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首页> 外文期刊>Archives of disease in childhood >Improved case confirmation in meningococcal disease with whole blood Taqman PCR.
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Improved case confirmation in meningococcal disease with whole blood Taqman PCR.

机译：使用全血Taqman PCR改善脑膜炎球菌疾病的病例确认。

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BACKGROUND: The clinical diagnosis of meningococcal disease (MCD) can be difficult. Non-culture methods like the previous ELISA meningococcal PCR improved case confirmation rates, but were not ideal. A Taqman meningococcal PCR, using DNA extracted from serum (S-Taqman), which has an improved sensitivity compared to the ELISA method in vitro, was introduced into clinical practice in July 1997. A new whole blood DNA extraction method for Taqman (WB-Taqman) was introduced in September 1999. AIMS: To determine the degree of improvement in the confirmation rate in clinically diagnosed MCD, following the introduction of WB-Taqman. METHODS: A total of 192 patients (WB-Taqman) with possible or probable MCD, including those admitted to our paediatric intensive care unit, were studied. Admission EDTA samples obtained were sent for bacterial DNA detection at the Meningococcal Reference Unit (MRU), Manchester. These patients were compared to 319 patients with possible and probable MCD, seen at the same hospital prior to the introduction of WB-Taqman. RESULTS: Following the introduction of WB-Taqman, 82 of the 95 probable cases (88%) had a positive meningococcal PCR result. This gives a diagnostic sensitivity and specificity for WB-Taqman of 87% and 100% respectively. Following WB-Taqman all blood culture positive patients were also PCR positive. Confirmation of cases by PCR rose from 47% (S-Taqman, n = 166) to 88% (WB-Taqman). When all confirmatory tests were included, case confirmation increased from 72% (S-Taqman) to 94% (WB-Taqman). CONCLUSION: The sensitivity of PCR in confirming clinical MCD has improved significantly with this new method. The gold standard for confirming cases of MCD is now the WB-Taqman PCR.
机译：背景：脑膜炎球菌病（MCD）的临床诊断可能很困难。像以前的ELISA脑膜炎球菌PCR这样的非培养方法可以提高病例确认率，但并不理想。 1997年7月，采用从血清中提取的DNA（S-Taqman）进行了Taqman脑膜炎球菌PCR，与体外ELISA方法相比，该方法具有更高的敏感性。Taqman的全血DNA提取新方法（WB- Taqman）于1999年9月推出。目的：在引入WB-Taqman之后，确定临床诊断的MCD确证率的改善程度。方法：共研究了192例可能或可能患有MCD的患者（WB-Taqman），包括入院小儿重症监护室的患者。将获得的入院EDTA样品送至曼彻斯特的脑膜炎球菌参考单位（MRU）进行细菌DNA检测。在引入WB-Taqman之前，在同一家医院将这些患者与319例可能的MCD患者进行了比较。结果：引入WB-Taqman后，在95例可能的病例中有82例（88％）的脑膜炎球菌PCR结果为阳性。 WB-Taqman的诊断灵敏度和特异性分别为87％和100％。 WB-Taqman之后，所有血培养阳性患者也均为PCR阳性。 PCR确诊病例从47％（S-Taqman，n = 166）上升到88％（WB-Taqman）。当包括所有确认性测试后，病例确诊率从72％（S-Taqman）增加到94％（WB-Taqman）。结论：采用这种新方法，PCR在确认临床MCD中的敏感性大大提高。现在，确定MCD病例的金标准是WB-Taqman PCR。

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