鼻咽 PCR 检测在儿童单纯性急性中耳炎中检测耳病原体的可靠性与培养法比较。
Reliability of nasopharyngeal PCR for the detection of otopathogens in children with uncomplicated acute otitis media compared to culture.
机构信息
Department of Pediatrics, Denver Health and Hospital Authority, Denver, CO, USA; Center for Health Systems Research, Denver Health and Hospital Authority, Denver, CO, USA; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
Division of Infectious Diseases, Department of Medicine, Denver Health and Hospital Authority, Denver, CO, USA; Division of Infectious Diseases, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
出版信息
Diagn Microbiol Infect Dis. 2023 Oct;107(2):116040. doi: 10.1016/j.diagmicrobio.2023.116040. Epub 2023 Jul 26.
Otopathogens in acute otitis media (AOM) have implications for care because the likelihood of resolution without antibiotics and optimal antibiotic agent varies by microorganism. We aimed to determine the sensitivity, specificity, positive predictive value, and negative predictive value of nasopharyngeal (NP) qualitative polymerase chain reaction (PCR) for common bacterial otopathogens in children with AOM compared to NP culture. NP flocked swabs collected from enrolled children aged 6 to 35 months with uncomplicated AOM in Denver, CO were tested by culture and multiplex PCR. The sensitivity and negative predictive value of PCR using culture as a reference were high (H. influenzae 93.3%, 98.0%; S. pneumoniae 94.2%, 95.1%; M. catarrhalis 92.3%, 86.4%); whereas the specificity and positive predictive value were lower and varied by organism (54.2%-84.1%, 55.1%-69.2%, respectively). PCR detected 1.5 times more organisms than culture. NP PCR has a high predictive value for excluding otopathogens compared to culture and warrants exploration as a diagnostic tool.
急性中耳炎（AOM）中的耳病原体对治疗有影响，因为在不使用抗生素的情况下和使用最佳抗生素药物的情况下，每种微生物的缓解可能性均有所不同。我们旨在确定与鼻咽（NP）培养相比，NP 定性聚合酶链反应（PCR）对 AOM 患儿常见细菌耳病原体的敏感性、特异性、阳性预测值和阴性预测值。在丹佛（CO）对患有单纯性 AOM 的 6 至 35 个月大的入组儿童采集 NP 集落拭子，并用培养和多重 PCR 进行检测。以培养为参照时，PCR 的敏感性和阴性预测值均较高（流感嗜血杆菌 93.3%，98.0%；肺炎链球菌 94.2%，95.1%；卡他莫拉菌 92.3%，86.4%）；而特异性和阳性预测值较低，且因病原体而异（分别为 54.2%-84.1%，55.1%-69.2%）。PCR 比培养检测到的病原体多 1.5 倍。NP-PCR 对排除耳病原体的预测值高于培养，值得进一步研究作为诊断工具。
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