[1]娄鉴芳,梅亚宁,张世昌,等.不同实验室环境下ELISA法检测血清GM结果的可靠性研究[J].现代检验医学杂志,2019,34(01):101-103.[doi:10.3969/j.issn.1671-7414.2019.01.026]
 LOU Jian-fang,MEI Ya-ning,ZHANG Shi-chang,et al.Reliability Study on Serum GM Results by ELISA Method in Different Laboratory Conditions[J].Journal of Modern Laboratory Medicine,2019,34(01):101-103.[doi:10.3969/j.issn.1671-7414.2019.01.026]
点击复制

不同实验室环境下ELISA法检测血清GM结果的可靠性研究()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第34卷
期数:
2019年01期
页码:
101-103
栏目:
论著
出版日期:
2019-02-28

文章信息/Info

Title:
Reliability Study on Serum GM Results by ELISA Method in Different Laboratory Conditions
文章编号:
1671-7414(2019) 01-101-03
作者:
娄鉴芳梅亚宁张世昌徐华国王加
(南京医 科大学第一附属医院检验学部,南京210029)
Author(s):
LOU Jian-fangMEI Ya-ningZHANG Shi-changXU Hua -guoWANG Jia
(Department of Clinical Laboratory,the First Affiliated Hospital of Nanjing Medical University,N anjing 21002 9,China)
关键词:
半乳甘露聚糖假阳性空气培养
分类号:
R446.61
DOI:
10.3969/j.issn.1671-7414.2019.01.026
文献标志码:
A
摘要:
目的探讨半乳甘露聚糖(galactomannan,GM)检测的实验 室环境影响因素以及如何降低假阳性,提高检测的准确性。方法选 择2016年6月~2017年4月在南京医科大学第一附属医院初诊为疑似侵袭性真菌病的住院患者 为研究对象,在不同的实验室环境下进行ELISA法检测血清GM。在一般环境下检测3 407例 样本,进行随机空气培养,观察培养结果并鉴定出菌落种类,并以培养菌落制备混悬液进行 处理取上清进行GM检测。在严格控制环境下检测1 167例样本,并进行两组之间的比较。〖 HT5结果在一般环境下检测的真阳性率为3.38%,敏感度为63.0%(34/ 54),特异度为40.9%(56/137),阳性预测值(positive predictive value,PPV)为29.6 %;在严格控制环境下真阳性率为3.94%,敏感度和特异度分别为79.4%(27/34)和34.5 %(10/29),PPV为58.7%(27/46)。两者之间,后者PPV明显高于前者,差异有统计学意义( χ2=11.85,P <0.001)。空气培养、鉴定结果及GM检测结果表明,随机污染的曲霉 菌属导致较强的假阳性结果,毛霉菌属导致中度的假阳性结果,而枯草芽孢杆菌导致轻度假 阳性结果。结论环境中的枯草芽孢杆菌,曲霉菌和毛霉菌对检测环 境的随机污染是导致GM检测假阳性结果的重要原因,通过对检测环境严格的控制和消毒措施 可以降低假阳性,改善检测结果,提高检测结果的敏感性。
Abstract:
Objective To explore the factors in the environ ment that could affect the accuracy of galactomannan (GM) detection and how t o reduce false-positives in order to improve accuracy.Methods The hospitalized patients who were initially diagnosed with suspicious in vasive fungal diseases in the First Affiliated Hospital of Nanjing Medical Unive rsity from June 2016 to April 2017 were selected as subjects,and serum GM was d etected by enzyme-linked immunosorbent assay(ELISA) method in different laborat ory environmental conditions.Detection of 3 40 7 samplesin were operated in normal circumstances and random air culture,observ ation of culture results,identification and treatment of bacterium suspension t o take the supernatant for GM detection were done as well.1 167 samples were te sted in strict controlled environment.Then comparisons between the two groups w ere performed.Results The true positive rate was 3.38% in the general environment,the sensitivity was 63.0% (34/54),while the specif icity was 40.9% (56/137),and the positive predictive value (PPV) was 29.6.% .The true positive rate was 3.94% in strict controlled environment,sensitivit y and specificity were 79.4% (27/34) and 34.5% (10/29),respectively,and PPV was 58.7% (27/46).Between the two,the latter PPV was significantly higher tha n the former,the difference was statistically sign ificant ( χ2=11.85,P <0.001).Air culture and microorganism identific ation showed that random contami nation by Aspergillus spp contributed to strong false-positive results, M ucor spp  contributed to moderate false-positive results,and Bacillus subt ilis c ontributed to mild false-positive results.Conclusion Ra ndom contamination of the testing environment by Bacillus subtilis,Aspergillu s spp and Mucor spp is an important cause of false-positive results in GM detection w hich can be improved by using disinfected and sterilized testing environment.

