多重PCR检测支气管肺泡灌洗液中细菌性病原体的研究

目的评价呼吸道感染患者肺泡灌洗标本进行多重PCR检测的准确性。方法选取2006～2009年本院住院的158例儿童为研究对象，同时选用需要接受纤维支气管镜检查的30例同龄非感染患儿作为对照。所有儿童24h内接受标准的纤维支气管镜介导的支气管肺泡灌洗。用多重PCR检测灌洗液中肺炎链球菌、流感嗜血杆菌、肺炎支原体和肺炎嗜衣原体。并用细菌培养等常规方法对这些患者的肺泡灌洗液进行分析。结果常规细菌学诊断方法显示，肺炎链球菌，流感嗜血杆菌，肺炎支原体，肺炎嗜衣原体在下呼吸道感染病人中分别占14％，21％，3．2％，和0％。而应用肺泡灌洗液多重PCR这种诊断方法，这些病原体在这些病人中分别占了28％，47％，4％和1％，其敏感性分别为87％。90％，100％和0％，特异性分别为81％，64％，100％和99％。在104位检查前服用了抗生素的支气管镜检患者中，肺炎链球菌通过细菌培养来确诊占2．9％，而通过多重PCR则为31％。在对照组中多重PCR鉴别肺炎链球菌的比例为17％．流感嗜血杆菌为40％。结论在下呼吸道感染病人中，支气管肺泡灌洗液结合多重PCR能够有效的用来鉴别肺炎链球菌，流感嗜血杆菌，肺炎支原体，肺炎嗜衣原体，这在已经用抗生素治疗的病人中尤为有效。

Detection of bacterial pathogens in bronchoalveolar lavage fluid by multiplex PCR

Aim To evaluate the accuracy of detection of bronchoalveolar lavage samples from patients with lower respiratory tract infection using multiplex PCR.Methods There 158 child inpatients infected bacteria were selected from 2006 to 2009 and 30 health children needed fiberoptic bronchoscopy were as control.All children received standard fiberoptic bronchoscopy mediated bronchoalveolar lavage within 24h.Multiplex PCR were used for detection of Streptococcus pneumoniae,Haemophilus influenzae,Mycoplasma pneumoniae...