The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Providence Portland Medical Center, Portland, Oregon, USA.
J Clin Microbiol. 2017 Nov;55(11):3258-3266. doi: 10.1128/JCM.00911-17. Epub 2017 Sep 6.
The purpose of this study was to perform a multisite evaluation to establish the performance characteristics of the BD Max extended enteric bacterial panel (xEBP) assay directly from unpreserved or Cary-Blair-preserved stool specimens for the detection of , enterotoxigenic (ETEC), , and The study included prospective, retrospective, and prepared contrived specimens from 6 clinical sites. BD Max xEBP results were compared to the reference method, which included standard culture techniques coupled with alternate PCR and sequencing, except for ETEC, for which the reference method was two alternate PCRs and sequencing. Alternate PCR was also used to confirm the historical results for the retrospective specimens and for discrepant result analysis. A total of 2,410 unformed, deidentified stool specimens were collected. The prevalence in the prospective samples as defined by the reference method was 1.2% ETEC, 0.1% , 0% , and 0% Compared to the reference method, the positive percent agreement (PPA) (95% confidence interval [CI]), negative percent agreement (NPA) (95% CI), and kappa coefficient (95% CI) for the BD Max xEBP assay for all specimens combined were as follows: ETEC, 97.6% (87.4 to 99.6), 99.8% (99.5 to 99.9), and 0.93 (0.87 to 0.99); , 100% (96.4 to 100), 99.7% (99.4 to 99.8), and 0.96 (0.93 to 0.99); , 99.0% (94.8 to 99.8), 99.9% (99.8 to 99.9), and 0.99 (0.98 to 1); , 100% (96.4 to 100), 99.8% (99.5 to 99.9), and 0.98 (0.95 to 1), respectively. In this multicenter study, the BD Max xEBP showed a high correlation (kappa, 0.97; 95% CI, 0.95 to 0.98) with the conventional methods for the detection of ETEC, , , and in stool specimens from patients suspected of acute gastroenteritis, enteritis, or colitis.
本研究旨在进行多站点评估,以直接从未经保存或 Cary-Blair 保存的粪便标本中建立 BD Max 扩展肠细菌检测试剂盒 (xEBP) 的性能特征,用于检测产肠毒素性大肠埃希菌 (ETEC)、艰难梭菌、志贺氏菌和沙门氏菌。该研究包括前瞻性、回顾性和准备好的人工标本,来自 6 个临床站点。BD Max xEBP 结果与参考方法进行比较,参考方法包括标准培养技术,结合替代 PCR 和测序,除了 ETEC,其参考方法是两种替代 PCR 和测序。替代 PCR 也用于确认回顾性标本的历史结果和用于不一致结果分析。共收集了 2410 份未成型、未识别的粪便标本。前瞻性标本中参考方法定义的患病率为 1.2% ETEC、0.1% 艰难梭菌、0% 志贺氏菌和 0% 沙门氏菌。与参考方法相比,BD Max xEBP 检测试剂盒对所有标本的阳性百分一致率 (PPA) (95%置信区间 [CI])、阴性百分一致率 (NPA) (95% CI) 和kappa 系数 (95% CI) 如下:ETEC,97.6% (87.4 至 99.6)、99.8% (99.5 至 99.9) 和 0.93 (0.87 至 0.99);艰难梭菌,100% (96.4 至 100)、99.7% (99.4 至 99.8) 和 0.96 (0.93 至 0.99);志贺氏菌,99.0% (94.8 至 99.8)、99.9% (99.8 至 99.9) 和 0.99 (0.98 至 1);沙门氏菌,100% (96.4 至 100)、99.8% (99.5 至 99.9) 和 0.98 (0.95 至 1)。在这项多中心研究中,BD Max xEBP 与传统方法对疑似急性胃肠炎、肠炎或结肠炎患者粪便标本中 ETEC、艰难梭菌、志贺氏菌和沙门氏菌的检测具有高度相关性 (kappa,0.97;95%CI,0.95 至 0.98)。