Smith Ina L, Northill Judy A, Harrower Bruce J, Smith Greg A
Public Health Virology, Queensland Health Scientific Services, 39 Kessels Road, Coopers Plains, Qld 4108, Australia.
J Clin Virol. 2002 Dec;25(3):285-91. doi: 10.1016/s1386-6532(02)00083-5.
Australian bat lyssavirus (ABLV) has been transmitted to humans following a scratch or bite from an infected bat in two cases. Following a scratch or bite to a person, the bat is usually submitted for testing and diagnosis is made using a direct fluorescent antibody test on a brain smear. A nested RT-PCR assay has also been utilised to confirm diagnosis. If positive for lyssavirus, post-exposure prophylaxis is administered.
The TaqMan assay was developed to improve the diagnosis of ABLV infection, following problems encountered with the generation of spurious PCR products in the nested RT-PCR and also to reduce the high risk of contamination inherent with nested PCRs.
RNA was extracted from 161 bat brains and the samples were compared using a conventional RT-PCR and the TaqMan based assay. Samples from a patient with an ABLV infection collected antemortem and postmortem were also tested.
The sensitivity of the new TaqMan based PCR assay compared favourably with the nested PCR previously in use in our laboratory. This assay was able to detect RNA in samples collected antemortem and postmortem for the diagnosis of a human case of ABLV.
The major advantage of the TaqMan based assay was the speed of diagnosis with a result within minutes of completing the PCR (a result within 4 h of receiving the specimen). This test greatly reduces the chance of false positives through the elimination of second-round PCR and the requirement for agarose gels. The assay is sensitive and specific and should be invaluable for future antemortem and postmortem diagnosis of ABLV infection in humans.
在两起病例中,澳大利亚蝙蝠狂犬病病毒(ABLV)经感染蝙蝠抓挠或咬伤后传播给了人类。人被蝙蝠抓挠或咬伤后,通常会将蝙蝠送检,并通过对脑涂片进行直接荧光抗体检测来进行诊断。巢式逆转录聚合酶链反应(RT-PCR)检测也已用于确诊。如果狂犬病病毒检测呈阳性,则进行暴露后预防。
由于巢式RT-PCR检测中出现假PCR产物生成的问题,且为降低巢式PCR固有的高污染风险,因此开发了TaqMan检测法以改进ABLV感染的诊断。
从161只蝙蝠的大脑中提取RNA,并使用传统RT-PCR和基于TaqMan的检测法对样本进行比较。还对一名ABLV感染患者生前和死后采集的样本进行了检测。
新的基于TaqMan的PCR检测法的灵敏度与我们实验室之前使用的巢式PCR检测法相比更具优势。该检测法能够检测生前和死后采集的样本中的RNA,用于诊断人类ABLV病例。
基于TaqMan的检测法的主要优点是诊断速度快,PCR完成后几分钟内即可得出结果(收到标本后4小时内得出结果)。该检测法通过省去第二轮PCR和对琼脂糖凝胶的需求,大大降低了假阳性的几率。该检测法灵敏且特异,对未来人类ABLV感染的生前和死后诊断应具有重要价值。