环介导等温扩增技术在重症社区获得性肺炎病原学诊断中的临床意义研究-内科学（呼吸内科）专业论文.docxVIP

AbstractABSTRACT Abstract ABSTRACT Background： There was lower positive rate of pahogens causing severe community acquired pneumonia(sCAP)，according to autopsies researches．Owing to a lack of valuable tools for detecting pathogens，a number of patients with sCAP had not received properly targeted therapy．LAMP is a recemly developed nucleic acid amplification technique．The unique advantage of LAMP is not only the straightforward operation， low requirements for needing equipment，but also the shortness reaction time．LAMP is suitable for the early detection of common pathogens． objeetive： To verify the Effectiveness and feasibility of LAMP for detecting common pathogens． Method： The target patients were confirmed sCAR Sputum or bronchus—alveolar lavage fluid was collected at the first day．LAMP and sputum culture were performed to detect 1 2 kinds of common pathogens．We calculated the sensitivity,specificity and accuracy of LAMP for diagnosis common pathogens causing sCAP，as sputum culture served as a standard test method． Result： In 79 patients，28 cases(3 5．44％)were positive by the standard test．When we took 2．95 as the cut—off point，the AUC was up to 0．871(95％C1 0．777．0．936， PO．05)；the sensitivity,specificity and their 95％C1 were 96．4％(8 1．7．99．9、and 68．63％(54．1 1—80．89)．The performance of LAMP was as follows：agreement 79．1％；sensitivity 96．4％；specificity 68．6％；positive-predictive value 80．O％： negative-predictive value 98．O％．The average DNA concentration(1910 copies／ml、 was(4．3+0．9)in the 28 positive cases，while the number Was(2．5+1．6)in t11e 5 1 negative cases(PO．05)．The most common detected pathogens by LAMP were Pseudomonas aeruginosa，methicillin—resistant Staph)rlococcus aureus，Klebsiella pneumoniae，Acinetobacter baumannii and maltophilia Aeromonas．The Spearman 万方数据 Abstractcorrelation Abstract correlation coefficient among DNA concentration．PCT and WBC were O．73(95％CI O．60一O．82．P0．05)、0．42(95％C1 0．21一O．59．P0．05)． Conelusion： 1．LAMP can be used as a mean of detectin