Honderlick P, Philippe B, Picard C, Thaler F, Couderc L-J
Service de microbiologie, hôpital Foch, 40, rue Worth, 92150 Suresnes cedex, France.
Pathol Biol (Paris). 2006 Oct-Nov;54(8-9):467-9. doi: 10.1016/j.patbio.2006.07.020. Epub 2006 Oct 5.
The aim was to evaluate the "strategical place" of the new commercial test Chlamylege (Argene-Biosoft-France) which allows the simultaneous detection in respiratory samples of Chlamydophila pneumoniae, Mycoplasma pneumoniae and most Legionella species using a PCR multiplex. 41 patients with an atypical pneumonia were included, all standard procedures of diagnosis were done and in addition the chamylege test. A pathogen was identified in 12 patients, an other microorganisms than the 3 targeted by our study was found in 8 patients. 4 positive PCR were obtained, 3 with M. pneumoniae and 1 with Legionella pneumophila 1. That means that for 29 patients no aetiology was found. Among them 23 clearly improved under antibiotic treatment. Though that PCR multiplex is an attractive test, easy to perform, sensitive, specific and convenient, we need further studies to approach the place of this PCR test in the diagnosis of multifaceted atypical pneumonia. We also need to know if the cost associated with the microbiological diagnosis (culture, serology, immunofluorescence, urinary antigen test, PCR...) for atypical pneumonia worth value? An algorithm as to be drawn to determine the value of intensive microbiological investigation. An other point to discuss, may be this kind of rapid and multiplex PCR technique could lead to spare the use of some antibiotics.
目的是评估新型商业检测试剂盒Chlamylege（法国阿金生物软件公司）的“战略地位”，该试剂盒可通过多重聚合酶链反应（PCR）同时检测呼吸道样本中的肺炎衣原体、肺炎支原体和大多数军团菌属。纳入了41例非典型肺炎患者，进行了所有标准诊断程序，此外还进行了Chlamylege检测。12例患者鉴定出病原体，8例患者发现了本研究未针对的其他微生物。获得了4次阳性PCR结果，3次为肺炎支原体阳性，1次为嗜肺军团菌1型阳性。这意味着29例患者未找到病因。其中23例在抗生素治疗下明显好转。尽管多重PCR检测是一种有吸引力的检测方法，操作简便、灵敏、特异且方便，但我们需要进一步研究以确定这种PCR检测在多方面非典型肺炎诊断中的地位。我们还需要了解非典型肺炎微生物诊断（培养、血清学、免疫荧光、尿抗原检测、PCR等）相关的成本是否值得？需要制定一种算法来确定强化微生物学检查的价值。另一个需要讨论的问题可能是，这种快速多重PCR技术是否可以减少某些抗生素的使用。
