[应用聚合酶链反应检测临床样本中的卡氏肺孢子虫。与亚甲胺银染色技术的比较]
[Detection of Pneumocystis carinii in clinical samples by the polymerase chain reaction. Comparison with the methenamine silver technique].
作者信息
Nogués A, García M, Rivas C, Falguera M, Puig T, Ruiz A
机构信息
Servicio de Análisis Clínicos y Microbiología, Hospital Arnau de Vilanova, Universidad de Lérida.
出版信息
Enferm Infecc Microbiol Clin. 1993 Mar;11(3):143-6.
BACKGROUND
A comparison of polymerase chain reaction (PCR) with methenamine silver stain was performed on clinical specimens for diagnosis of Pneumocystis carinii pneumonia in immunosuppressed patients.
METHODS
25 clinical samples (10 induced sputa, 12 transthoracic needle aspirations and 2 bronchoalveolar lavages) from 17 patients with AIDS and respiratory symptoms were studied. We performed DNA amplification by using 2 primers that amplify the mitochondrial large rDNA sequence of P. carinii.
RESULTS
The sensitivity and specificity of the PCR technique were 92.8% and 100% respectively, with a positive predictive value of 100% and negative predictive value of 92.3%. The sensitivity of the silver stain were 65%, specificity 100%, positive predictive value 100% and negative predictive value 63%.
CONCLUSION
The PCR technique is more sensitive than the methenamine silver stain for detecting Pneumocystis carinii in respiratory specimens from patients with pneumonia. Consequently it could be a very good alternative to classical methods in diagnosis of P. carinii infections.
背景
对临床标本进行聚合酶链反应（PCR）与亚甲胺银染色比较，以诊断免疫抑制患者的卡氏肺孢子虫肺炎。
方法
研究了17例有艾滋病且有呼吸道症状患者的25份临床样本（10份诱导痰、12份经胸针吸活检样本和2份支气管肺泡灌洗样本）。我们使用2种引物进行DNA扩增，这2种引物可扩增卡氏肺孢子虫的线粒体大核糖体DNA序列。
结果
PCR技术的敏感性和特异性分别为92.8%和100%，阳性预测值为100%，阴性预测值为92.3%。银染色的敏感性为65%，特异性为100%，阳性预测值为100%，阴性预测值为63%。
结论
在检测肺炎患者呼吸道标本中的卡氏肺孢子虫方面，PCR技术比亚甲胺银染色更敏感。因此，在诊断卡氏肺孢子虫感染方面，它可能是传统方法的一个很好的替代方法。
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