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首页> 外文期刊>Neurosurgery >Diagnosis of ventricular drainage-related bacterial meningitis by broad-range real-time polymerase chain reaction.
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Diagnosis of ventricular drainage-related bacterial meningitis by broad-range real-time polymerase chain reaction.

机译：广泛实时聚合酶链反应诊断室引流相关细菌性脑膜炎。

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OBJECTIVE: To compare a broad-range real-time polymerase chain reaction (PCR) diagnostic strategy with culture to evaluate additional effects on the etiological diagnosis and the quantification of the bacterial load during the course of ventricular drainage-related bacterial meningitis (VR-BM). METHODS: We applied a PCR that targeted conserved regions of the 16S ribosomal ribonucleic acid gene to cerebrospinal fluid (CSF) samples from patients with external ventricular drainage or a ventriculoperitoneal shunt during the course of VR-BM. We compared the PCR results with CSF cultures. A total of 350 routine CSF samples were consecutively collected from 86 patients. The CSF deoxyribonucleic acid was automatically purified and subjected to PCR. Amplicons from the PCR samples that were positive for VR-BM were subsequently deoxyribonucleic acid sequenced for final identification. Clinical data were extracted from patient files. RESULTS: Sixteen patients had at least one VR-BM-positive sample as diagnosed from culture or PCR. Nineteen episodes were diagnosed with signs of VR-BM (n = 16 patients) or were determined to be contaminated (n = 3 patients). Four episodes of VR-BM were diagnosed via PCR alone and were predominantly caused by gram-negative pathogens, five episodes were diagnosed via culture alone, and seven episodes were diagnosed via both culture and PCR. Five patients had mixed infections. Overall, 71 samples were positive for VR-BM as indicated by either one or both of the methods. Eighteen CSF samples were VR-BM positive as indicated by culture alone, and 21 CSF samples were positive as indicated via PCR alone. CONCLUSIONS: Culture supplemented with broad-range, real-time PCR may increase the number of etiologically diagnosed VR-BM episodes, particularly when these are caused by gram-negative bacteria.
机译：目的：将广泛的实时聚合酶链反应（PCR）诊断策略与培养进行比较，以评估在心室引流相关细菌性脑膜炎（VR-BM）过程中对病因学诊断和细菌载量量化的其他影响）。方法：我们应用了一种PCR，将16S核糖体核糖核酸基因的保守区域靶向于VR-BM过程中外部脑室引流或脑室-腹膜分流患者的脑脊液（CSF）样品。我们将PCR结果与CSF培养物进行了比较。从86例患者中连续收集了350例常规CSF样本。自动纯化CSF脱氧核糖核酸并进行PCR。随后对PCR样品中VR-BM呈阳性的扩增子进行脱氧核糖核酸测序，以进行最终鉴定。从患者档案中提取临床数据。结果：根据培养或PCR诊断，有16例患者至少有1例VR-BM阳性样品。被诊断为VR-BM体征的19例发作（n = 16例患者）或被确定为受污染（n = 3例）。仅通过PCR诊断出4例VR-BM，主要由革兰氏阴性病原体引起，仅通过培养诊断出5例，通过培养和PCR诊断出7例。五例患者混合感染。总体而言，一种或两种方法均显示71份VR-BM阳性。如单独通过培养表明，有18个CSF样品为VR-BM阳性，单独通过PCR表明为21个CSF样品为阳性。结论：补充有广泛实时荧光定量PCR的培养物可能会增加病因诊断出的VR-BM发作的数量，尤其是当这些是由革兰氏阴性细菌引起的时候。

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