Čeprnja Marina, Oros Damir, Janeš Andrea, Žučko Jurica, Barišić Karmela, Škrlin Jasenka, Starčević Antonio
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摘要

标准尿培养仍然被认为是识别尿路感染(UTI)的金标准,但耗时,并且在大约20%的尿路感染症状患者中产生假阴性结果。医学界和科学界正在寻找一种更快、更准确、但价格合理、具有较高临床实用性的方法。尿流式细胞仪(UFC)筛选法是常规临床中标准培养的补充,用于检测尿培养阴性样本。这可以缩短无菌尿液培养报告的发布时间和分析本身的成本。此外,尿试纸试验和尿液沉淀物的显微检查也可在生化实验室进行,但通常在此之前进行尿液培养。目前,蛋白质组学和基因组学等先进方法被用于识别引起尿路感染的病原体,但仍主要用于科学目的,很少用于临床实践。从基因组学的角度来看,PCR、16S rRNA基因测序和宏基因组测序正在研究中。PCR是一种很好的针对性诊断方法,16S RNA基因扩增可以确定细菌属及其丰度,但不适合深入的物种分析,而宏基因组学是最全面、最公正的方法。蛋白质组学领域也提供了多种微生物鉴定方法,其中质谱是最主要的方法。质谱平台的临床应用通常意味着MALDI-TOF质谱分析仪,它产生称为肽质量指纹的特征谱,或更多用于科学目的的LC-MS/MS-based肽测序。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Systematic review–how do we identify urinary tract infections today?
Standard urine culture is still considered a gold standard in the identification of Urinary Tract Infections (UTIs), but is time-consuming and in approximately 20% of patients with UTI symptoms produces false-negative results. Medical and scientific communities are in search of a faster, more accurate, yet affordable method with high clinical utility. As a supplement to standard culture in routine practice Urine Flow Cytometer (UFC) screening method is used, in order to detect negative urine culture samples. This allows for shortening issuing time for sterile urine culture reports and the cost of the analysis itself. In addition, urine dipstick tests and microscopic examinations of urine sediment can also be performed in biochemical laboratories but are usually preceded by urine culture. Nowadays, advanced methods such as proteomics and genomics are used to identify pathogens causing UTIs but are still used mainly for scientific purposes and rarely in clinical practice. From genomic methods PCR, 16S rRNA gene sequencing, and metagenome sequencing are being researched. PCR is great for targeted diagnostics, 16S RNA gene amplification can determine bacterial genera and their abundance, but is not good for in-depth species analysis, while metagenomics is the most comprehensive and unbiased method. The proteomics field also offers several methods for microbial identification, with MS as the leading one. Clinical applications of MS platforms usually imply MALDI-TOF MS analyzers which produce a characteristic spectrum called peptide mass fingerprint or more present for scientific purposes LC-MS/MS-based peptide sequencing.
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