参考文献/References:


[1]DESOUBEAUX G, BAILLY E,CHANDENIER J.Diagnosis of invas ive pulmonary aspergillosis:updates and recommendations[J].Med Mal Infect,2 014,44(3):89-101.
[2]ZHANG Li,GUO ZhuSheng,XIE Shujin,et al.The performance of galactom annan in combination with 1,3-β-D-glucan or aspergillus-lateral flow devic e for the diagnosis of invasive aspergillosis:Evidences from 13 studies[J].D iagn Microbiol Infect Dis,2019,93(1):44-53.
[3]CUMMINGS J R,JAMISON G R,BOUDREAUX J W,et al.Cross-reactivity o f non- Aspergillus fungal species in the Aspergillus galactomannan enzym e immunoassay[J].Diagn Microbiol Infect Dis,2007,59(1):113-115.
[4]GIACCHINO M,CHIAPELLO N,BEZZIO S,et al. Aspergillus galact omannan enzyme-linked immunosorbent assay cross-reactivity caused by invasive Geotrichum capitatum [J].J Clin Microbiol,2006,44(9):3432-3434.
[5]ROIZ M P,GAROCíA M D S,MARTíNEZMARTí-NEZ L.Repeating the PlateliaTM Aspergillus test in samples positive for serum galactomannan:Is it nec essary?[J].Rev Iberoam Micol,2015,32(3):204-207.
[6]PFEIFFER C D,FINE J P,SAFDAR N.Diagnosis of invasive aspergillosi s using a galactomannan assay:a meta-analysis[J].Clin Infect Dis,2006,42( 10):1417-1427.
[7]XAVIER M O,ARAUJO J S,AQUINO V R,et al.Variability in galactomannan detection by platelia aspergillus EIATM according to the Aspergillus sp ecie s [J].Rev Inst Med Trop Sao Paulo,2013,55(3)pii:s0036-46652013000300 145.
[8]LEEFLANG M M,DEBETS-OSSENKOPP Y J,VISSER C E,et al.Galactomannan det ection for invasive aspergillosis in immunocompromised patients[J].Cochrane Database Syst Rev,2015,4(4):CD007394.
[9]CABANA A L,MENDES J F,KLAFKE G B,et al.Can Aspergillus fumigatu s conidia cause false-positive results in the galactomannan enzyme immunoassay test?[J].Rev Soc Bras Med Trop,2018,51(3):387-389.
[10]RACHOW T,DORNAUS S,SAYER H G,et al.Case report:false p ositive elevated serum-galactomannan levels after autologous hematopoietic ste m cell transplantation caused by oral nutritional supplements[J].Clin Case Re p,2016,4(5):505-508.
[11]GUIGUE N,LARDEUX S,ALANIO A,et al.Importance of operational fa ctors in the reproducibility of Aspergillus galactomannan enzyme immune assa y[J].PLoS One,2015,10(4):e0124044.
[12]JOHNSON G L,BIBBY D F,WONG S,et al.A MIQE-compliant real-time PCR assay for Aspergillus detection[J].PLoS One,2012,7(7):e40022.

相似文献/References:

[1]宁明哲,陶 月,陈雨欣,等.新型冠状病毒血清特异性抗体检测的假性问题分析和对策探讨[J].现代检验医学杂志,2020,35(06):129.[doi:doi:10.3969/j.issn.1671-7414.2020.06.031]
 NING Ming-zhe,TAO Yue,CHEN Yu-xin,et al.SARS-CoV-2 Serological Antibody Testing: Problems of FalseDetections and the Solutions[J].Journal of Modern Laboratory Medicine,2020,35(01):129.[doi:doi:10.3969/j.issn.1671-7414.2020.06.031]

备注/Memo

备注/Memo:
基金项目:江苏省实验诊断学重点实验室(项目编号:ZDXKB2016005)。
作者简介:娄鉴芳(1985-),女,硕士研究生,主治医师,研究方 向:免疫学诊断,E-mail:loujianfang@126.com。
通讯作者:王加,女,主管技师,硕士研究生,E-mail:qaz8 405@sohu.com。
更新日期/Last Update: 2019-02-28