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基于多病原体探针的实时荧光定量PCR技术(SeptiFast)在菌血症患者血流感染快速诊断中的附加价值

Added value of multi-pathogen probe-based real-time PCR SeptiFast in the rapid diagnosis of bloodstream infections in patients with bacteraemia.

作者信息

Mongelli Gino, Romeo Maria Antonietta, Denaro Carmelo, Gennaro Mauro, Fraggetta Filippo, Stefani Stefania

机构信息

Department of Bio-Medical Science, Section Microbiology, University of Catania, Italy.

Unit of Clinical Pathology, Cannizzaro Hospital, Catania, Italy.

出版信息

J Med Microbiol. 2015 Jul;64(7):670-675. doi: 10.1099/jmm.0.000074. Epub 2015 Apr 29.

Abstract

The commercial multi-pathogen probe-based real-time PCR SeptiFast (SF) was evaluated as a rapid and complementing tool for the microbiological diagnosis of bloodstream infections (BSIs) in a series of 138 matched blood samples from 65 patients with bacteraemia, hospitalized in an intensive care unit, when antibiotics had already been administered. SF was positive in 32.6 % of the samples, whereas blood culture (BC) was positive in 21.7 % (P < 0.05). SF identified more pathogens (11 versus 5; specificity, 90.7 %) and reduced the time of aetiological diagnosis, with a mean of 16.3 versus 55.4 h needed for BC (P < 0.05). SF enabled appropriate pathogen-oriented therapy in 72 % (36/50) of the BSI group of patients on the basis of epidemiological data. According to our data, the use of SF provided important added value to BC, in terms of earlier aetiological diagnosis of BSIs, enabling pathogen-oriented therapy in patients receiving empirical antibiotic treatment.

摘要

在一家重症监护病房,对65例已接受抗生素治疗的菌血症住院患者的138份配对血样进行了研究,评估了基于商业多病原体探针的实时PCR SeptiFast(SF)作为血流感染(BSI)微生物诊断的快速补充工具的效果。SF在32.6%的样本中呈阳性,而血培养(BC)在21.7%的样本中呈阳性(P<0.05)。SF鉴定出更多病原体(11种对5种;特异性为90.7%),并缩短了病因诊断时间,BC平均需要55.4小时,而SF平均需要16.3小时(P<0.05)。基于流行病学数据,SF使72%(36/50)的BSI患者组能够接受适当的针对病原体的治疗。根据我们的数据,就BSI的早期病因诊断而言,SF的使用为BC提供了重要的附加价值,使接受经验性抗生素治疗的患者能够接受针对病原体的治疗。

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