real-time polymerase chain reaction

实时聚合酶链反应
  • 文章类型: Journal Article
    据报道,喉癌(LC)在全球所有类型的头颈部癌症中具有较高的发病率。由于涉及侵袭和转移,导致LC发病机理的机制很复杂,因此需要了解这种复杂的多步骤过程。包括基质金属蛋白酶(MMPs)在内的许多分子参与调节转移机制。此外,在包括炎症在内的多种病理和生理事件中观察到不同类型MMP的激活和表达,入侵,和转移。在MMPs的所有成员中,基质金属蛋白酶-2(MMP-2),和基质金属蛋白酶-9(MMP-9)经常被报道与肿瘤发病机制相关。本研究旨在检查MMP-2和MMP-9在LC发病机制中的参与。收集184例喉肿瘤样品以及邻近的未涉及的健康切片,以使用实时PCR和免疫组织化学(IHC)检查LC中上述基因的表达失调。实时PCR和IHC分析显示,与对照组相比,喉肿瘤中MMP-2(P<0.0001)和MMP-9(P<0.0001)基因的显着上调。Spearman相关显示,在喉发病机制中,选择的MMPs的表达失调与晚期TNM分期[MMP-2,(P<.0001);MMP-9,P<.0001]和吸烟状态[MMP-2(P<.0001);MMP-9P<.0001]呈正相关。受试者工作曲线(ROC)分析显示所述标志物在喉癌患者中具有良好的诊断/预后价值。本研究表明,发现所选MMP的显著上调与喉癌的风险增加相关,并且可以作为检测所述疾病的良好诊断标记。
    Laryngeal carcinoma (LC) is reported to have a higher incidence rate among all types of head and neck cancers around the globe. Mechanisms resulting in the pathogenesis of LC are complicated due to involvement of invasion and metastasis and there is a need to understand this complicated multistep process. Numerous molecules including matrix metalloproteinases (MMPs) are involved in regulating metastatic mechanisms. Furthermore, activation and expression of different classes of MMPs have been observed in multiple pathological and physiological events including inflammation, invasion, and metastasis. Among all members of MMPs, matrix metalloproteinases-2 (MMP-2), and matrix metalloproteinases-9 (MMP-9) have been frequently reported to correlate with tumor pathogenesis. The present study is designed to check the involvement of MMP-2 and MMP-9 in LC pathogenesis. 184 laryngeal tumor samples along with adjacent uninvolved healthy sections were collected to check the expression deregulation of the above-mentioned gene in LC using real-time PCR and immunohistochemistry (IHC). Real-time PCR and IHC analyses showed the significant upregulation of MMP-2 (P < .0001) and MMP-9 (P < .0001) genes in laryngeal tumors compared to controls. Spearman correlation showed the positive correlation of expression deregulation of selected MMPs with advanced TNM stage [MMP-2, (P < .0001); MMP-9, P < .0001] and smoking status [MMP-2 (P < .0001); MMP-9 P < .0001] in laryngeal pathogenesis. Receiver operating curve (ROC) analysis showed the good diagnostic/prognostic value of said markers in laryngeal cancer patients. The present study showed that significant upregulation of selected MMPs was found associated with an increased risk of laryngeal cancer and can act as good diagnostic markers for the detection of said disease.
