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首页> 外文期刊>Journal of Clinical Microbiology >Feasibility of a Molecular Screening Method for Detection of Salmonella enterica and Campylobacter jejuni in a Routine Community-Based Clinical Microbiology Laboratory
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Feasibility of a Molecular Screening Method for Detection of Salmonella enterica and Campylobacter jejuni in a Routine Community-Based Clinical Microbiology Laboratory

机译：基于常规社区临床微生物学实验室检测肠炎沙门氏菌和空肠弯曲菌的分子筛查方法的可行性

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Conventional diagnostic methods for the detection of Salmonella enterica and Campylobacter jejuni are laborious and time-consuming procedures, resulting in final results, for the majority of specimens, only after 3 to 4 days. Molecular detection can improve the time to reporting of the final results from several days to the next day. However, molecular assays for the detection of gastrointestinal pathogens directly from stool specimens have not made it into the routine clinical microbiology laboratory. In this study we have assessed the feasibility of a real-time PCR-based molecular screening method (MSM), aimed at S. enterica and C. jejuni, in the daily practice of a routine clinical microbiology laboratory. We have prospectively analyzed 2,067 stool specimens submitted for routine detection of gastrointestinal bacterial pathogens over a 7-month period. The MSM showed 98 to 100% sensitivity but routine culture showed only 77.8 to 86.8% sensitivity when an extended “gold standard” that included all culture-positive and all MSM-positive specimens, as confirmed by an independent secondary PCR of a different target gene, was used. An overall improvement in the rate of detection of both pathogens of 15 to 18% was observed. Both approaches performed nearly identically with regard to the specificity, positive predictive value, and negative predictive value, with the values for MSM being 99.7%, 93.1 to 96.6%, and 99.8 to 100%, respectively, and those for routine culture being 100%, 100%, and 97.6 to 99.5%, respectively. Finally, the final results were reported between 3 and 4 days earlier for negative specimens compared to the time of reporting of the results of routine culture. Positive specimens, on the other hand, required an additional 2 days to obtain a final result compared to the time required for routine culture, although preliminary MSM PCR-positive results were reported, on average, 2.9 to 3.8 days before the final routine culture results were reported. In conclusion, MSM can be incorporated into the daily practice of a routine clinical microbiology laboratory with ease. Furthermore, it provides an improvement in the screening for S. enterica and C. jejuni and substantially improves the time to the reporting of negative results.
机译：检测肠炎沙门氏菌和空肠弯曲杆菌的常规诊断方法既费力又费时，只能在3至4次后才能对大多数标本产生最终结果。天。分子检测可以缩短从几天到第二天报告最终结果的时间。然而，直接从粪便标本中检测胃肠道病原体的分子分析尚未将其纳入常规临床微生物学实验室。在这项研究中，我们评估了针对 S的基于实时PCR的分子筛查方法（MSM）的可行性。 enterica 和 C。空肠，在常规临床微生物学实验室的日常操作中。我们对7个月内常规检测胃肠道细菌病原体的2067个粪便标本进行了前瞻性分析。 MSM显示98至100％的敏感性，但是常规的培养物在扩展的“金标准”中仅显示77.8至86.8％的敏感性，其中包括所有培养阳性和所有MSM阳性标本，通过不同靶基因的独立二次PCR证实，已被使用。两种病原体的检出率总体提高了15％至18％。两种方法在特异性，阳性预测值和阴性预测值方面的表现几乎相同，MSM的值分别为99.7％，93.1至96.6％和99.8至100％，常规培养的值为100％ ，100％和97.6至99.5％。最后，与报告常规培养结果的时间相比，阴性样品的最终结果要早3-4天报告。另一方面，阳性标本与常规培养相比需要额外的2天才能获得最终结果，尽管据报道初步MSM PCR阳性结果平均要比常规培养前晚2.9至3.8天被报道。总之，MSM可以轻松地纳入常规临床微生物学实验室的日常操作中。此外，它提供了对 S的筛选的改进。 enterica 和 C。 jejuni 并大大缩短了报告负面结果的时间。

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