蓝鱼o_0 发表于 2012-9-11 22:14

技术革新显著提高临床诊断效率——Real time PCR用于诊断CD感染

BackgroundThe impact of a switch from a toxin A/B enzyme immunoassay (EIA) to a polymerase chain reaction (PCR) method for detection of toxigenic Clostridium difficile was assessed for C difficile infection (CDI) rates, patient isolation-days, and CDI-related treatment.
MethodsA 6-month retrospective study was done on symptomatic patients tested by the toxin A/B EIA and PCR assays. Data on the number of C difficile tests ordered, patient isolation-days, and treatment with metronidazole or vancomycin were collected. CDI rates were reported as cases per 10,000 patient-days, and differences between both groups were compared by χ2 and Z-test analysis.ResultsThe CDI incidence was 11.2 and 12.7/10,000 patient-days in the EIA and PCR test periods, respectively (P = .36). Health care-associated CDI decreased from 4.4 per 10,000 patient-days during EIA testing to 0.9 per 10,000 patient-days during PCR testing (P = .02). A significant decrease in patient isolation-days (P < .00001), tests ordered (P = .002), and metronidazole treatment for patients with a negative C difficile test (P = .02) was observed with PCR testing.
ConclusionPCR testing is a viable option for small community hospitals, providing accurate and timely results for patient management and infection control. This can potentially lead to improved outcomes, increased patient satisfaction, and significant hospital cost savings.

佳蕙淼淼 发表于 2012-9-11 23:44

有意思，我们国内有此思维？

蓝鱼o_0 发表于 2012-9-11 23:59

佳蕙淼淼 发表于 2012-9-11 23:44 static/image/common/back.gif
有意思，我们国内有此思维？

思维也许有，但是经费不够。
一个REAL TIME PCR大概要60W。二级和一级临床科室人家未必会配备。

细心的您应该可以发现，在国外，这篇研究是用于社区医院。可想而知，对于医学的投入，我国跟国外相差还是很大的。

有这样一个数字，发达国家对于医疗卫生的投入占总体GDP的30%以上。而我国只有不到7%的之处，还要照顾到14亿人口，其中在农村就占到了8亿。这该需要多少的投入啊。

佳蕙淼淼 发表于 2012-9-12 12:28

蓝鱼o_0 发表于 2012-9-11 23:59 static/image/common/back.gif
思维也许有，但是经费不够。
一个REAL TIME PCR大概要60W。二级和一级临床科室人家未必会配备。



没有想法就无从谈起。我们国家主要是政府愿不愿做的问题。

佳蕙淼淼 发表于 2012-9-12 12:29

是技术和权术的博弈呵呵。{:1_12:}{:1_12:}{:1_12:}{:1_12:}

鬼才 发表于 2012-9-12 16:07

CDI的检测一直我们的一道瓶颈，尤其是基层医院的微生物实验室根本无法开展CDI检测。

蓝鱼o_0 发表于 2012-9-12 16:12

鬼才 发表于 2012-9-12 16:07 static/image/common/back.gif
CDI的检测一直我们的一道瓶颈，尤其是基层医院的微生物实验室根本无法开展CDI检测。

这也是现状。还是应该做些积累的工作，并有所区分，不要所有的人都一头扎在MRSA, AB里面，也没意思。

鬼才 发表于 2012-9-12 16:17

蓝鱼o_0 发表于 2012-9-12 16:12 static/image/common/back.gif
这也是现状。还是应该做些积累的工作，并有所区分，不要所有的人都一头扎在MRSA, AB里面，也没意思。

这是一个值得重视的问题，但每当我与我院微生物实验室主任聊起这事，她直摇头。这中间有技术力量的问题，也有设备的问题，真的一言难尽。其实CD耐药菌株的危害大家还是清楚的。
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