Reno W L, McDaniel D O, Turner W W, Williams M D
Department of Surgery, University of Mississippi Medical Center, Jackson, USA.
Am Surg. 2001 Jun;67(6):508-12.
Analysis of blood by polymerase chain reaction (PCR) is a more rapid and sensitive method to detect bacteremia than blood culture. The PCR was performed on blood obtained from patients during blood culture draws and on blood from normal volunteers. Eighty-seven patients provided 125 blood samples for blood culture comparison with PCR. Specific PCR primers for Staphylococcus aureus and Escherichia coli that targeted conserved regions common to gram-positive and gram-negative bacteria were used. Selective stringency conditions identified other gram-positive and gram-negative bacteria. The blood culture agreed with the PCR in 93 of the 125 patient specimens (74%). In 29 of these specimens the PCR was positive yet the blood culture was negative. When clinical information was included with positive blood culture to define sepsis in these patients and their specimens were added to the positive blood cultures the statistical accuracy of PCR was 93 per cent. Only three of the 78 specimens with negative PCR had positive blood cultures. The PCR was negative in all but one of the 50 volunteers. PCR is more sensitive than blood culture, and it can quickly rule out bacteremia.
通过聚合酶链反应（PCR）分析血液是一种比血培养更快速、灵敏的检测菌血症的方法。对血培养采血时从患者身上采集的血液以及正常志愿者的血液进行了PCR检测。87名患者提供了125份血样用于与PCR进行血培养比较。使用了针对革兰氏阳性和革兰氏阴性细菌共有的保守区域的金黄色葡萄球菌和大肠杆菌特异性PCR引物。选择性严格条件鉴定出其他革兰氏阳性和革兰氏阴性细菌。125份患者标本中有93份（74%）血培养结果与PCR结果一致。在这些标本中，有29份PCR结果为阳性而血培养结果为阴性。当将阳性血培养的临床信息纳入以定义这些患者的脓毒症，并将其标本添加到阳性血培养中时，PCR的统计准确率为93%。78份PCR结果为阴性的标本中只有3份血培养结果为阳性。50名志愿者中除1人外，其余所有人的PCR结果均为阴性。PCR比血培养更灵敏，并且可以快速排除菌血症。
