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1、3種艱難梭菌感染檢測方法的比較王麗志陳麗丹肖斌甘燕玲李林海王前南方醫(yī)科大學南方醫(yī)院檢驗科中國人民解放軍廣州總醫(yī)院檢驗科X關(guān)注成功！加關(guān)注后您將方便地在我的關(guān)注中得到本文獻的被引頻次變化的通知！·新浪微博·騰訊微博·人人網(wǎng)·開心網(wǎng)·豆瓣網(wǎng)·網(wǎng)易微博摘????要：目的評價3種艱難梭菌感染(CDI)檢測方法的診斷效能,為CDI尋找合適的診斷方案。方法收集中國人民解放軍廣州總醫(yī)院2016年5月12月疑似CDI的腹瀉患者糞便標本70例,采用3種方法進行檢測:(1)培養(yǎng)法;(2)酶聯(lián)熒光法檢測艱難梭菌毒素A/B(CDAB)和谷氨酸脫氫酶(GDH);(3
2、)q-PCR擴增艱難梭菌特異性基因tpi和毒素基因(tcdA/tcdB)。以培養(yǎng)法的檢測結(jié)果作為參考標準,計算3種方法的診斷指標。結(jié)果收集糞便樣本70例,分離艱難梭菌13例(18.57%),其中產(chǎn)毒株6例(8.57%)。q-PCR法鑒定tpi基因陽性17例,其敏感度、特異度、陽性預測值、陰性預測值、診斷符合率分別為92.31%、91.23%、70.59%、98.11%、91.43%,均高于GDH法(84.62%、84.21%、55.00%、96.00%、84.29%)(χ2=24.881,P<0.001),且q-PCR擴增tcdA/tcdB
3、的敏感度(66.67%)優(yōu)于CDAB(33.33%)(χ2=35.918,P<0.001)。結(jié)論CDAB檢測和q-PCR法特異性較高,GDH法具有較好的靈敏度,3者均有較高的陰性預測值。與其他檢測方法相比,q-PCR法檢測CDI具有時效性強,靈敏度高,特異性好等優(yōu)勢,適用于臨床推廣。關(guān)鍵詞：艱難梭菌感染;實驗室技術(shù)和方法;診斷指標;作者簡介：王麗志,碩士研究生,E-mail:631193294@qq.com作者簡介：王前,教授,E-mail:nfyywangqian@163.comEfficacyofreal-timePCRfordetec
4、tingClostridiumdifficileinfection:comparisonwithenzyme-linkedfluorescentspectroscopy-basedapproachesWANGLizhiCHENLidanXIAOBinGANYanlingLILinhaiWANGQianDepartmentofLaboratoryMedicine,NanfangHospital,SouthernMedicalUniversity;DepartmentofLaboratoryMedicine,GeneralHospitalofG
5、uangzhouMilitaryCommandofPLA;Abstract：ObjectiveToevaluatethediagnosticefficacyofreal-timepolymerasechainreaction(q-PCR)forClostridiumdifficileinfection(CDI)incomparisonwithroutinecultureandenzyme-linkedfluorescentspectroscopy-basedaprroaches.MethodsStoolsampleswerecollecte
6、dfromsuspectedCDIcasesinGeneralHospitalofGuangzhouMilitaryCommandofPLAbetweenMayandDecemberin2016.Allthesampleswereexaminedwith3methods,namelyenzyme-linkedfluorescentspectroscopyfordetectingClostridiumdifficiletoxinA/B(CDAB),detectionofglutamatedehydrogenase(GDH),andq-PCRf
7、oramplificationofClostridiumdifficile-specificgenetpiandtoxingene(tcdA/tcdB),withtheresultsoffecalcultureasthereferenceforevaluatingthediagnosticefficacyofthe3methods.ResultsOfthetotalof70fecalsamples,13(18.57%)werefoundtobepositiveforClostridiumdifficile,includingtoxin-pr
8、oducingstrainsin6(8.57%)samples.Thesensitivity,specificity,positivepredictivevalue,negati
