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16S rRNA 与降钙素原联合检测在新生儿临床疑似败血症中的诊断价值。

Combination of 16S rRNA and procalcitonin in diagnosis of neonatal clinically suspected sepsis.

机构信息

Department of Neonatology, The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi, China.

出版信息

J Int Med Res. 2020 Mar;48(3):300060519892418. doi: 10.1177/0300060519892418. Epub 2019 Dec 19.

Abstract

OBJECTIVE

To investigate the application of 16S rRNA in diagnosing patients with neonatal sepsis.

METHODS

We studied 60 consecutive neonatal patients with clinically suspected sepsis and 20 non-infective cases as controls. All patients were diagnosed with sepsis by clinical and experimental criteria. Clinical characteristics were recorded and 16S rRNA sequencing was conducted for all patients. The sensitivity, specificity, and accuracy of the detection methods were analyzed.

RESULTS

The detection limit of 16S rRNA sequencing was 1 × 10 CFU/mL. For suspected sepsis, the positive rate of 16S rRNA detection was 93.3%, which was similar to that of procalcitonin detection (85%), and was significantly higher than that of bacterial culture (51.7%). The specificity of procalcitonin detection (74.1%) was significantly lower than that of 16S rRNA detection (100%). Moreover, the combination of 16S rRNA and procalcitonin detection showed a sensitivity of 100%, specificity of 74.1%, and accuracy of 92.0%. For proven sepsis, the sensitivity and specificity of 16S rRNA detection were both 100.0%, and those for procalcitonin were 87.1% and 87.0%, respectively.

CONCLUSION

Detection of 16S rRNA has high sensitivity and specificity in diagnosing sepsis. The combination of 16S rRNA and procalcitonin has even better sensitivity with acceptable specificity.

摘要

目的

探讨 16S rRNA 在诊断新生儿败血症中的应用。

方法

研究了 60 例连续的临床疑似败血症新生儿患者和 20 例非感染性病例作为对照。所有患者均通过临床和实验标准诊断为败血症。记录临床特征,并对所有患者进行 16S rRNA 测序。分析检测方法的灵敏度、特异性和准确性。

结果

16S rRNA 测序的检测限为 1×10 CFU/mL。对于疑似败血症,16S rRNA 检测的阳性率为 93.3%,与降钙素原检测(85%)相似,明显高于细菌培养(51.7%)。降钙素原检测的特异性(74.1%)明显低于 16S rRNA 检测(100%)。此外,16S rRNA 和降钙素原联合检测的灵敏度为 100%,特异性为 74.1%,准确性为 92.0%。对于已证实的败血症,16S rRNA 检测的灵敏度和特异性均为 100.0%,降钙素原的灵敏度和特异性分别为 87.1%和 87.0%。

结论

16S rRNA 检测对诊断败血症具有较高的灵敏度和特异性。16S rRNA 和降钙素原联合检测具有更高的灵敏度,特异性可接受。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/811d/7782951/19a3cd164ae4/10.1177_0300060519892418-fig1.jpg

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