[Bacteriological assessment of infectious diseases using a real-time PCR method in Tenri Hospital--focusing on diagnosis for atypical pneumonia and hemorrhagic enterocolitis].

Abstract

In recent years, the detection of specific pathogens has been remarkably speedy with the development of new nucleic acid amplification methods such as real-time PCR, which is expected to be a great contribution to clinical diagnosis. Real-time PCR was introduced in our hospital, 2004 with the aim of detecting various pathogens. The system has been established and used for rapid bacteriological diagnosis for outpatient services in our hospital. This system can contribute greatly to achieving reliable and quick diagnosis, particularly for atypical pneumonia and hemorrhagic colitis caused by Escherichia coli. This system requires only 45 minutes on average for atypical pneumonia diagnosis, from receiving a specimen to the reporting of its results, which shortens the diagnosis time to about one-tenth of conventional methods. Survey on the type of initial dose in cases of Mycoplasma pneumoniae PCR positives shows that any administration of beta-lactam antibiotics, not effective to M. pneumoniae, has not been reported. Concerning the diagnosis of hemorrhagic colitis caused by Escherichia coli, it has been possible for us to report the results within one and a half hours, or within two hours including the legal notification of a third class infectious disease to a public health center. The SYBR Green Idetection system used in our hospital is superior to other detection systems comparing with versatility and cost-effectiveness. This report advocates that real-time PCR can contribute greatly to a rapid and cost-effective diagnostic system making full use of the characteristics of conventional bacteriological rapid-diagnostic methods, such as Gram staining and immuno-chromatography.