断学
- 传染病 传染病 传染病 传染病
背景情况:
- 广泛的聚合酶连锁反应 (BR-PCR) 可以从临床样本直接识别微生物,绕过传统的培养限制.
- 与标准培养方法相比,BR-PCR的临床实用性和诊断影响仍然不完全定义,特别是对于各种微生物点.
- 这项研究解决了对临床环境中BR-PCR应用的基于证据的指导方针的需求.
研究的目的:
- 为了比较细菌,真菌和酸性细菌 (AFB) BR-PCR测定与传统微生物学培养的性能.
- 评估BR-PCR结果的临床实用性,特别是它们改变抗微生物治疗或治疗持续时间的能力.
- 为了确定BR-PCR利用的最佳临床场景.
主要方法:
- 来自马里兰大学医学系统的327名患者 (2018-2021) 的348个独特标本的回顾性审查.
- 对BR-PCR鉴定生物与并发的细菌 (n=302),真菌 (n=137) 和AFB (n=111) 培养进行比较.
- 评估BR-PCR结果对临床管理决策的影响.
主要成果:
- 与一致培养相比,BR-PCR敏感性为细菌的30.9%,真菌的18.8%,AFB的33.3%.
- 高细菌负百分比协议 (80.1%) 表明检测细菌有机体或考虑先前使用抗生素的潜力.
- 在6%的病例中,BR-PCR结果导致了临床管理的变化,尽管周转时间比培养时间更长.
结论:
- 作为标准培养方法的补充工具,BR-PCR证明了它的实用性,特别是在疑似细致的生物或培养负的病例中.
- 目前的BR-PCR性能不需要替代常规培养方法.
- 需要进一步的研究来优化BR-PCR协议,并扩大其在传染病诊断中的作用.
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