实时 PCR 检测脑膜炎患者脑脊液中猪链球菌 2 型。
Real-time PCR for detection of Streptococcus suis serotype 2 in cerebrospinal fluid of human patients with meningitis.
机构信息
Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
出版信息
Diagn Microbiol Infect Dis. 2011 Aug;70(4):461-7. doi: 10.1016/j.diagmicrobio.2010.12.015.
Streptococcus suis serotype 2 is an emerging zoonotic pathogen and is the main cause of acute bacterial meningitis in adult patients in Vietnam. We developed an internally controlled real-time PCR for detection of S. suis serotype 2 in cerebrospinal fluid (CSF) samples targeted at the cps2J gene. Sensitivity and specificity in culture-confirmed clinical samples were 100%. The PCR detected S. suis serotype 2 infection in 101 of 238 (42.4%) prospectively collected CSF samples, of which 55 (23%) were culture positive. Culture-negative but PCR-positive CSF samples were significantly associated with the use of antimicrobial agents before admission. S. suis serotype 2 infection was more common than infections with Streptococcus pneumoniae and Neisseria meningitidis combined. Our results strikingly illustrate the additional diagnostic value of PCR in patients who are pretreated with antimicrobial agents and demonstrate the extremely high prevalence of S. suis infections among Vietnamese adult patients with bacterial meningitis.
猪链球菌 2 型是一种新兴的人畜共患病病原体，也是越南成人细菌性脑膜炎的主要病因。我们针对 cps2J 基因开发了一种用于检测脑脊液（CSF）样本中猪链球菌 2 型的内部对照实时 PCR。在经过培养确认的临床样本中，该 PCR 的灵敏度和特异性均为 100%。该 PCR 在 238 份前瞻性采集的 CSF 样本中检测到了 101 份（42.4%）猪链球菌 2 型感染，其中 55 份（23%）为培养阳性。培养阴性但 PCR 阳性的 CSF 样本与入院前使用抗菌药物显著相关。猪链球菌 2 型感染比肺炎链球菌和脑膜炎奈瑟菌的合并感染更为常见。我们的结果惊人地说明了 PCR 在接受抗菌药物预处理的患者中的额外诊断价值，并表明猪链球菌感染在越南成人细菌性脑膜炎患者中的流行率极高。
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