Farrell John J, Hujer Andrea M, Sampath Rangarajan, Bonomo Robert A
Department of Medicine, Division of Infectious Disease, University of Illinois College of Medicine, 723 N.E. Glen Oak Ave. Peoria, IL 61603, USA.
Expert Rev Mol Diagn. 2015 Mar;15(3):349-60. doi: 10.1586/14737159.2015.989216. Epub 2014 Dec 19.
Broad-range 16S ribosomal RNA gene PCR coupled with Sanger sequencing was originally employed by soil scientists and was subsequently adapted for clinical applications. PCR coupled with electrospray ionization mass spectrometry has also progressed from initial applications in the detection of organisms from environmental samples into the clinical realm and has demonstrated promise in detection of pathogens in clinical specimens obtained from patients with suspected infection but negative cultures. We review studies of multiplex PCR, 16S ribosomal RNA gene PCR and sequencing and PCR coupled with electrospray ionization mass spectrometry for detection of bacteria in specimens that were obtained from patients during or after administration of antibiotic treatment, and examine the role of each for assisting in antimicrobial treatment and stewardship efforts. Following an exploration of the available data in this field, we discuss the opportunities that the preliminary investigations reveal, as well as the challenges faced with the implementation of these strategies in clinical practice.
广谱16S核糖体RNA基因聚合酶链反应（PCR）结合桑格测序最初由土壤科学家采用，随后被应用于临床。PCR结合电喷雾电离质谱也已从最初用于检测环境样本中的微生物发展到临床领域，并在检测疑似感染但培养结果为阴性的患者临床标本中的病原体方面显示出前景。我们回顾了多重PCR、16S核糖体RNA基因PCR和测序以及PCR结合电喷雾电离质谱在检测抗生素治疗期间或之后从患者获取的标本中细菌的研究，并探讨了每种方法在协助抗菌治疗和管理工作中的作用。在探索该领域现有数据之后，我们讨论了初步研究所揭示的机遇，以及在临床实践中实施这些策略所面临的挑战。
