Vocale C, Rimoldi S G, Pagani C, Grande R, Pedna F, Arghittu M, Lunghi G, Maraschini A, Gismondo M R, Landini M P, Torresani E, Topin F, Sambri V
Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, St. Orsola Malpighi University Hospital, Via Massarenti 9, 40138 Bologna, Italy.
Laboratory of Clinical Microbiology, Virology and Bioemergency, "L. Sacco" University Hospital, Milan, Italy.
Int J Infect Dis. 2015 May;34:33-7. doi: 10.1016/j.ijid.2015.02.011. Epub 2015 Mar 5.
Gastroenteritis caused by a single pathogen or multiple pathogens remains a major diagnostic challenge for the laboratory. The treatment of diarrhoea is based on microbiological results. Diagnosis is achieved using different laboratory techniques that have variable sensitivity and specificity. xTAG GPP is a new multiplex PCR assay that simultaneously detects 15 different pathogens responsible for diarrhoea. The results of the first multicentre study in Italy to evaluate the potential clinical application of the GPP assay in the laboratory diagnosis of diarrhoea are reported here.
Faeces specimens (N=664) from hospitalized patients were tested with the GPP assay using a Luminex 200 instrument. All specimens were run using comparator methods following a routine algorithm: culture for bacteria, enzyme immunoassay and PCR for viruses, and microscopy for parasites.
Of the samples tested with the GPP, 53.61% (356/664) gave positive results, as compared to 45.33% by routine testing. Of the positive specimens, 34.55% showed the presence of genomic DNA from multiple pathogens. The Luminex method showed an increase in the percentage of positivity of 8.28%.
The GPP assay can be considered a helpful tool for the detection of gastrointestinal pathogens, with a hands-on time of 5h; it provides accurate data for the clinical management of hospitalized patients and for epidemiological surveillance.
由单一病原体或多种病原体引起的肠胃炎仍是实验室面临的主要诊断挑战。腹泻的治疗基于微生物学结果。诊断通过使用具有不同敏感性和特异性的不同实验室技术来实现。xTAG GPP是一种新的多重聚合酶链反应(PCR)检测方法,可同时检测15种导致腹泻的不同病原体。本文报告了意大利首次多中心研究的结果,该研究旨在评估GPP检测方法在腹泻实验室诊断中的潜在临床应用。
使用Luminex 200仪器,采用GPP检测方法对住院患者的粪便标本(N = 664)进行检测。所有标本均按照常规算法采用对照方法进行检测:细菌培养、病毒酶免疫测定和PCR以及寄生虫显微镜检查。
采用GPP检测的样本中,53.61%(356/664)呈阳性结果,而常规检测的阳性率为45.33%。在阳性标本中,34.55%显示存在多种病原体的基因组DNA。Luminex方法显示阳性率提高了8.28%。
GPP检测方法可被视为检测胃肠道病原体的有用工具,实际操作时间为5小时;它为住院患者的临床管理和流行病学监测提供了准确的数据。