Hassan Reem Mostafa, El Enany Mervat G, Rizk Hussien H
Faculty of Medicine, Cairo University, Cairo, Egypt.
J Infect Dev Ctries. 2014 Oct 15;8(10):1252-8. doi: 10.3855/jidc.4867.
Diagnosis of bloodstream infections using bacteriological cultures suffers from low sensitivity and reporting delay. Advanced molecular techniques introduced in many laboratories provide rapid results and may show improvements in patient outcomes. This study aimed to evaluate the usefulness of a molecular technique, broad-range 16S rRNA PCR followed by sequencing for the diagnosis of bloodstream infections, compared to blood culture in different patient groups.
Conventional PCR was performed, using broad-range 16S rRNA primers, on blood cultures collected from different patients with suspected bloodstream infections; results were compared with those of blood culture.
Though blood culture is regarded as the gold standard, PCR evaluation showed sensitivity of 86.25%, specificity of 91.25%, positive predictive value of 76.67%, negative predictive value of 95.22%, and accuracy of 88.8%.
Molecular assays seem not to be sufficient to replace microbial cultures in the diagnosis of bloodstream infections, but they can offer a rapid, good negative test to rule out infection due to their high negative predictive value.
使用细菌培养诊断血流感染存在敏感性低和报告延迟的问题。许多实验室引入的先进分子技术能提供快速结果，且可能改善患者预后。本研究旨在评估一种分子技术——广谱16S rRNA聚合酶链反应（PCR）随后测序——在不同患者群体中用于诊断血流感染的效用，并与血培养进行比较。
使用广谱16S rRNA引物对从不同疑似血流感染患者采集的血培养样本进行常规PCR，将结果与血培养结果进行比较。
尽管血培养被视为金标准，但PCR评估显示其敏感性为86.25%，特异性为91.25%，阳性预测值为76.67%，阴性预测值为95.22%，准确性为88.8%。
在血流感染的诊断中，分子检测似乎不足以取代微生物培养，但因其高阴性预测值，可提供快速、良好的阴性检测以排除感染。
