军团菌肺炎病原体诊断策略研究进展

Advances in diagnostic strategies for the pathogens of Legionnaires’ disease

摘要:

军团菌肺炎是一种由军团菌属引起的严重肺部感染，早期诊断对治疗和预后至关重要。实验室检测方法主要包括分离培养、抗原检测、核酸检测和血清学检测。分离培养是金标准，但灵敏度低，培养时间长；抗原检测操作简便快速，但特异性有待提高；核酸检测灵敏度高，但操作复杂、成本较高；血清学检测早期诊断价值有限。尿抗原检测是目前国际上广泛应用的早期诊断方法，但只能检测嗜肺军团菌Ⅰ型。多种新型核酸检测技术展现出良好的应用前景，例如数字PCR、等温扩增和二代测序技术。未来需要进一步研究开发更简便、快速、灵敏的检测方法，以提高军团菌肺炎的早期诊断率。

Abstract:

Legionnaires’ disease, a serious pulmonary infection caused by Legionella, requires early diagnosis for effective treatment and favorable outcomes. Laboratory diagnostic methods primarily encompass isolation and culture, antigen detection, nucleic acid detection, and serological testing. Although isolation and culture are considered the gold standard, it is characterized by low sensitivity and extended culture duration. Antigen detection offers simple and fast operation but necessitates improved specificity. Nucleic acid detection, although being highly sensitive, has complex operation and high costs. Serological testing provides limited value for early diagnosis. Urine antigen detection, extensively employed globally, is limited to the detection of Legionella pneumophila serogroup I. Novel nucleic acid detection technologies, including digital PCR, isothermal amplification, and next-generation sequencing, present promising applications. Future research should aim to develop more streamlined, rapid, and sensitive detection methods to enhance the early diagnostic rate of Legionnaires’ disease.