摘要
目的探讨艰难梭菌毒素A/B及其相关毒素基因检测对艰难梭菌相关性腹泻的诊断价值。方法收集2015年1月至2015年10月我院ICU病房腹泻疑似艰难梭菌感染患者的粪便标本133例作为研究对象,分别采用艰难梭菌培养法、CDAB法、PCR毒素基因检测法及艰难梭菌毒素GDH检测法进行检测,以艰难梭菌培养法结果为金标准,计算各方法的诊断指标所包含有的特异度、敏感度、阴性预测值和阳性预测值等。结果本研究收集的133例粪便标本中,经过金标准粪便样本厌氧培养法检出阳性结果 20例,阴性结果 113例。CDAB法具有低敏感度(0.550)和高特异度(0.912),诊断符合率为0.932,BD-PCR毒素基因检测法具有高敏感度(0.950)和高特异度(0.929),诊断符合率为0.932,艰难梭菌毒素GDH检测法的高敏感度(0.900)和低特异度(0.779),诊断符合率为0.797。结论对于疑似艰难梭菌感染,可联合艰难梭菌GDH、艰难梭菌毒素A/B(CDAB)或进行荧光定量PCR毒素基因共同检测,有效降低检测时间,为临床医师及时提供准确的诊断依据,并制定行之有效的治疗措施。
Objective To study the diagnostic value of Clostridium Botulinum toxin A/B and its associated toxin gene in the diagnosis of Clostridium Botulinum associated diarrhea. Methods A total of 133 patients with diarrhea stool specimens suspected having Clostridium difficile infection were selected as the research objects. Clostridium difficile culture method for stool specimens, Clostridium difficile toxin A/B （CDAB） PCR toxin gene detection, and Clostridium difficile toxin GDH detection were used for the study. We took Clostridium difficile culture as a gold standard and calculated sensitivity, specificity, positive /negative predictive value for each method. Results Out of 133 cases stool specimens, 20 cases were positive for Clostridium difficile infection, 113 cases were negative based on the gold standard of stool samples anaerobic culture. The CDAB method had low sensitivity （0. 550 ） and high specificity （0. 912 ）, the diagnostic accordance rate was 0. 932. BD-PCR toxin gene detection method had high sensitivity （0. 950 ） and high specificity （0. 929 ）, the diagnostic accordance rate was 0. 932. Clostridium difficile toxin GDH detection method had high-sensitivity sense （0. 900） and low specificity （0. 779 ）, diagnostic coincidence rate was 0.797. Conclusion Clostridium difficile GDH can be combined with Clostridium difficile toxin A/B （CDAB） or PCR toxin gene detection for suspected Clostridium difficile infection. It can effectively reduce the detection time, provide accurate diagnosis for clinicians in order to develop effective treatment measures.
出处
《标记免疫分析与临床》
CAS
2016年第9期1016-1019,共4页
Labeled Immunoassays and Clinical Medicine
