Haase A, Brennan M, Barrett S, Wood Y, Huffam S, O'Brien D, Currie B
Royal Darwin Hospital, Tiwi, Northern Territory, Australia.
J Clin Microbiol. 1998 Apr;36(4):1039-41. doi: 10.1128/JCM.36.4.1039-1041.1998.
Previously published PCR-based diagnostic tests for melioidosis were evaluated for clinical usefulness. A Burkholderia pseudomallei 16S rRNA-derived primer set had a sensitivity approaching 100% for clinical samples from 22 culture-confirmed cases of melioidosis and enabled diagnosis of 3 culture-negative cases. However, samples from 10 of 30 inpatients from Royal Darwin Hospital with other diagnoses were positive by PCR, giving a specificity of 67% and a positive predictive value of only 70%. Although there are a number of intriguing possible explanations for our results, concerns of inappropriate therapy resulting from a positive result by PCR have led us to forgo the advantage of rapid PCR diagnosis for melioidosis until a better system is validated.
我们对之前发表的基于聚合酶链反应（PCR）的类鼻疽诊断测试的临床实用性进行了评估。一套源自伯克霍尔德菌假鼻疽16S核糖体RNA的引物对22例经培养确诊的类鼻疽临床样本的敏感性接近100%，并能够诊断出3例培养阴性的病例。然而，来自达尔文皇家医院30例患有其他疾病的住院患者中的10例样本经PCR检测呈阳性，特异性为67%，阳性预测值仅为70%。尽管对于我们的结果有许多有趣的可能解释，但由于PCR阳性结果导致不适当治疗的担忧，使我们在更好的系统得到验证之前，放弃了PCR快速诊断类鼻疽的优势。
