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非 HIV 免疫功能低下患者中 RealStar PCR 试剂盒与 AmpliSens ()-FRT PCR 试剂盒检测的比较评估。

Comparative Evaluation Between the RealStar PCR Kit and the AmpliSens ()-FRT PCR Kit for Detecting in Non-HIV Immunocompromised Patients.

机构信息

Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Ann Lab Med. 2019 Mar;39(2):176-182. doi: 10.3343/alm.2019.39.2.176.

Abstract

BACKGROUND

Real-time PCR is more sensitive than microscopic examination for detecting . We compared the performance of two assays for detecting DNA: the RealStar PCR Kit 1.0 CE (Altona Diagnostics, Hamburg, Germany) and the AmpliSens ()-FRT PCR kit (InterLabService Ltd., Moscow, Russia).

METHODS

We used 159 samples from the lower respiratory tract (112 bronchoalveolar lavage [BAL] fluid, 37 sputum, and 10 endotracheal aspirate [ETA] samples) of non-HIV immunocompromised patients. Nested PCR and sequencing were used to resolve discordant results. The performance of the two assays was evaluated according to clinical categories (clinical pneumonia [PCP], possible PCP, or unlikely PCP) based on clinical and radiological observations.

RESULTS

The positive and negative percent agreement values were 100% (95% confidence interval [CI], 85.4-100%) and 96.6% (95% CI, 90.9-98.9%), respectively, and kappa was 0.92 (95% CI, 0.84-0.99). DNA load was significantly higher in the clinical PCP group than in the other groups (<0.05). When stratified by sample type, the positive rate for BAL fluids from the clinical PCP group was 100% using either assay, whereas the positive rate for sputum/ETA samples was only 20%.

CONCLUSIONS

The two assays showed similar diagnostic performance and detected low burden in BAL fluids. Both assays may be useful as routine methods for detecting DNA in a clinical laboratory setting, though their results should be interpreted considering sample type.

摘要

背景

实时 PCR 比显微镜检查更灵敏,可用于检测 。我们比较了两种检测 DNA 的方法:RealStar PCR 试剂盒 1.0 CE(Altona Diagnostics,德国汉堡)和 AmpliSens ()-FRT PCR 试剂盒(InterLabService Ltd.,俄罗斯莫斯科)。

方法

我们使用了 159 份来自非 HIV 免疫功能低下患者下呼吸道的样本(112 份支气管肺泡灌洗液 [BAL]、37 份痰液和 10 份气管抽吸物 [ETA])。使用嵌套 PCR 和测序解决不一致的结果。根据临床和影像学观察,根据临床类别(临床肺炎 [PCP]、可能 PCP 或不太可能 PCP)评估两种方法的性能。

结果

两种方法的阳性和阴性百分比一致性值分别为 100%(95%置信区间 [CI],85.4-100%)和 96.6%(95% CI,90.9-98.9%),kappa 值为 0.92(95% CI,0.84-0.99)。临床 PCP 组的 DNA 载量明显高于其他组(<0.05)。按样本类型分层,两种方法检测临床 PCP 组 BAL 液的阳性率均为 100%,而痰/ETA 样本的阳性率仅为 20%。

结论

两种方法的诊断性能相似,均能检测到 BAL 液中的低 负荷。两种方法均可作为临床实验室检测 DNA 的常规方法,但应考虑样本类型来解释其结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c593/6240529/f36152aea46a/alm-39-176-g001.jpg

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