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核酸扩增检测对感染患者临床结局的影响

Impact of Nucleic Acid Amplification Test on Clinical Outcomes in Patients with Infection.

作者信息

Yamada Yota, Miyazaki Motoyasu, Kushima Hisako, Komiya Yukie, Nakashima Akio, Ishii Hiroshi, Imakyure Osamu

机构信息

Department of Pharmacy, Fukuoka University Chikushi Hospital, Fukuoka 818-8502, Japan.

Department of Infection Control and Prevention, Fukuoka University Chikushi Hospital, Fukuoka 818-8502, Japan.

出版信息

Antibiotics (Basel). 2023 Feb 21;12(3):428. doi: 10.3390/antibiotics12030428.

Abstract

A nucleic acid amplification test (NAAT) is recommended to determine whether or not patients have a infection (CDI) when the glutamate dehydrogenase activity assay is positive and the rapid membrane enzyme immunoassays for toxins is negative. In our hospital, a NAAT was introduced to diagnose CDI precisely in April 2020. This study aimed to investigate the impact of a NAAT on the clinical outcomes in patients with CDI at our hospital. Seventy-one patients diagnosed with CDI between April 2017 and March 2022 were included in our study. Patients with CDI were divided into two groups: before (pre-NAAT) and after (post-NAAT) the introduction of NAAT. The clinical outcome was compared between the two groups. Of the 71 patients with CDI, 41 were sorted into the pre-NAAT group and 30 into the post-NAAT group. The clinical cure rate was significantly higher in the post-NAAT group compared to the pre-NAAT group (76.7% vs. 48.8%, = 0.018). In the multivariable analysis, the clinical cure was significantly associated with the introduction of NAAT ( = 0.022). Our findings suggest that the introduction of NAAT can improve the clinical outcomes in CDI patients.

摘要

当谷氨酸脱氢酶活性检测呈阳性且毒素快速膜酶免疫检测呈阴性时,建议进行核酸扩增试验(NAAT)以确定患者是否患有艰难梭菌感染(CDI)。2020年4月,我院引入了NAAT以准确诊断CDI。本研究旨在调查NAAT对我院CDI患者临床结局的影响。2017年4月至2022年3月期间诊断为CDI的71例患者纳入本研究。CDI患者分为两组:NAAT引入前(NAAT前)和引入后(NAAT后)。比较两组的临床结局。在71例CDI患者中,41例被归入NAAT前组,30例被归入NAAT后组。NAAT后组的临床治愈率显著高于NAAT前组(76.7%对48.8%,P = 0.018)。在多变量分析中,临床治愈与NAAT的引入显著相关(P = 0.022)。我们的研究结果表明,NAAT的引入可以改善CDI患者的临床结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78e6/10044602/6347b1effe9b/antibiotics-12-00428-g001.jpg

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