Shaat Samar S, El Shazly Soraya A, Badr Eldin Mohamed M, Barakat Shahira S, Hashish Mona H
aDepartment of Microbiology, High Institute of Public Health bDepartment of Pediatrics, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
J Egypt Public Health Assoc. 2013 Dec;88(3):160-4. doi: 10.1097/01.EPX.0000441294.14692.4c.
Neonatal bacterial sepsis is a challenging disease that needs to be detected early. As it is a life-threatening condition, the use of an approach that could be more rapid than standard culture and identification techniques for detection of neonatal sepsis would be highly desirable.
The aim of this work was to assess the effectiveness of the PCR technique compared with blood culture for the early detection of bacterial sepsis.
This study included 50 neonates with suspected sepsis. A blood sample was collected and divided into two parts: one part was subjected to broad-range 16S rDNA detection by PCR (runtime 6 h) and the other part was inoculated onto blood culture bottles (monitored for 6 days). In addition, some risk factors associated with clinical sepsis were explored.
Twenty-four neonates (48%) were positive for bacterial DNA by PCR and 17 cases (34%) had a positive blood culture. Seventeen neonates were positive for both blood culture and bacterial DNA. There was no statistical significance between both methods and the risk factors studied, except for sex and blood culture. The results of PCR in the detection of bacterial sepsis when compared with blood culture showed 100% sensitivity, 78.79% specificity, 70.83% positive predictive value, and 100% negative predictive value. An excellent agreement was found between the two methods (κ=0.716, P<0.001).
The PCR detected a higher rate of sepsis in neonates than blood culture. Therefore, PCR is useful for the rapid and accurate diagnosis of bacterial infection, with a significant impact on the current inappropriate and unnecessary use of antibiotics in the treatment of newborns. We recommend using broad-range PCR to rapidly diagnose infants with sepsis.
新生儿细菌性败血症是一种具有挑战性的疾病，需要早期检测。由于它是一种危及生命的病症，因此非常需要一种比标准培养和鉴定技术更快的方法来检测新生儿败血症。
本研究旨在评估与血培养相比，PCR技术在早期检测细菌性败血症方面的有效性。
本研究纳入了50例疑似败血症的新生儿。采集血样并分为两部分：一部分通过PCR进行广谱16S rDNA检测（运行时间6小时），另一部分接种到血培养瓶中（监测6天）。此外，还探讨了一些与临床败血症相关的危险因素。
24例新生儿（48%）PCR检测细菌DNA呈阳性，17例（34%）血培养阳性。17例新生儿血培养和细菌DNA均为阳性。除性别和血培养外，两种方法与所研究的危险因素之间均无统计学意义。与血培养相比，PCR检测细菌性败血症的结果显示敏感性为100%，特异性为78.79%，阳性预测值为70.83%，阴性预测值为100%。两种方法之间具有良好的一致性（κ=0.716，P<0.001）。
PCR检测新生儿败血症的发生率高于血培养。因此，PCR有助于快速准确地诊断细菌感染，对目前新生儿治疗中不适当和不必要使用抗生素的情况有显著影响。我们建议使用广谱PCR快速诊断败血症婴儿。
