微流控环介导等温扩增法在脓毒症患者肺炎克雷伯菌检测中的应用价值(1)
[摘要] 目的 探討微流控环介导等温扩增法在脓毒症患者肺炎克雷伯菌检测中的应用价值。 方法 收集2015年7月～2018年5月河北北方学院附属第一医院重症医学科脓毒症患者152例作为研究对象，自然咳痰采集法收集痰液标本99例，经支气管镜抽吸法收集标本53例，分别进行细菌培养及微流控环介导等温核酸检测，根据细菌培养是否分离到肺炎克雷伯菌分为肺炎克雷伯菌组42例和非肺炎克雷伯菌组110例。 结果 细菌培养检出肺炎克雷伯菌阳性率为27.6%(42/152)，微流控环介导等温核酸检测法阳性率为38.8%(59/152)，后者阳性率高于前者，差异有高度统计学意义(P < 0.01)。肺炎克雷伯菌组经微流控环介导等温核酸扩增法检出阳性菌37例，其中自然咳痰采集法检出21例，支气管镜抽吸法检出16例，非肺炎克雷伯菌组检出阳性菌22例，其中自然咳痰法检出15例，支气管镜抽吸法检出7例，经支气管镜抽吸法和自然咳痰采集法检测的ROC曲线下面积为0.847和0.836，约登指数前者(0.694)高于后者(0.672)。与细菌培养法的一致性评价(Kappa值为0.604 > 0.600，P < 0.05)比较，两种检测方法有较高的一致性。 结论 微流控环介导等温扩增法在脓毒症患者肺炎克雷伯菌检测中具有快速、灵敏的优势，与传统的细菌培养法有较高的一致性，为临床提供更好的的诊疗依据。
[关键词] 微流控;环介导等温扩增;脓毒症;肺炎克雷伯菌
[中图分类号] R563.1 [文献标识码] A [文章编号] 1673-7210(2019)03(a)-0144-05
[Abstract] Objective To explore the clinical value of microfluidic loop-mediated isothermal amplification detection in the diagnosis of Klebsiella pneumoniae infection in sepsis patients. Methods From June 2015 to May 2018， 152 sepsis patients who were from the department of ICU of the First Affiliated Hospital of Hebei North University were collected， 99 cases of sputum specimens samples were collected by natural cough method， 53 cases were collected by bronchoscopy. All these samples were simultaneously detected by traditional pathogen culture method and microfluidic loop-mediated isothermal amplification method. According to the traditional bacterial culture result， all cases were divided into two group， 42 cases were Klebsiella pneumoniae infection group and 110 cases were non Klebsiella pneumoniae infection group. Results The positive rate of Klebsiella pneumoniae detected by bacterial culture was 27.6%(42/152)， and by microfluidic loop-mediated isothermal amplification detection was 38.8%(59/152)， which was higher than the former， the difference was statistically significant(P < 0.01). The method of microfluidics loop-mediated isothermal amplification detected 37 positive cases from Klebsiella pneumoniae infection group， including 21 cases natural cough sample and 16 cases bronchoscopy sample， Non Klebsiella pneumoniae infection group was detected by the method of microfluidics loop-mediated isothermal amplification had 22 cases positive samples，including 15 cases natural cough samples and 7 cases bronchoscopy samples. The area under the ROC curve of the bronchoscopy suction method and natural cough collection method was 0.836 and 0.847. The Jordan index of former (0.694) was higher than the latter (0.672). The Kappa value was 0.604 > 0.600， P < 0.05， indicating a high consistency between the two methods. Conclusion Microfluidic loop-mediated isothermal amplification has the advantages of rapid and sensitive detection of Klebsiella pneumoniae in sepsis patients， which is highly consistent with the traditional bacterial culture method and can provide better clinical diagnosis and treatment basis., http://www.100md.com(苏华 陈琛 蒋丽娜)
[关键词] 微流控;环介导等温扩增;脓毒症;肺炎克雷伯菌
[中图分类号] R563.1 [文献标识码] A [文章编号] 1673-7210(2019)03(a)-0144-05
[Abstract] Objective To explore the clinical value of microfluidic loop-mediated isothermal amplification detection in the diagnosis of Klebsiella pneumoniae infection in sepsis patients. Methods From June 2015 to May 2018， 152 sepsis patients who were from the department of ICU of the First Affiliated Hospital of Hebei North University were collected， 99 cases of sputum specimens samples were collected by natural cough method， 53 cases were collected by bronchoscopy. All these samples were simultaneously detected by traditional pathogen culture method and microfluidic loop-mediated isothermal amplification method. According to the traditional bacterial culture result， all cases were divided into two group， 42 cases were Klebsiella pneumoniae infection group and 110 cases were non Klebsiella pneumoniae infection group. Results The positive rate of Klebsiella pneumoniae detected by bacterial culture was 27.6%(42/152)， and by microfluidic loop-mediated isothermal amplification detection was 38.8%(59/152)， which was higher than the former， the difference was statistically significant(P < 0.01). The method of microfluidics loop-mediated isothermal amplification detected 37 positive cases from Klebsiella pneumoniae infection group， including 21 cases natural cough sample and 16 cases bronchoscopy sample， Non Klebsiella pneumoniae infection group was detected by the method of microfluidics loop-mediated isothermal amplification had 22 cases positive samples，including 15 cases natural cough samples and 7 cases bronchoscopy samples. The area under the ROC curve of the bronchoscopy suction method and natural cough collection method was 0.836 and 0.847. The Jordan index of former (0.694) was higher than the latter (0.672). The Kappa value was 0.604 > 0.600， P < 0.05， indicating a high consistency between the two methods. Conclusion Microfluidic loop-mediated isothermal amplification has the advantages of rapid and sensitive detection of Klebsiella pneumoniae in sepsis patients， which is highly consistent with the traditional bacterial culture method and can provide better clinical diagnosis and treatment basis., http://www.100md.com(苏华 陈琛 蒋丽娜)