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  • 文章类型: Journal Article
    如今,qPCR在肠道微孢子虫病诊断中的应用越来越多。关于qPCR性能的评价有几项研究,但很少关注DNA提取前的粪便预处理步骤,然而,这是关键的一步。本研究着重于粪便的机械预处理,用于肠胞虫孢子DNA提取。首先,进行了一项多中心比较研究,评估了七种提取方法(手动或自动),包括各种机械预处理。其次,几个持续时间和研磨速度和类型的珠进行了测试,以优化机械预处理。各个中心的提取方法具有广泛的性能,尤其是对于微孢子虫负载低的样品。Nuclisens®easyMAG(BioMérieux)和QuickDNA粪便/土壤微生物微制备试剂盒(ZymoResearch)表现出最佳性能(低孢子浓度的最高检测频率和最低Ct值)。通过使用各种材料和尺寸的商业珠子(来自ZymoResearch或MPBiomedicals)在60s内使用TissueLyserII(Qiagen)施加30Hz的速度,可以获得最佳的机械预处理性能。总的来说,粪便样品中所含E.bieneusi孢子的最佳DNA提取方法是使用来自各种材料的小尺寸珠子通过强烈但短的珠子跳动获得的。
    Nowadays, the use of qPCR for the diagnosis of intestinal microsporidiosis is increasing. There are several studies on the evaluation of qPCR performance but very few focus on the stool pretreatment step before DNA extraction, which is nevertheless a crucial step. This study focuses on the mechanical pretreatment of stools for Enterocytozoon bieneusi spores DNA extraction. Firstly, a multicenter comparative study was conducted evaluating seven extraction methods (manual or automated) including various mechanical pretreatment. Secondly, several durations and grinding speeds and types of beads were tested in order to optimize mechanical pretreatment. Extraction methods of the various centers had widely-varying performances especially for samples with low microsporidia loads. Nuclisens® easyMAG (BioMérieux) and Quick DNA Fecal/Soil Microbe Microprep kit (ZymoResearch) presented the best performances (highest frequencies of detection of low spore concentrations and lowest Ct values). Optimal performances of mechanical pretreatment were obtained by applying a speed of 30 Hz during 60 s with the TissueLyser II (Qiagen) using commercial beads of various materials and sizes (from ZymoResearch or MP Biomedicals). Overall, the optimal DNA extraction method for E. bieneusi spores contained in stool samples was obtained with a strong but short bead beating using small-sized beads from various materials.
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  • 文章类型: Journal Article
    下一代风险评估依赖于来自新方法的机械数据,包括转录组数据。各种技术,如高通量靶向测序方法和基于互补探针杂交的微阵列技术,用于确定差异表达基因(DEGs)。整合来自不同技术的数据需要很好地理解使用各种技术所产生的差异。为了更好地了解TempO-Seq平台和Affymetrix芯片技术之间的差异,比较了挥发性化合物二甲胺的全基因组数据.还使用RTqPCR验证来确认所选择的DEGs。尽管TempO-Seq和Affymetrix之间的DEG重叠不高于37%,根据log2fold变化对基因调控进行比较显示出非常高的一致性。RTqPCR证实了所检查的数据集中来自任一平台的大部分DEGs。仅发现少数冲突(11%),而22%的人没有得到证实,3%未检测到。尽管观察到两个平台之间存在差异,两者都可以使用RTqPCR进行验证。在这里,我们强调两个平台之间的一些差异,并讨论它们在毒理学中的应用。
    Next-generation risk assessment relies on mechanistic data from new approach methods, including transcriptome data. Various technologies, such as high-throughput targeted sequencing methods and microarray technologies based on hybridization with complementary probes, are used to determine differentially expressed genes (DEGs). The integration of data from different technologies requires a good understanding of the differences arising from the use of various technologies.To better understand the differences between the TempO-Seq platform and Affymetrix chip technology, whole-genome data for the volatile compound dimethylamine were compared. Selected DEGs were also confirmed using RTqPCR validation. Although the overlap of DEGs between TempO-Seq and Affymetrix was no higher than 37%, a comparison of the gene regulation in terms of log2fold changes revealed a very high concordance. RTqPCR confirmed the majority of DEGs from either platform in the examined dataset. Only a few conflicts were found (11%), while 22% were not confirmed, and 3% were not detected.Despite the observed differences between the two platforms, both can be validated using RTqPCR. Here we highlight some of the differences between the two platforms and discuss their applications in toxicology.
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  • 文章类型: Journal Article
    黄病毒西尼罗河病毒(WNV),它是由蚊子传播的,对人类和动物都构成重大威胁,它的爆发经常挑战欧洲和其他大陆的公共卫生。近年来,在几个欧洲国家,WNV的发病率有增加的趋势.然而,是否存在全年循环或季节性引入尚待阐明。实时聚合酶链反应(PCR)在2022年冬季检查的146个池中的6个池中鉴定出WNV阳性淡色库蚊,对应于24个研究区域中的3个。位于阿提卡的两个沿海地区,希腊。同一地区六个阳性池的空间分散表明,2022年冬季WNV的聚集循环。这是第一个记录Cx中WNV鉴定的研究。Pipiens种群,在冬季捕获在成人陷阱。我们的发现强调了将昆虫学监测计划扩展到包括冬季的必要性,特别是在温带气候和受WNV历史影响的地区。
    The flavivirus West Nile Virus (WNV), which is transmitted by mosquitoes, poses a significant threat to both humans and animals, and its outbreaks often challenge public health in Europe and other continents. In recent years, there is an increasing trend of WNV incidence rates across several European countries. However, whether there is a year-round circulation or seasonal introduction has yet to be elucidated. Real-time polymerase chain reaction (PCR) identified WNV-positive Culex pipiens mosquitos in 6 out of 146 pools examined in winter 2022 that correspond to three out of the 24 study areas, located in two coastal regions units in Attica, Greece. Spatial dispersion of the six positive pools in the same region suggests a clustered circulation of WNV during the winter of 2022. This is the first study that documents the identification of WNV in Cx. pipiens populations, captured in adult traps during winter period. Our findings underscore the need to extend entomological surveillance programs to include the winter period, specifically in temperate climates and historically affected areas by WNV.
