Yadav Ashok K, Wilson C G, Prasad P L, Menon P K
Department of Pediatrics, Armed Forces Medical College, Pune , Maharashtra 411 040, India. ashokyadav@.rediffmail.com
Indian Pediatr. 2005 Jul;42(7):681-5.
In a prospective study a total of hundred neonates who fulfilled the American College of Obstetrics and Gynecology's (ACOG) criteria for probable sepsis admitted to NICU of tertiary care armed forces hospital were investigated for evidence of sepsis. The investigation protocol included sepsis screen, blood culture and 1 mL of venous blood for molecular analysis by polymerase chain reaction (PCR) for bacterial DNA component encoding 16 s RNA in all cases. 100 newborns with probable sepsis were studied to evaluate the molecular diagnosis of sepsis using PCR amplification of 16 S RNA in newborns with risk factors for sepsis or those who have clinical evidence of sepsis. We compared the results of PCR with blood culture and other markers of sepsis screen (total leucocyte count (TLC), absolute neutrophil count (ANC), immature/total neutrophil count ratio (I/T ratio), peripheral blood smear, micro ESR and C reactive protein (CRP). Controls consisted of 30 normal healthy newborns with no overt evidence of sepsis. Sepsis screen was positive in 24 (24%) of cases in study group with sensitivity and specificity of 100% and 83.5% respectively. Blood culture was positive in 09(9%t) with sensitivity of 69.2% and specificity of 100%. PCR was positive in 13(13%) of cases (9% are both blood culture and sepsis screen positive and 4% are positive by sepsis screen); the sensitivity of PCR was 100% and specificity was 95.6%. Blood culture is the most reliable method for diagnosis of neonatal sepsis. Polymerase chain reaction is useful and superior to blood culture for early diagnosis of sepsis in neonates.
在一项前瞻性研究中，对入住三级医疗军队医院新生儿重症监护病房（NICU）的100名符合美国妇产科医师学会（ACOG）可能发生败血症标准的新生儿进行了败血症证据调查。调查方案包括败血症筛查、血培养以及采集1毫升静脉血，用于通过聚合酶链反应（PCR）对所有病例中编码16 s RNA的细菌DNA成分进行分子分析。研究了100名可能患有败血症的新生儿，以评估在有败血症危险因素或有败血症临床证据的新生儿中，使用PCR扩增16 S RNA进行败血症分子诊断的情况。我们将PCR结果与血培养结果以及败血症筛查的其他指标（总白细胞计数（TLC）、绝对中性粒细胞计数（ANC）、未成熟/总中性粒细胞计数比值（I/T比值）、外周血涂片、微量血沉率和C反应蛋白（CRP））进行了比较。对照组由30名无明显败血症证据的正常健康新生儿组成。研究组中24例（24%）败血症筛查呈阳性，敏感性和特异性分别为100%和83.5%。血培养9例（9%）呈阳性，敏感性为69.2%，特异性为100%。PCR检测13例（13%）呈阳性（9%血培养和败血症筛查均为阳性，4%败血症筛查呈阳性）；PCR的敏感性为100%，特异性为95.6%。血培养是诊断新生儿败血症最可靠的方法。聚合酶链反应在新生儿败血症的早期诊断中有用且优于血培养。
