Comparative study of multiple nucleic acid tests with conventional bacterial culture methods for detection of six kinds of pathogenic bacteria in lower respiratory tract
Objective To explore the value and application of multiple nucleic acid tests in the early diagnosis of lower respiratory tract infections caused by pathogenic bacteria through a comparative study of multiple nucleic acid tests and traditional bacterial culture methods.Methods We collected the specimens undergoing nucleic acid tests for six kinds of pathogens in the lower respiratory tract from July 12,2022 to July 26,2023,and the specimens underwent traditional bacterial cultures during the same period.The differences in the detection rates of pathogens between the two methods were analyzed and compared.Results The detection rates of Haemophilus influenzae and Streptococcus pneumoniae in sputum specimens undergoing multiple nucleic acid tests were higher than those in sputum specimens undergoing traditional bacterial cultures(12.39％vs.4.42％,P=0.012;27.43％vs.0.00％),but no statistically significant differences were found in the detection rates of Pseudomonas aeruginosa,Staphylococcus aureus,and Klebsiella pneumoniae between the two methods(all P＞0.05),with a fair to moderate concordance(kappa=0.328 &0.387 & 0.490,all P＜0.001).As for Klebsiella pneumoniae and Streptococcus pneumoniae in specimens of bronchoalveolar lavage fluid,the detection rates based on multiple nucleic acid tests were higher than those based on traditional bacterial cultures(29.87％vs.14.29％,P＜0.001;14.29％vs.0.00％),but no statistically significant differences were observed in the detection rates of Staphylococcus aureus and Pseudomonas aeruginosa between the two methods(P＞0.05),with a fair to moderate concordance(kappa=0.252 & 0.490,both P＜0.05).The intra-laboratory turnaround time based on multiple nucleic acid tests was less than that based on traditional bacterial cultures(X2=7,905.733,P＜0.001).Conclusion Multiple nucleic acid tests are more advantageous in the detection of some lower respiratory tract pathogens.The detection of some bacteria based on multiple nucleic acid tests has a certain degree of consistency with that based on traditional cultures,moreover,multiple nucleic acid tests show a shorter intra-laboratory turnaround time,and can rapidly and accurately provide diagnostic and therapeutic information for clinical practice.There is a certain degree of complementarity between the two methods,and the combination of the two methods can effectively avoid the leakage of diagnosis and misdiagnosis.
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