Nikkari Simo, Lopez Fred A, Lepp Paul W, Cieslak Paul R, Ladd-Wilson Stephen, Passaro Douglas, Danila Richard, Relman David A
Stanford University School of Medicine, California, USA.
Emerg Infect Dis. 2002 Feb;8(2):188-94. doi: 10.3201/eid0802.010150.
Broad-range rDNA polymerase chain reaction (PCR) provides an alternative, cultivation-independent approach for identifying pathogens. In 1995, the Centers for Disease Control and Prevention initiated population-based surveillance for unexplained life-threatening infections (Unexplained Death and Critical Illness Project [UNEX]). To address the causes of UNEX cases, we examined 59 specimens from 46 cases by using broad-range bacterial 16S rDNA PCR and phylogenetic analysis of amplified sequences. Specimens from eight cases yielded sequences from Neisseria meningitidis (cerebrospinal fluid from two patients with meningitis), Streptococcus pneumoniae (cerebrospinal fluid from one patient with meningitis2 and pleural fluid from two patients with pneumonia), or Stenotrophomonas maltophilia (bone marrow aspirate from one patient with pneumonia). Streptococcus pneumoniae rDNA sequence microheterogeneity was found in one pleural fluid specimen, suggesting the presence of multiple strains. In conclusion, known bacterial pathogens cause some critical illnesses and deaths that fail to be explained with traditional diagnostic methods.
广谱核糖体DNA聚合酶链反应（PCR）为识别病原体提供了一种无需培养的替代方法。1995年，疾病控制与预防中心启动了针对不明原因的危及生命感染的基于人群的监测（不明原因死亡和重症疾病项目[UNEX]）。为了查明不明原因死亡病例的病因，我们使用广谱细菌16S核糖体DNA PCR和扩增序列的系统发育分析，对46例病例的59份标本进行了检测。8例病例的标本检测出序列来自脑膜炎奈瑟菌（2例脑膜炎患者的脑脊液）、肺炎链球菌（1例脑膜炎患者的脑脊液和2例肺炎患者的胸水）或嗜麦芽窄食单胞菌（1例肺炎患者的骨髓抽吸物）。在一份胸水标本中发现了肺炎链球菌核糖体DNA序列微异质性，提示存在多种菌株。总之，已知的细菌病原体导致了一些用传统诊断方法无法解释的重症疾病和死亡。
