Prospective clinical evaluation of the accuracy of 16S rRNA real-time PCR assay for the diagnosis of melioidosis

被引:28
作者
Chantratita, Narisara
Wuthiekanun, Vanaporn
Limmathurotsakul, Direk
Thanwisai, Aunchalee
Chantratita, Wasun
Day, Nicholas P. J.
Peacock, Sharon J.
机构
[1] Mahidol Univ, Fac Trop Med, Mahidol Oxford Trop Med Res Unit, Bangkok 10400, Thailand
[2] Mahidol Univ, Ramathibodi Hosp, Fac Med, Dept Pathol, Bangkok 10700, Thailand
[3] Univ Oxford, Nuffield Dept Clin Med, Ctr Clin Vaccinol & Trop Med, Churchill Hosp, Oxford, England
基金
英国惠康基金;
关键词
D O I
10.4269/ajtmh.2007.77.814
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
The accuracy of a Burkholderia pseudomallei 16s rRNA real-time PCR assay was evaluated against culture for the diagnosis of melioidosis in Thailand. A total of 846 samples were obtained from 383 patients with suspected melioidosis. One or more specimens were PCR positive for 47 of 77 patients with culture-proven melioidosis (sensitivity 61.0%, 95% CI: 49.2-72.0%). PCR was negative for all 306 patients who were culture negative for B. pseudomallei (specificity 100%, 95% CI: 98.8-100%). Diagnostic sensitivity of PCR was 22.7% for patients who were culture positive for blood only, compared with 79.4% for patients who were culture positive for samples other than blood. The median (interquartile range) B. pseudomallei colony count in blood for 44 of 77 patients with positive blood cultures was 2.4 CFU/ml (0.2-13.5 CFU/ml); this may explain the low sensitivity of PCR for this specimen. The PCR assay described here is not sufficiently sensitive to replace culture in our clinical setting.
引用
收藏
页码:814 / 817
页数:4
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