16S 核糖体 RNA PCR 与传统诊断培养在疑似细菌性角膜炎中的应用比较。
16S Ribosomal RNA PCR Versus Conventional Diagnostic Culture in the Investigation of Suspected Bacterial Keratitis.
机构信息
Department of Eye and Vision Sciences, University of Liverpool, Liverpool, UK.
St. Paul's Eye Unit, Liverpool University Hospitals NHS Trust, Liverpool, UK.
出版信息
Transl Vis Sci Technol. 2020 Dec 1;9(13):2. doi: 10.1167/tvst.9.13.2. eCollection 2020 Dec.
PURPOSE
The purpose of this study was to compare conventional diagnostic culture (CDC) to 16S ribosomal RNA polymerase chain reaction (PCR) analysis for diagnosing bacterial keratitis.
METHODS
Samples collected from 100 consecutive patients presenting to the Royal Liverpool University Hospital with bacterial keratitis were processed using CDC and 16S PCR analysis.
RESULTS
The overall detection rate using both methods was 36%. Of these, 72.2% (26/36) were detected by PCR and 63.9% (23/36) isolated by CDC ( = 0.62). Using a combination of both PCR and CDC increased the detection rate for pathogenic bacteria by 13% compared to using CDC alone ( = 0.04). In CDC negative samples, 16S PCR identified more pathogens than CDC in 16S PCR negative samples. Neither order of sample collection nor prior antimicrobial use affected the detection rate.
CONCLUSIONS
16S rRNA gene PCR performed in addition to CDC on corneal samples from patients with clinically suspected bacterial keratitis led to additional pathogen detection.
TRANSLATIONAL RELEVANCE
16S rRNA gene PCR should be developed to become an additional part of clinical service for patients with bacterial keratitis rather than used in isolation.
目的
本研究旨在比较传统诊断培养（CDC）与 16S 核糖体 RNA 聚合酶链反应（PCR）分析在诊断细菌性角膜炎中的应用。
方法
对 100 例连续就诊于利物浦皇家医院的细菌性角膜炎患者的样本分别采用 CDC 和 16S PCR 分析进行处理。
结果
两种方法的总体检测率均为 36%。其中，72.2%（26/36）通过 PCR 检测到，63.9%（23/36）通过 CDC 分离到（=0.62）。与单独使用 CDC 相比，同时使用 PCR 和 CDC 可将致病细菌的检测率提高 13%（=0.04）。在 CDC 阴性样本中，16S PCR 在 16S PCR 阴性样本中比 CDC 检测到更多的病原体。样本采集顺序或之前使用的抗菌药物均不影响检测率。
结论
对临床疑似细菌性角膜炎患者的角膜样本进行 CDC 检测的同时进行 16S rRNA 基因 PCR 可提高病原体的检测率。
临床相关性
16S rRNA 基因 PCR 应作为细菌性角膜炎患者临床服务的一部分，而不是单独使用。
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