社区获得性急性呼吸道疾病的诊断:从传统微生物检测到分子检测(多元)

D. Bouvet , C. Gaudy-Graffin , D. Garot , S. Sunder , C. De Gialluly , A. Goudeau
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引用次数: 6

摘要

社区获得性急性呼吸系统疾病的病因调查可能导致更好的治疗决策和患者的结果。在常规护理环境中,我们在连续的社区获得性急性呼吸道疾病成人病例中评估了多重PCR检测与传统微生物学方法的诊断性能。我们纳入了2011-2012年冬季在图尔大学医院因社区获得性急性呼吸系统疾病住院的279名成年患者。采用间接免疫荧光法和多重PCR法对呼吸道样本(主要是鼻咽吸入物)进行前瞻性研究,分别检测到8种病毒和21种呼吸道病原体。279份样本中有255份(91.4%)两种方法均可解释结果。171份(65%)标本经多重PCR检出至少一种呼吸道病原体。总体而言,171份阳性样本中有130份(76%)仅为一种呼吸道病原体阳性,37份(22%)为两种病原体阳性,4份(2%)为三种病原体阳性。通过间接免疫荧光测定,255份标本中有27份(11%)检测到呼吸道病毒。间接免疫荧光法检测到部分经多重PCR鉴定的甲型流感病毒(15/51,29%)、部分人偏肺病毒(7/15,47%)和呼吸道合胞病毒(5/12,42%)感染,但不能检测到所有腺病毒感染。因此,与传统方法相比,获得多重分子检测提高了诊断范围和准确性,增加了识别社区获得性急性呼吸道疾病涉及的呼吸道病原体的频率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Diagnosis of community-acquired acute respiratory illness: From conventional microbiological methods to molecular detection (multiplex)

Diagnosis of community-acquired acute respiratory illness: From conventional microbiological methods to molecular detection (multiplex)

Diagnosis of community-acquired acute respiratory illness: From conventional microbiological methods to molecular detection (multiplex)

Investigations of the etiologic agents of community-acquired acute respiratory illness may lead to better treatment decisions and patient outcomes. In a routine care setting, we assessed the diagnostic performance of a multiplex PCR assay with respect to conventional microbiological methods, in a continuous series of adult cases of community-acquired acute respiratory illness. We enrolled 279 adult patients hospitalised for community-acquired acute respiratory illness at Tours University Hospital during the winter of 2011–2012. Respiratory samples (mostly nasopharyngeal aspirates) were studied prospectively by indirect immunofluorescence assay and multiplex PCR, that enable detection of 8 viruses and 21 respiratory pathogens respectively. In total, 255 of the 279 (91.4%) samples had interpretable results by both methods. At least one respiratory pathogen was detected by multiplex PCR in 171 specimens (65%). Overall, 130 (76%) of the 171 positive samples were positive for only one respiratory pathogen, 37 (22%) samples were positive for two pathogens and four (2%) were positive for three pathogens. With indirect immunofluorescence assay, a respiratory virus was detected in 27 of the 255 (11%) specimens. Indirect immunofluorescence assay detected some of the influenza virus A (15/51, 29%) infections identified by multiplex PCR and some (7/15, 47%) human metapneumovirus and (5/12, 42%) respiratory syncytial virus infections, but it did not detect all the adenovirus infections. Thus, access to multiplex molecular assays improves the diagnostic spectrum and accuracy over conventional methods, increasing the frequency of identification of the respiratory pathogens involved in community-acquired acute respiratory illness.

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来源期刊
Pathologie-biologie
Pathologie-biologie 医学-病理学
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