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  • 文章类型: Journal Article
    目的:巴尔通体是新兴的细菌人畜共患病病原菌。利用凝结的血液样本来监测野生动物中的这些细菌已经开始取代组织的使用;然而,这些样品的功效尚未得到充分研究。我们的目的是比较脾脏和血液样品在DNA提取和直接检测Bartonellaspp中的功效。通过qPCR。此外,我们提出了一种改进的从凝块中提取DNA的方案,粒化(即,离心)从野生小型哺乳动物中获得的血液样品。
    结果:试剂盒提取的血凝块样品中的DNA浓度较低,A260/A280吸光度比表明杂质较高。基于试剂盒的脾脏样品的DNA提取是有效的,并且产生了高质量的大量DNA浓度。我们开发了一种内部提取血凝块的方法,与通过MagMAXDNAUltra2.0试剂盒提取的脾脏样品相比,该方法可获得适当的DNA质量。我们使用PCR在9/30(30.0%)试剂盒提取的脾脏DNA样品和11/30(36.7%)内部提取的血凝块样品中检测到巴尔通体。我们的结果表明,基于试剂盒的方法可能不太适合从血凝块中提取DNA,并且血凝块样本可能优于检测巴尔通体的组织。
    OBJECTIVE: Bartonella are emerging bacterial zoonotic pathogens. Utilization of clotted blood samples for surveillance of these bacteria in wildlife has begun to supersede the use of tissues; however, the efficacy of these samples has not been fully investigated. Our objective was to compare the efficacy of spleen and blood samples for DNA extraction and direct detection of Bartonella spp. via qPCR. In addition, we present a protocol for improved DNA extraction from clotted, pelleted (i.e., centrifuged) blood samples obtained from wild small mammals.
    RESULTS: DNA concentrations from kit-extracted blood clot samples were low and A260/A280 absorbance ratios indicated high impurity. Kit-based DNA extraction of spleen samples was efficient and produced ample DNA concentrations of good quality. We developed an in-house extraction method for the blood clots which resulted in apposite DNA quality when compared to spleen samples extracted via MagMAX DNA Ultra 2.0 kit. We detected Bartonella in 9/30 (30.0%) kit-extracted spleen DNA samples and 11/30 (36.7%) in-house-extracted blood clot samples using PCR. Our results suggest that kit-based methods may be less suitable for DNA extraction from blood clots, and that blood clot samples may be superior to tissues for Bartonella detection.
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  • 文章类型: Journal Article
    Objective: To assess the capability of seven reference medical laboratories to detect BCR::ABL1 p210 transcription levels and to compare the results among those laboratories. Methods: The interlaboratory comparison was carried out in two stages. The samples were prepared by the reference laboratory. The quantitative values of BCR::ABL1 p210 of the comparison samples covered 0.001%-0.01%, 0.01%-0.1%, 0.1%-1%, 1%-10% and>10% in each stage. Real-time quantitative PCR (RT-PCR) and dPCR (digital PCR) were used to examine the samples. The conversion factor (CF) was calculated and validated for each laboratory. Results: In the RT-PCR comparison, one laboratory was failed to detect BCR::ABL1 p210 in fourteen samples at the first stage. The results of the other six laboratories were qualified with the bias <±1.2 folds (-0.133-0.338) and 95% limits of agreement within ±5 folds (upper limit 0.147-0.785, lower limit -0.770--0.109), and the corresponding CF values were calculated and validated. In the dPCR comparison, one laboratory did not report results at the second stage. The results of the other six laboratories were qualified with the bias <±1.2 folds (-0.026-0.267) and 95% limits of agreement within±5 folds (upper limit 0.084-0.991, lower limit -0.669--0.135), and the corresponding CF values were calculated and validated. The samples with BCR::ABL1 p210 quantitative values of 0.01%-0.1%, 0.1%-1%, 1%-10% and >10% could be detected by both RT-PCR and qPCR. When the quantitative value of BCR::ABL1 p210 was 0.001%-0.01%, the detection rate of dPCR was higher than that of RT-PCR (85.56% vs. 68.00%). Conclusions: A good consistency is present among various laboratories. The quantitative value of BCR::ABL1 p210 is comparable among laboratories as shown by the CF value conversion. For quantitative detection of BCR::ABL1 p210 deep molecular reaction, dPCR has a higher positive detection rate and more advantages than RT-PCR. To ensure the accuracy and reproducibility of the BCR::ABL1 p210 test, it is imperative for every laboratory to enhance their daily quality control practices.
