聚合酶链反应快速诊断浅部真菌病

目的评价聚合酶链反应（PCR）技术直接从临床标本中检测浅部真菌病病原真菌的方法.方法采用蛋白酶K消化法和煮沸法处理临床标本,从中提取致病菌DNA,然后用真菌通用引物ITS1进行PCR扩增检测,并与直接镜检和培养法作对比.结果共收集112例临床标本,PCR检测、直接镜检和培养的敏感性分别为80.7%、96.5%和70.2%,特异性分别为100%、89.1%和100%,阳性预测值分别为100%、90.2%和100%,阴性预测值分别为83.3%、96.1%和76.4%.PCR方法在24 h内即可完成从标本处理至结果判读的全过程.结论PCR检测具有较好的特异性和准确性,且比培养缩短了近2周的时间,为临床快速诊断和及时、合理地治疗浅部真菌病提供参考.

Direct Detection of Pathogenic Fungi in Superficial Fungal Infections Based on Polymerase Chain Reaction

Objective To develop a rapid and reliable polymerase chain reaction (PCR) procedure to detect the pathogenic fungi in clinical specimens. Methods Skin, nail and hair samples were taken from patients suspected of being infected with superficial mycosis. Pathogens were detected by PCR based on the ITS1 primer, and the results were compared with those from microscopic examination and culture. Results One hundred and twelve patients were recruited in this study. For PCR, microscopic examination and culture the sensitivities were 80.7%, 96.5% and 70.2%, the specificities were 100%, 89.1% and 100%, the positive predictive values were 100%, 90.2% and 100%, and the negative predictive values were 83.3%, 96.1% and 76.4%, respectively. The PCR process could be completed within 24 h. Conclusions PCR assay has good specificity and accuracy, while fungal culture takes 2 weeks to get the results. PCR is helpful for making rapid clinical diagnosis, which leads to the appropriate treatment of superficial fungal infection.