van Elden Leontine J R, van Kraaij Marian G J, Nijhuis Monique, Hendriksen Karin A W, Dekker Ad W, Rozenberg-Arska Maja, van Loon Anton M
Eijkman-Winkler Institute of Medical Microbiology, Infectious Diseases and Inflammation, Department of Virology, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands.
Clin Infect Dis. 2002 Jan 15;34(2):177-83. doi: 10.1086/338238. Epub 2001 Dec 4.
We retrospectively analyzed the value of polymerase chain reaction (PCR) for the detection of respiratory viral infections in 43 patients with hematological cancer whose bronchoalveolar lavage (BAL) samples had been stored. In addition, 17 nose-throat (NT) swabs and 29 blood samples had been obtained. PCR was performed to detect parainfluenza viruses 1-3, respiratory syncytial virus, rhinovirus, influenza viruses A and B, enteroviruses, and coronaviruses. Viral cultures or antigen testing of BAL samples revealed 9 respiratory viruses in 8 patients. By use of PCR, 8 more respiratory viruses were detected in another 7 patients, increasing the rate of identification from 19% to 35% (P<.0005). Available NT swabs yielded the same results with PCR as did BAL samples. We conclude that PCR is more sensitive than viral culture or antigen or serologic testing for detection of respiratory viruses in patients with hematological malignancies, and that it offers the possibility for early, more rapid diagnosis.
我们回顾性分析了聚合酶链反应(PCR)在检测43例血液系统癌症患者呼吸道病毒感染中的价值,这些患者的支气管肺泡灌洗(BAL)样本已被保存。此外,还采集了17份鼻咽(NT)拭子和29份血液样本。采用PCR检测副流感病毒1 - 3型、呼吸道合胞病毒、鼻病毒、甲型和乙型流感病毒、肠道病毒和冠状病毒。BAL样本的病毒培养或抗原检测在8例患者中发现了9种呼吸道病毒。通过PCR检测,另外7例患者又检测出8种呼吸道病毒,使识别率从19%提高到35%(P<0.0005)。可用的NT拭子通过PCR检测得到的结果与BAL样本相同。我们得出结论,对于血液系统恶性肿瘤患者呼吸道病毒的检测,PCR比病毒培养、抗原或血清学检测更敏感,并且它为早期、更快速的诊断提供了可能性。