D-乳酸检测在细菌感染诊断中的应用
D-lactic acid measurements in the diagnosis of bacterial infections.
作者信息
Smith S M, Eng R H, Campos J M, Chmel H
机构信息
Medical Service, Veterans Administration Medical Center, East Orange, New Jersey 07019.
出版信息
J Clin Microbiol. 1989 Mar;27(3):385-8. doi: 10.1128/jcm.27.3.385-388.1989.
Body fluids suspected of bacterial infection were cultured and examined for the presence of D-lactic acid, a specific bacterial metabolite. We examined 206 patients and 264 specimens. D-Lactic acid was found in concentrations of greater than or equal to 0.15 mM in 11 of 11 infected and 6 of 40 noninfected ascitic fluids, 6 of 6 infected and 4 of 33 noninfected pleural fluids, 4 of 4 infected and 0 of 13 noninfected synovial fluids, and 26 of 27 infected and 2 of 130 noninfected cerebrospinal fluids. The overall sensitivity was 79.7%, and the specificity was 99.5% when the D-lactic acid concentration was at least 0.15 mM. The most important clinical utility of the D-lactic acid measurement appears to be for patients with bacterial infection in various body compartments and in patients who have already received antimicrobial therapy. An elevation in D-lactic acid may indicate the presence of bacterial infection even when cultures are negative.
对怀疑有细菌感染的体液进行培养，并检测一种特定的细菌代谢产物——D-乳酸的存在情况。我们检查了206名患者和264份标本。在11份感染的腹水样本中有11份、40份未感染的腹水样本中有6份检测到D-乳酸浓度大于或等于0.15 mM；在6份感染的胸水样本中有6份、33份未感染的胸水样本中有4份检测到；在4份感染的滑膜液样本中有4份、13份未感染的滑膜液样本中有0份检测到；在27份感染的脑脊液样本中有26份、130份未感染的脑脊液样本中有2份检测到。当D-乳酸浓度至少为0.15 mM时，总体敏感性为79.7%，特异性为99.5%。D-乳酸检测最重要的临床用途似乎是针对各个体腔有细菌感染的患者以及已经接受抗菌治疗的患者。即使培养结果为阴性，D-乳酸升高也可能表明存在细菌感染。
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