16SrRNA 基因检测在儿童细菌性脑膜炎早期诊断中的应用.

Objective　To explore the value of 16SrRNA gene detection in cerebrospinal fluid （CSF） in the early diagnosis of bacterial meningitis （BM） in children. Methods　CSF specimens were collected from 40 patients with BM who were diagnosed of BM in Kunming Children’s Hospital between January 2019 and June 2020. PCR was used to detect the 16SrRNA gene in the specimens. Then the 16SrRNA gene was sequenced for the positive samples by PCR， and the sequencing results sequence alignment and homology were analyzed by NCBI BLAST. At the same time， all the specimens were cultured simultaneously. Results　Of the 40 children’s CSF samples， 16 were positive for 16SrRNA gene PCR， with a positive rate of 40%; 7 cases were positive for bacterial culture， with a positive rate of 17.5%. The positive rate of PCR method was higher than that of the bacterial culture method （χ2 = 4.93，P < 0.05），with CSF as the “gold standard”， the sensitivity and specificity of PCR assay were 71.4% （5/7） and 66.7% （22/33）；the results of 16SrRNA gene sequencing were consistent with the results of CSF culture， and five bacterias which were not detected by CSF culture; the time of CSF culture was （61.21±12.62） h， however， the PCR detection time required （7.09±0.45） h， and the difference of detection time between the two methods was statistically significant （P < 0.05）. Conclusion　The PCR detection method of 16SrRNA gene in CSF can improve the detection rate of CSF pathogenic bacteria in BM patients， and it can reduce the missed detection rate. It has the specific and rapid characteristics and can provide the reliable pathogenic basis for early diagnosis of clinical BM in time. [ABSTRACT FROM AUTHOR]