本研究旨在评估肽聚糖(PGN)的诊断价值,疑似血流感染患者的脂多糖(LPS)和(1,3)-β-D-葡聚糖(BDG)。我们收集了2020年11月至2021年3月在北京协和医院接受血液培养的患者的493份肝素抗凝剂样本。PGN,LPS,使用自动酶标记分析仪检测血浆中的BDG,GLP-F300。PGN的诊断效能,LPS,和BDG通过计算灵敏度进行评估,特异性,阳性预测值(PPV),和阴性预测值(NPV)。这项研究不仅验证了常见的细菌和真菌,还有一些罕见的细菌和真菌,可以通过测试PGN来检测,LPS,BDG,在等离子体中。敏感性,特异性,总符合率为83.3%,95.6%,PGN为94.5%;77.9%,95.1%,LPS为92.1%;83.8%,96.9%,BDG为95.9%,分别,与临床诊断一致。PGN的阳性率,LPS,和BDG以及PGN的多标记检测方法,LPS,BDG分别为11.16%,17.65%,和9.13%,显著高于血培养的32.86%(p<0.05)。PGN的AUC值,LPS,BDG为0.881(0.814−0.948),0.871(0.816−0.925),和0.897(0.825−0.969),分开,高于C反应蛋白(0.594[0.530−0.659])和降钙素原(0.648[0.587−0.708])。等离子PGN,LPS,和BDG在革兰氏阳性和革兰氏阴性细菌和真菌病原体引起的血流感染的早期诊断中表现良好。
This
study aimed to assess the diagnostic values of
peptidoglycan (PGN), lipopolysaccharide (LPS) and (1,3)-Beta-D-Glucan (BDG) in patients with suspected bloodstream infection. We collected 493 heparin anticoagulant samples from patients undergoing blood culture in Peking Union Medical College Hospital from November 2020 to March 2021. The PGN, LPS, and BDG in the plasma were detected using an automatic enzyme labeling analyzer, GLP-F300. The diagnostic efficacy for PGN, LPS, and BDG were assessed by calculating the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). This
study validated that not only common bacteria and fungi, but also some rare bacteria and fungi, could be detected by testing the PGN, LPS, and BDG, in the plasma. The sensitivity, specificity, and total coincidence rate were 83.3%, 95.6%, and 94.5% for PGN; 77.9%, 95.1%, and 92.1% for LPS; and 83.8%, 96.9%, and 95.9% for BDG, respectively, which were consistent with the clinical diagnosis. The positive rates for PGN, LPS, and BDG and the multi-marker detection approach for PGN, LPS, and BDG individually were 11.16%, 17.65%, and 9.13%, and 32.86% significantly higher than that of the blood culture (p < 0.05). The AUC values for PGN, LPS, and BDG were 0.881 (0.814−0.948), 0.871 (0.816−0.925), and 0.897 (0.825−0.969), separately, which were higher than that of C-reactive protein (0.594 [0.530−0.659]) and procalcitonin (0.648 [0.587−0.708]). Plasma PGN, LPS, and BDG performs well in the early diagnosis of bloodstream infections caused by Gram-positive and Gram-negative bacterial and fungal pathogens.