Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia.
International Vaccine Institute, Seoul, Republic of Korea.
Am J Trop Med Hyg. 2021 Nov 8;106(2):454-456. doi: 10.4269/ajtmh.21-0814.
Quantitative polymerase chain reaction (qPCR) of dried blood spots (DBS) for pathogen detection is a potentially convenient method for infectious disease diagnosis. This study tested 115 DBS samples paired with whole blood specimens of children and adolescent from Burkina Faso, Sudan, and Madagascar by qPCR for a wide range of pathogens, including protozoans, helminths, fungi, bacteria, and viruses. Plasmodium spp. was consistently detected from DBS but yielded a mean cycle threshold (Ct) 5.7 ± 1.6 higher than that from whole blood samples. A DBS qPCR Ct cutoff of 27 yielded 94.1% sensitivity and 95.1% specificity against the whole blood qPCR cutoff of 21 that has been previously suggested for malaria diagnosis. For other pathogens investigated, DBS testing yielded a sensitivity of only 8.5% but a specificity of 98.6% compared with whole blood qPCR. In sum, direct PCR of DBS had reasonable performance for Plasmodium but requires further investigation for the other pathogens assessed in this study.
定量聚合酶链反应（qPCR）检测干血斑（DBS）中的病原体是一种用于传染病诊断的潜在便捷方法。本研究通过 qPCR 对来自布基纳法索、苏丹和马达加斯加的儿童和青少年的 115 对 DBS 样本和全血样本进行了广泛的病原体检测，包括原生动物、蠕虫、真菌、细菌和病毒。DBS 中始终可以检测到疟原虫，但平均循环阈值（Ct）比全血样本高 5.7±1.6。先前已提出将全血 qPCR 的截止值 21 用于疟疾诊断，DBS qPCR 的截止值为 27 时，对全血 qPCR 的截止值为 21 时的敏感性为 94.1%，特异性为 95.1%。对于其他研究的病原体，DBS 检测的敏感性仅为 8.5%，但特异性为 98.6%。总的来说，DBS 的直接 PCR 对疟原虫具有合理的性能，但需要对本研究评估的其他病原体进行进一步研究。
