Macfarlane-Smith Louissa R, Ahmed Shadia, Wilcox Mark H
Public Health England Leeds Regional Laboratory, Leeds, UK.
Department of Microbiology, Leeds Teaching Hospitals NHS Trust.
Curr Opin Gastroenterol. 2018 Jan;34(1):19-24. doi: 10.1097/MOG.0000000000000405.
Molecular-based diagnostic methods for the detection of gastrointestinal pathogens are becoming increasingly commonplace in microbiology laboratories. This review aims to summarize recent developments in this field and discuss the clinical application and limitations of implementing these techniques.
Recent evaluations of multiplex PCR assays show increased sensitivity whenever compared with standard microbiological culture-based methods. In addition to shorter turnaround times, assays can detect an increased repertoire of pathogens from a single specimen and provide useful information for infection prevention and control practices. There are many limitations, however, associated with their use, including clinical interpretation of results and lack of concordance between different test panels. Newer technologies, such as metagenomic analysis, can provide comprehensive information useful to both patient management and public health surveillance.
Molecular techniques are capable of replacing culture in the diagnosis of gastrointestinal infections. Whether all positive results, however, represent true infection is still debateable, as is the clinical significance of identifying more than one pathogen. As it currently stands, microbiological culture remains vital for public health surveillance, monitoring antibiotic resistance and managing outbreaks.
基于分子的胃肠道病原体检测诊断方法在微生物实验室中越来越普遍。本综述旨在总结该领域的最新进展，并讨论实施这些技术的临床应用及局限性。
近期对多重聚合酶链反应（PCR）检测的评估表明，与基于标准微生物培养的方法相比，其灵敏度有所提高。除了周转时间更短外，这些检测还能从单个样本中检测出更多种类的病原体，并为感染预防和控制措施提供有用信息。然而，其使用存在许多局限性，包括结果的临床解读以及不同检测平台之间缺乏一致性。宏基因组分析等新技术可为患者管理和公共卫生监测提供有用的综合信息。
分子技术能够在胃肠道感染诊断中取代培养法。然而，所有阳性结果是否都代表真正的感染仍存在争议，识别出一种以上病原体的临床意义也存在争议。就目前情况而言，微生物培养对于公共卫生监测、监测抗生素耐药性和管理疫情仍至关重要。
