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目的 寻找快速筛选及鉴别细菌性和非细菌性脑膜炎的方法。方法 二步 PCR法 ,第一步检测真细菌 ,所用引物 U3- r U8,区分细菌性和非细菌性 ;第二步检测目的菌 ,引物为 r U 8- NM,r U8- HI,r U8- STIEP,TB1-TB2 ,区分化脓性和结核性。应用此法检测临床脑膜炎 CSF标本总共 113例 ,对照组 6 6例。结果 第一步真细菌引物特异性试验阳性模板均为阳性结果 ,第一步各菌引物对应目的菌阳性 ,其余阴性。PCR灵敏度各菌最低检测浓度为 2 0 CFU /m l。临床检测 1周内特异性为 10 0 % ,敏感性为 93.75 % ,准确性为 98.32 %。 1周后临床检测特异性为10 0 % ,敏感性为 86 .5 7% ;准确性为 94.6 7%。结论 1周内早期诊断敏感性和准确性更高。联合检测法为脑膜炎早期快速筛选鉴别的有效方法。
Objective To search for a rapid screening and identification of bacterial and non-bacterial meningitis. Methods Two-step PCR was used to detect the eubacteria in the first step. The primers U3-U8 were used to distinguish the bacteria from the non-bacteria. The second step was to detect the target bacteria. The primers were rU8-NM, rU8-HI and rU8 - STIEP, TB1-TB2, distinguishing purulent and tuberculous. A total of 113 cases of clinical meningitis CSF specimens were detected by this method and 66 cases of control group. Results In the first step, the positive template of the eukaryotic primer-specific test was positive. In the first step, the primers of each bacterial strain were positive for the target bacteria and the rest were negative. PCR sensitivity The minimum detectable concentration of each bacteria is 20 CFU / ml. The specificity of clinical examination for one week was 100%, the sensitivity was 93.75% and the accuracy was 98.32%. After 1 week, the specificity of clinical test was 100%, the sensitivity was 86.57% and the accuracy was 94.6%. Conclusion Early diagnosis within 1 week has higher sensitivity and accuracy. Joint detection method for the rapid screening of meningitis early identification of effective methods.