真菌荧光染色联合呼吸道标本培养与鉴定和血清1,3-β-D葡聚糖检测诊断侵袭性肺部真菌感染的应用价值

doi:10.19871/j.cnki.xfcrbzz.2021.04.011

新发传染病电子杂志 ›› 2021, Vol. 6 ›› Issue (4): 315-318.doi: 10.19871/j.cnki.xfcrbzz.2021.04.011

真菌荧光染色联合呼吸道标本培养与鉴定和血清1,3-β-D葡聚糖检测诊断侵袭性肺部真菌感染的应用价值

邹芳^1,2,3, 刘子杰^1,2,3, 张慧^1,2,3, 钟敏^1,2,3

1.昆明医科大学第一附属医院检验科,昆明 650032;
2.云南省检验医学重点实验室,昆明 650032;
3.云南省医学检验临床医学研究中心,昆明 650032

收稿日期:2021-08-19 出版日期:2021-11-30 发布日期:2021-12-13
通讯作者: 钟敏,Email：zhongm111@126.com
基金资助:
云南省“高层次人才培养支持计划”青年拔尖人才（RLQB20200007）

Application value of fungal fluorescence staining combined with respiratory tract specimen culture and identification and serum 1, 3-β-D-glucan detection in the diagnosis of invasive pulmonary fungal infections

Zou Fang^1,2,3, Liu Zijie^1,2,3, Zhang Hui^1,2,3, Zhong Min^1,2,3

1. Department of Clinical Laboratory, the First Affiliated Hospital of Kunming Medical University, Kunming 650032,China;
2. Yunnan Key Laboratory of Laboratory Medicine, Kunming 650032, China;
3. Yunnan Province Clinical Research Center for Laboratory Medicine, Kunming 650032, China

Received:2021-08-19 Online:2021-11-30 Published:2021-12-13

摘要/Abstract

摘要： 目的评估实验室常用三种真菌检测方法对侵袭性肺部真菌感染（IPFI）的诊断效能,为IPFI的诊疗提供依据。方法回顾性分析2020年1月至2020年12月昆明医科大学第一附属医院呼吸内科收治的具有高危IPFI因素的住院患者301例,其中临床出院诊断为侵袭性肺部真菌感染患者83例作为观察组,肺部细菌感染患者218例作为对照组,分别进行真菌荧光染色、血清1,3-β-D葡聚糖、呼吸道标本培养与鉴定联合检测,评估联合三种检测方法对IPFI的诊断效能。结果真菌荧光染色检测、血清1,3-β-D葡聚糖、呼吸道标本培养与鉴定检测对IPFI的检出率分别为36.9%（111/301）、9.6%（29/301）、18.6%（56/301）。在观察组中三种方法的阳性率分别为80.7%（67/83）,15.7%（13/83）,45.8%（38/83）,高于对照组的20.1%（44/218）,7.3%（16/218）,8.3%（18/218）,差异均有统计学意义（P<0.05）。真菌荧光染色检测灵敏度、特异度、曲线下面积（AUC）分别为80.7%、79.8%、0.803;血清1,3-β-D葡聚糖检测分别为15.7%、92.7%、0.542;呼吸道标本培养与鉴定检测分别为45.8%、91.7%、0.688;三项指标联合检测分别为86.7%、77.5%、0.855,优于任何一类单项检测效能。结论真菌荧光染色法在IPFI检测中更具优势,是一种快速可靠,敏感性高的IPFI的诊断方法;但三项指标联合检测对诊断IPFI的应用价值更显著,可以提高诊断效率。

关键词: 真菌荧光染色检测, 血清1,3-β-D葡聚糖, 呼吸道标本培养与鉴定, 侵袭性肺部真菌感染

Abstract: Objective To evaluate the diagnostic performance of three common laboratory fungal detection methods for invasive pulmonary fungal infections (IPFI),in order to provide a basis for the diagnosis and treatment of IPFI. Methods A retrospective analysis was performed on 301 inpatients with high-risk IPFI who were admitted to the Department of Respiratory Medicine of The First Affiliated Hospital of Kunming Medical University from January 2020 to December 2020. Including 83 cases in the observation group and 218 cases in the control group. Fungal fluorescent dye,serum1,3-β-D-glucan, respiratory specimens culture and identification were performed respectively. To evaluate the diagnosis efficacy of the three detection methods for IPFI. Results The detection rates of IPFI were 36.9%（111/301）、9.6%（29/301）、18.6%（56/301）by fungal fluorescence staining, serum 1,3-β-D-glucan and respiratory specimen culture and identification, respectively. The positive rates of the three methods in the observation group were 80.7%（67/83）、15.7%（13/83）、45.8%（38/83）, respectively, which were higher than those in the control group 20.1%（44/218）、7.3%（16/218）、8.3%（18/218）,the differences were statistically significant (P<0.05). The sensitivity、specificity and AUC of fungal fluorescence staining were 80.7%、79.8%、0.803, respectively. serum1,3-β-D glucan levels were 15.7%、92.7%、0.542, respectively. Respiratory specimen culture and identification were 45.8%、91.7%、0.688, respectively. The combined detection of the three indexes were 86.7%、77.5%、0.855, respectively, which was better than any single detection efficiency. Conclusion Fungal fluorescence staining has more advantages in IPFI detection, which is a fast, reliable and sensitive diagnosis method of IPFI, However, the combined detection of the three indicators has more significant application value in diagnosing IPFI, which can improve the diagnosis efficiency and worth of clinical promotion.

Key words: Fungal fluorescence staining, Serum1,3-β-D-glucan, Culture and identification of respiratory specimens, Invasive pulmonary fungal infection

邹芳, 刘子杰, 张慧, 钟敏. 真菌荧光染色联合呼吸道标本培养与鉴定和血清1,3-β-D葡聚糖检测诊断侵袭性肺部真菌感染的应用价值[J]. 新发传染病电子杂志, 2021, 6(4): 315-318.

Zou Fang, Liu Zijie, Zhang Hui, Zhong Min. Application value of fungal fluorescence staining combined with respiratory tract specimen culture and identification and serum 1, 3-β-D-glucan detection in the diagnosis of invasive pulmonary fungal infections[J]. Electronic Journal of Emerging Infectious Diseases, 2021, 6(4): 315-318.

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真菌荧光染色联合呼吸道标本培养与鉴定和血清1,3-β-D葡聚糖检测诊断侵袭性肺部真菌感染的应用价值

Application value of fungal fluorescence staining combined with respiratory tract specimen culture and identification and serum 1, 3-β-D-glucan detection in the diagnosis of invasive pulmonary fungal infections

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