    目的: 评估7家独立医学实验室BCR::ABL1 p210转录水平定量检测能力及实验室之间结果的可比性。 方法: 比对分两个阶段完成,由参考实验室制备比对样本,每个阶段比对样本的BCR::ABL1 p210定量值均覆盖0.001%~0.01%、0.01%~0.1%、0.1%~1%、1%~10%及>10%。各比对实验室分别采用即时荧光定量PCR法(real-time quantitative PCR,RT-PCR)和数字PCR法(digital PCR,dPCR)进行比对样本的检测,计算并确认各比对实验室转换因子(conversion factor,CF)。 结果: (1)RT-PCR比对中,1家实验室第一阶段14例样本未检出,其余6家实验室比对结果合格,偏倚<±1.2倍(-0.133~0.338),95%一致性界限<±5倍(上限0.147~0.785,下限-0.770~-0.109),计算并确认CF值;(2)dPCR比对中,1家实验室第二阶段未回报结果,其余6家实验室比对结果合格,偏倚<±1.2倍(-0.026~0.267),95%一致性界限<±5倍(上限0.084~0.991,下限-0.669~-0.135),计算并确认CF值;(3)BCR::ABL1 p210定量值为0.01%~0.1%、0.1%~1%、1%~10%及>10%时,RT-PCR和dPCR均能全部检出;BCR::ABL1 p210定量值为0.001%~0.01%时,dPCR检出率高于RT-PCR法(85.56%比68.00%)。 结论: 各比对实验室结果呈较好一致性,各实验室间BCR::ABL1 p210定量检测通过CF值换算具备可比性;BCR::ABL1 p210深度分子反应定量检测中,dPCR法阳性检出率更高,更有优势;为保证检测结果的准确性和稳定性,各实验室应加强日常质控工作。.
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  • 文章类型: Journal Article
    背景:据报道,印度不同州有几例寨卡病毒病的散发性病例和暴发。
    目的:本文探讨了寨卡病毒(ZIKV)在印度中部博帕尔地区持续传播的可能性,这种疾病的最后一次爆发是在2018年。
    方法:我们筛选了一组75例发热患者,这些患者的局部地方性发热原因如登革热检测呈阴性,基孔肯雅,肠热,疟疾,斑疹伤寒和两组无症状健康个体,以献血者(n=75)和产前母亲(n=75)为代表。我们使用实时聚合酶链反应(PCR)测试了发热患者的血液样本中的ZIKVRNA,对于健康的人来说,我们使用酶联免疫吸附试验测定了抗寨卡免疫球蛋白G(IgG)抗体。
    结果:在通过实时PCR测定法测试的75个样品中的任何一个中均未检测到ZIKVRNA。在自愿献血者和产前母亲中,共发现10例(15.38%)和5例(6.66%)抗ZIKVIgG抗体血清阳性,分别。与血清阴性个体26.60(±5.12)岁相比,血清阳性组的年龄更高33.06(±10.83)岁(P=0.037)。
    结论:这项研究,这是印度抗寨卡抗体血清阳性率的首次调查,报告健康人群中抗寨卡抗体的总血清阳性率为10%,暗示一个正在进行的,低水平,ZIKV在当地社区的无声传播。
    BACKGROUND: Several sporadic cases and outbreaks of Zika virus disease have been reported from different states of India.
    OBJECTIVE: This paper explored the possibility of any ongoing transmission of Zika virus (ZIKV) in the Bhopal region of Central India, where the last outbreak of this disease was reported in 2018.
