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念珠菌聚合酶链反应在孕妇外阴阴道念珠菌病诊断中的应用

Utility of Cand PCR in the Diagnosis of Vulvovaginal Candidiasis in Pregnant Women.

作者信息

García-Salazar Eduardo, Betancourt-Cisneros Paola, Ramírez-Magaña Xóchitl, Díaz-Huerta Hugo, Martínez-Herrera Erick, Frías-De-León María Guadalupe

机构信息

Laboratorio de Micología Molecular, Unidad de Investigación Biomédica, Hospital Regional de Alta Especialidad de Ixtapaluca, Instituto Mexicano de Seguro Social para el Bienestar (IMSS-BIENESTAR), Carretera Federal México-Puebla Km 34.5, Ixtapaluca CP 56530, Mexico.

Servicio de Ginecología y Obstetricia, Hospital Regional de Alta Especialidad de Ixtapaluca, Instituto Mexicano de Seguro Social para el Bienestar (IMSS-BIENESTAR), Carretera Federal México-Puebla Km 34.5, Ixtapaluca CP 56530, Mexico.

出版信息

J Fungi (Basel). 2024 Dec 25;11(1):5. doi: 10.3390/jof11010005.

Abstract

Vulvovaginal candidiasis (VVC) can lead to multiple complications when it occurs during pregnancy, so it is necessary to diagnose it promptly for effective treatment. Traditional methods for identifying spp. are often too time-consuming and have limited specificity and sensitivity. In this work, we evaluated the diagnostic utility of an endpoint PCR assay (Cand PCR) in vaginal swab specimens. Using a cotton swab, 108 vaginal swab samples were taken from pregnant women who consented to participate in the study. The samples were inoculated in Sabouraud agar plates (the gold standard) and subsequently used to extract DNA directly from the exudate. The yeasts isolated from the Sabouraud agar were identified in CHROMagar™ Candida. DNA extracted from vaginal swabs was amplified by Cand PCR. Based on the results of the Cand PCR and the gold standard, sensitivity (S), specificity (E), positive predictive values (PPVs), and negative predictive values (NPVs) were determined. Cand PCR presented an S = 65%, E = 100%, PPV = 100% and NPV = 91%. Cand PCR showed low sensitivity for detecting spp. directly from vaginal swabs, but it was useful for identifying the etiologic agent and reducing the time to obtain the result, which is usually at least 48 h.

摘要

外阴阴道念珠菌病(VVC)在孕期发生时可导致多种并发症,因此有必要及时诊断以便进行有效治疗。传统的鉴定念珠菌属的方法往往耗时过长,特异性和敏感性有限。在本研究中,我们评估了终点PCR检测法(Cand PCR)在阴道拭子标本中的诊断效用。使用棉拭子从同意参与研究的孕妇中采集了108份阴道拭子样本。将样本接种于沙氏琼脂平板(金标准),随后直接用于从渗出物中提取DNA。从沙氏琼脂中分离出的酵母菌在科玛嘉念珠菌显色培养基中进行鉴定。从阴道拭子中提取的DNA通过Cand PCR进行扩增。根据Cand PCR和金标准的结果,确定了敏感性(S)、特异性(E)、阳性预测值(PPV)和阴性预测值(NPV)。Cand PCR的S = 65%,E = 100%,PPV = 100%,NPV = 91%。Cand PCR直接从阴道拭子中检测念珠菌属时敏感性较低,但有助于鉴定病原体并缩短获得结果的时间,通常至少需要48小时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4683/11766305/35e24e40c5fd/jof-11-00005-g001.jpg

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