目的:探讨下呼吸道病原菌核酸检测在诊断下呼吸道病原菌感染中的价值。方法:选取2023年12月-2024年11月进行下呼吸道病原菌核酸检测又进行细菌培养的患者为研究对象,比较2种方法呼吸道病原菌的检出率。结果:对于6种下呼吸道常见致病菌,核酸检测方法阳性检出率显著高于常规细菌培养(69.68%;20.88%),对于铜绿假单胞菌,两种方法的阳性检出率具有较好的一致性(Kappa=0.644,P＜0.001),肺炎克雷伯杆菌两种方法检出率一致性一般(Kappa=0.473,P＜0.001),金黄色葡萄球菌2种方法检出率一致性较差(Kappa=0.287,P＜0.001)。核酸检测实验室内平均周转时间为4.68 h,常规细菌培养实验室内平均周转时间为49.75 h,实验室内平均周转时间核酸检测显著低于细菌培养(P＜0.001)。结论:下呼吸道病原菌核酸检测在快速鉴定呼吸道病原菌中更有优势,具有更短的实验室内周转时间,可及时为临床医生提供病原菌的信息,对重症且进展迅速的患者临床意义较高。

Objective: To explore the value of nucleic acid detection of pathogenic bacteria in lower respiratory tract in the diagnosis of lower respiratory tract infection. Methods: Patients who underwent nucleic acid testing and bacterial culture for lower respiratory pathogens from December 2023 to November 2024 were selected as subjects. The detection rates of respiratory pathogens by both methods were compared. Results: For six common pathogens causing lower respiratory infections, the positive detection rate of nucleic acid testing was significantly higher than that of conventional bacterial culture (69.68% vs.20.88%). For Pseudomonas aeruginosa, the two methods had good consistency in positive detection rates (Kappa=0.644, P＜0.001), while the consistency of detection rate of klebsiella pneumoniae between the two methods was general (Kappa=0.473, P＜0.001), and that of staphylococcus aureus was poor (Kappa=0.287, P＜0.001). The average turnaround time within the laboratory for nucleic acid testing was 4.68 hours, while that for conventional bacterial culture was 49.75 hours, the average turnaround time of nucleic acid detection in the laboratory was significantly lower than that of bacterial culture (P＜0.001). Conclusion: Nucleic acid detection of pathogenic bacteria in lower respiratory tract has more advantages in rapid identification of pathogenic bacteria in respiratory tract, with shorter laboratory turnaround time, can provide timely information on pathogenic bacteria for clinicians, and has higher clinical significance for patients with severe and rapid progress.