    METHODS: We screened a group of 75 febrile patients who had already tested negative for the locally endemic causes of fever like dengue, chikungunya, enteric fever, malaria, and scrub typhus and two groups of asymptomatic healthy individuals represented by blood donors (n = 75) and antenatal mothers (n = 75). We tested blood samples of febrile patients for ZIKV RNA using real-time polymerase chain reaction (PCR), and for the healthy individuals, we determined anti-zika immunoglobulin G (IgG) antibodies using enzyme-linked immunosorbent assay.
    RESULTS: ZIKV RNA was not detected in any of the 75 samples tested by real-time PCR assay. Among the voluntary blood donors and antenatal mothers, a total of 10 (15.38%) and 5 (6.66%) individuals were found to be seropositive for anti-ZIKV IgG antibodies, respectively. The seropositive group was found to have higher age 33.06 (±10.83) years as compared to seronegative individuals 26.60 (±5.12) years (P = 0.037).
    CONCLUSIONS: This study, which is the first survey of seroprevalence of anti-Zika antibodies from India, reports an overall seropositivity rate of 10% for anti-Zika antibodies among the healthy population, suggesting an ongoing, low level, silent transmission of ZIKV in the local community.
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  • DOI:
    文章类型: Journal Article
    由于缺乏有效的疫苗,目前非洲猪瘟病毒(ASFV)的控制措施和根除策略依赖于早期发现和严格的淘汰程序。在本研究中,我们开发了两个独立的等温扩增试验,即,环介导等温扩增(LAMP)和聚合酶螺旋反应(PSR),用于临床样品中ASFV基因组的快速可视化。此外,开发了基于实时定量PCR(qRT-PCR)的水解探针测定法,用于与开发的等温测定法进行灵敏度比较评估。LAMP的分析灵敏度,PSR,和qRT-PCR被发现是2.64×105拷贝/微升,2.64×102拷贝/微升,和2.64×101拷贝/微升,分别。使用开发的视觉测定法测试了总共165个临床样品。相对精度,相对特异性,LAMP与PSR的相对诊断灵敏度分别为95.37%和102.48%,97.46%vs101.36%,73.33%和113.33%,分别。
    Owing to the lack of effective vaccines, current control measures and eradication strategies for the African swine fever virus (ASFV) rely on early detection and stringent stamping-out procedures. In the present study, we developed two independent isothermal amplification assays, namely, loop-mediated isothermal amplification (LAMP) and polymerase spiral reaction (PSR), for quick visualization of the ASFV genome in clinical samples. Additionally, a quantitative real-time PCR (qRT-PCR)-based hydrolysis probe assay was developed for comparative assessment of sensitivity with the developed isothermal assays. The analytical sensitivity of the LAMP, PSR, and qRT-PCR was found to be 2.64 ×105 copies/µL, 2.64 ×102 copies/µL, and 2.64 ×101 copies/µL, respectively. A total of 165 clinical samples was tested using the developed visual assays. The relative accuracy, relative specificity, and relative diagnostic sensitivity for LAMP vs PSR were found to be 95.37% vs 102.48%, 97.46% vs 101.36%, and 73.33% vs 113.33%, respectively.
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  • 文章类型: Journal Article
    目的:幽门螺杆菌的非侵入性检测(H.pylori)及其对克拉霉素和左氧氟沙星的耐药性通过实现量身定制的根除治疗而显着改善了感染患者的管理,而无需内窥镜程序。这项研究旨在评估实时PCR(RT-PCR)检测在粪便和胃活检标本中鉴定幽门螺杆菌感染和抗生素耐药性的有效性。
    方法:在住院后三天内收集患者的粪便和胃活检样本。共分析了115个样本的幽门螺杆菌感染,使用基于RT-PCR的分子测试评估了另外115个样品对克拉霉素和左氧氟沙星的耐药性。使用(SPSS26.0IBMCorp.,Armonk,NY,美国)。
    结果:在115名患者中(53名男性,平均年龄50.8±13.2岁),在93.1%的粪便样本和93.9%的胃活检样本中检测到幽门螺杆菌。RT-PCR检测的灵敏度为99.1%,特异性为100%,总体诊断准确率为99.1%。在37.3%的粪便和46.9%的胃活检标本中发现克拉霉素耐药,分析显示79.6%的灵敏度和98.4%的特异性。在32.1%的粪便样本和31.3%的胃活检样本中发现左氧氟沙星耐药,分子检测的敏感性为86.3%,特异性为91.1%。
    结论:基于RT-PCR检测粪便样本中幽门螺杆菌及其对克拉霉素和左氧氟沙星的耐药性是一种有希望的方法,可以提高根除治疗效果。有可能提高治疗效果。Chictr.org.cn:ChiCTR2300070267。
    OBJECTIVE: The non-invasive detection of Helicobacter pylori (H. pylori) and its resistance to clarithromycin and levofloxacin significantly improves the management of infected patients by enabling tailored eradication treatments without the need for endoscopic procedures. This study aimed to assess the effectiveness of real-time PCR (RT-PCR) assays in identifying H. pylori infection and antibiotic resistance in stool and gastric biopsy specimens.
