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多重聚合酶链反应对细菌和真菌感染诊断及合适抗菌治疗选择的影响

Impact of Multiplex PCR on Diagnosis of Bacterial and Fungal Infections and Choice of Appropriate Antimicrobial Therapy.

作者信息

Serapide Francesca, Pallone Rita, Quirino Angela, Marascio Nadia, Barreca Giorgio Settimo, Davoli Chiara, Lionello Rosaria, Matera Giovanni, Russo Alessandro

机构信息

Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy.

Unit of Clinical Microbiology, Department of Health Sciences, "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy.

出版信息

Diagnostics (Basel). 2025 Apr 20;15(8):1044. doi: 10.3390/diagnostics15081044.

Abstract

Multiplex Polymerase Chain Reaction (PCR) has significantly impacted the field of infectious disease diagnostics, offering rapid and precise identification of bacterial and fungal pathogens. Unlike traditional culture methods, which may take days to yield results, multiplex PCR provides diagnostic insights within hours, enabling faster, targeted antimicrobial therapy and reducing the delay in treating critical infections like sepsis. The technique's high sensitivity and broad pathogen coverage make it ideal for both single and polymicrobial infections, improving outcomes across respiratory, bloodstream, and bacterial/fungal infections. However, multiplex PCR is not without challenges; initial high costs and the need for specialized training can limit its adoption, especially in low-resource settings. This review discusses the clinical advantages and limitations of multiplex PCR, highlighting its influence on diagnostic accuracy, antimicrobial stewardship, and the global fight against antimicrobial resistance (AMR). Furthermore, recent innovations in multiplex PCR, such as digital PCR and portable devices, are explored as potential tools for expanding access to rapid diagnostics worldwide.

摘要

多重聚合酶链反应(PCR)对传染病诊断领域产生了重大影响,能够快速、准确地鉴定细菌和真菌病原体。与传统培养方法不同,传统培养方法可能需要数天才能得出结果,而多重PCR能在数小时内提供诊断信息,从而实现更快、更有针对性的抗菌治疗,并减少治疗败血症等严重感染的延迟。该技术的高灵敏度和广泛的病原体覆盖范围使其成为单一和多微生物感染的理想选择,改善了呼吸道、血流以及细菌/真菌感染的治疗效果。然而,多重PCR并非没有挑战;初始成本高昂以及需要专门培训可能会限制其应用,尤其是在资源匮乏的环境中。本综述讨论了多重PCR的临床优势和局限性,强调了其对诊断准确性、抗菌药物管理以及全球抗击抗菌药物耐药性(AMR)斗争的影响。此外,还探讨了多重PCR的最新创新,如数字PCR和便携式设备,作为在全球范围内扩大快速诊断可及性的潜在工具。

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