微滴式数字聚合酶链式反应在血流感染快速诊断中的性能评价及应用

Performance and application of droplet digital polymerase chain reaction in rapid diagnosis of bloodstream infections

  • 摘要:
    目的 使用临床菌株和标准菌株验证微滴式数字聚合酶链式反应(ddPCR)试剂检测性能,并评估ddPCR技术临床应用的有效性和实用性。
    方法 使用临床菌株和标准菌株验证ddPCR试剂盒符合率、特异度、精密度、最低检出限等。收集74例疑似血流感染患者的血液样本,同时采用ddPCR和血培养2种方法测定患者血液标本的病原体。
    结果 ddPCR血流感染病原体检测的平均检测时间为3.5 h, 能够同时检测十几种常见病原体, ddPCR血流感染病原体检测试剂盒的符合率、特异度、精密度、最低检测限均满足临床要求。疑似血流感染的74例患者中,采用ddPCR方法检测的阳性率为64.86%, 采用血培养检测的阳性率为40.54%, 差异有统计学意义(P < 0.05)。
    结论 ddPCR可快速﹑批量﹑高效地检测血流感染常见病原体,检测性能可以满足临床需要,血培养联合ddPCR技术检测血流感染有利于临床血流感染患者的早期快速诊断。

     

    Abstract:
    Objective To validate the performance of droplet digital polymerase chain reaction (ddPCR) reagents using clinical and standard strains, and to evaluate the effectiveness and practicability of ddPCR technology in clinical applications.
    Methods The concordance rate, specificity, precision, and lower limit of detection of the ddPCR kit were validated using clinical and standard strains. Blood samples from 74 patients with suspected bloodstream infections were collected, and both ddPCR and blood culture methods were used to determine the pathogens in the patient's blood samples.
    Results The average detection time of ddPCR for pathogens of bloodstream infection was 3.5 hours, which was able to complete the detection of over a dozen common pathogens simultaneously. The concordance rate, specificity, precision, and lower limit of detection of the ddPCR kit for bloodstream infection pathogens all met clinical requirements. Among the 74 patients with suspected bloodstream infections, the positive detection rate using the ddPCR method was 64.86%, while was 40.54% using blood culture, with a statistically significant difference (P < 0.05).
    Conclusion The method of ddPCR can detect common pathogens of bloodstream infections rapidly, efficiently, and in large quantities, and its main detection performance can meet clinical needs. The combination of blood culture and ddPCR technology is conductive to early and rapid diagnosis of clinical bloodstream infection patients.

     

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