    METHODS: Stool and gastric biopsy samples were collected from patients within three days of post-hospitalization. A total of 115 samples were analyzed for H. pylori infection, and an additional 115 samples were evaluated for resistance to clarithromycin and levofloxacin using an RT-PCR-based molecular test. Statistical analyses were performed using (SPSS 26.0 IBM Corp., Armonk, NY, USA).
    RESULTS: Among 115 patients (53 males, average age 50.8±13.2 years), H. pylori was detected in 93.1% of stool samples and 93.9% of gastric biopsies. The RT-PCR assay demonstrated a sensitivity of 99.1% and a specificity of 100%, with an overall diagnostic accuracy of 99.1%. Clarithromycin resistance was found in 37.3% of stool and 46.9% of gastric biopsy specimens, with the assay showing 79.6% sensitivity and 98.4% specificity. Levofloxacin resistance was identified in 32.1% of stool samples and 31.3% of gastric biopsies, with 86.3% sensitivity and 91.1% specificity of the molecular test.
    CONCLUSIONS: The RT-PCR-based detection of H. pylori and its resistance to clarithromycin and levofloxacin in stool samples represents a promising approach to enhance eradication therapy outcomes, potentially improving treatment efficacy. Chictr.org.cn: ChiCTR2300070267.
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  • 文章类型: Journal Article
    准确识别骨科感染的病因对于正确及时的临床管理非常重要,但是研究很少。在当前的研究中,我们探索了多种细菌病原体与骨科感染的关联。
    住院的骨科患者在青岛的一家乡村医院登记,中国。收集伤口或渗出物拭子样品,并通过培养和多重实时PCR测试十二种细菌病原体。
    共纳入349例骨科住院患者,其中193例入院时出现感染表现,156例无感染迹象。骨科感染患者主要为男性(72.5%),住院时间较长(中位数为15天)。在42.5%(82/193)的感染患者中至少检测到一种病原体,在没有感染的患者中至少检测到一种病原体(P<0.001)。金黄色葡萄球菌是最常见的病原体(15.5%)。观察到数量依赖性病原体与感染的关联,特别是铜绿假单胞菌和肺炎克雷伯菌,可能提示亚临床感染.大多数检测到病原体的患者都有骨科手术史(比值比2.8,P=0.038)。有病原体特异性临床表现。多重qPCR,因为它的高灵敏度,优越的特异性,强大的定量可以与培养结合使用,以指导抗菌治疗并跟踪治疗期间骨科感染的进展。
    UNASSIGNED: Accurate identification of the etiology of orthopedic infection is very important for correct and timely clinical management, but it has been poorly studied. In the current study we explored the association of multiple bacterial pathogens with orthopedic infection.
    UNASSIGNED: Hospitalized orthopedic patients were enrolled in a rural hospital in Qingdao, China. Wound or exudate swab samples were collected and tested for twelve bacterial pathogens with both culture and multiplex real time PCR.
    UNASSIGNED: A total of 349 hospitalized orthopedic patients were enrolled including 193 cases presenting infection manifestations upon admission and 156 with no sign of infection. Orthopedic infection patients were mainly male (72.5%) with more lengthy hospital stay (median 15 days). At least one pathogen was detected in 42.5% (82/193) of patients with infection while 7.1% (11/156) in the patients without infection (P < 0.001). S. aureus was the most prevalent causative pathogen (15.5%). Quantity dependent pathogen association with infection was observed, particularly for P. aeruginosa and K. pneumoniae, possibly indicating subclinical infection. Most of the patients with detected pathogens had a previous history of orthopedic surgery (odds ratio 2.8, P = 0.038). Pathogen specific clinical manifestations were characterized. Multiplex qPCR, because of its high sensitivity, superior specificity, and powerful quantification could be utilized in combination with culture to guide antimicrobial therapy and track the progression of orthopedic infection during treatment.
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