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四种常见念珠菌属鉴定方法的比较

COMPARISON BETWEEN FOUR USUAL METHODS OF IDENTIFICATION OF Candida SPECIES.

作者信息

Souza Margarida Neves, Ortiz Stéfanie Otowicz, Mello Marcelo Martins, Oliveira Flávio de Mattos, Severo Luiz Carlos, Goebel Cristine Souza

机构信息

Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, BR.

Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, BR.

出版信息

Rev Inst Med Trop Sao Paulo. 2015 Jul-Aug;57(4):281-7. doi: 10.1590/S0036-46652015000400002.

Abstract

Infection by Candida spp. is associated with high mortality rates, especially when treatment is not appropriate and/or not immediate. Therefore, it is necessary to correctly identify the genus and species of Candida. The aim of this study was to compare the identification of 89 samples of Candida spp. by the manual methods germ tube test, auxanogram and chromogenic medium in relation to the ID 32C automated method. The concordances between the methods in ascending order, measured by the Kappa index were: ID 32C with CHROMagar Candida(κ = 0.38), ID 32C with auxanogram (κ = 0.59) and ID 32C with germ tube (κ = 0.9). One of the species identified in this study was C. tropicalis,which demonstrated a sensitivity of 46.2%, a specificity of 95.2%, PPV of 80%, NPV of 81.1%, and an accuracy of 80.9% in tests performed with CHROMagar Candida;and a sensitivity of 76.9%, a specificity of 96.8%, PPV of 90.9%, NPV of 91%, and an accuracy of 91% in the auxanogram tests. Therefore, it is necessary to know the advantages and limitations of methods to choose the best combination between them for a fast and correct identification of Candida species.

摘要

念珠菌属感染与高死亡率相关,尤其是在治疗不当和/或不及时的情况下。因此,正确鉴定念珠菌的属和种很有必要。本研究的目的是比较通过芽管试验、生长谱法和显色培养基等手工方法对89份念珠菌属样本的鉴定结果与ID 32C自动化方法的鉴定结果。按Kappa指数衡量,各方法之间的一致性由低到高依次为:ID 32C与科玛嘉念珠菌显色培养基(κ = 0.38)、ID 32C与生长谱法(κ = 0.59)、ID 32C与芽管试验(κ = 0.9)。本研究鉴定出的其中一种念珠菌为热带念珠菌,在用科玛嘉念珠菌显色培养基进行的试验中,其敏感性为46.2%,特异性为95.2%,阳性预测值为80%,阴性预测值为81.1%,准确率为80.9%;在生长谱法试验中,其敏感性为76.9%,特异性为96.8%,阳性预测值为90.9%,阴性预测值为91%,准确率为91%。因此,有必要了解各种方法的优缺点,以便在它们之间选择最佳组合,从而快速、准确地鉴定念珠菌种。

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