3种艰难梭菌感染检测方法的比较

Subjects: Medicine, Pharmacy >> Preclinical Medicine submitted time 2018-01-25 Cooperative journals: 《南方医科大学学报》

王丽志 陈丽丹 肖 斌 甘燕玲 李林海 王 前

Abstract： Objective To evaluate the diagnostic efficacy of real-time polymerase chain reaction (q-PCR) for Clostridium difficile infection (CDI) in comparison with routine culture and enzyme-linked fluorescent spectroscopy-based aprroaches. Methods Stool samples were collected from suspected CDI cases in General Hospital of Guangzhou Military Command of PLAbetween May and December in 2016. All the samples were examined with 3 methods, namely enzyme-linked fluorescent spectroscopy for detecting Clostridium difficile toxinA/B (CDAB), detection of glutamate dehydrogenase (GDH), and q-PCRfor amplification ofClostridiumdifficile-specificgenetpiandtoxingene(tcdA/tcdB),withtheresultsoffecalcultureasthereferenceforevaluating the diagnostic efficacy of the 3 methods. Results Of the total of 70 fecal samples, 13 (18.57%) were found to be positive for Clostridium difficile, including toxin-producing strains in 6 (8.57%) samples. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic coincidence rate of q-PCR for tpi were 92.31%, 91.23%, 70.59%, 98.11% and 91.43%, respectively,whichweresignificantlyhigherthanthoseofGDHtest(84.62%,84.21%,55.00%,96.00%,and84.29%,respectively; χ2=24.881, P<0.001). The sensitivity of q-PCR for tcdA/cdB was significantly higher than that of enzyme-linked fluorescent spectroscopy for CDAB in detecting CDI (66.67% vs 33.33%; χ2=35.918, P<0.001). Conclusion Both CDAB detection and q-PCR have a high specificity in detecting CDI, but GDH detection has a good sensitivity, and all these 3 methods have a high negative predictive value. Compared with other detection methods, amplification of tpi and tcdA/tcdB using q-PCR allows morerapid,sensitiveandspecificdetectionofCDI.

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