Steed L L, Salmon V C, Overall J C
Diagnostic Virology Laboratory, Associated Regional and University Pathologists, Inc., Salt Lake City, UT 84108, USA.
Clin Diagn Virol. 1994 Jun;2(3):181-9. doi: 10.1016/0928-0197(94)90021-3.
Influenza continues to be a major cause of morbidity and mortality especially in the elderly and persons with underlying disease. Shell vial cell culture and antigen detection techniques may speed up diagnosis and enable better patient treatment and management.
To compare shell vial centrifugation culture with commercially available direct fluorescence and enzyme immunoassay kits using a variety of respiratory specimens.
To detect influenza A virus, we compared direct fluorescent antibody (DFA) staining using the Bartels Viral Respiratory Panel and the Directigen FLU-A enzyme immunoassay (EIA) with shell vial centrifugation culture. Ninety-seven fresh specimens from a variety of respiratory sources, and transported from hospitals throughout the U.S. to our national referral laboratory, were tested.
Fifteen specimens were true positives: culture positive or both antigen tests positive. Sensitivity with culture was 93%, EIA 67%, and DFA 47%. Specificity was excellent with all three methods: 100%, 98%, 99%. Culture detected additional viruses that can cause respiratory tract disease: herpes simplex, cytomegalovirus, respiratory syncytial, influenza B, and adenovirus. Fourteen (70%) of 20 frozen specimens previously positive for influenza A were positive on retest by EIA. Overall sensitivity of EIA compared with culture using 35 positive specimens was 69%.
The rapid EIA is useful to screen for influenza A, but critical antigen-negative specimens should be submitted to a virology laboratory for culture. Shell vial cultures can provide a sensitive and universal diagnostic system for influenza A and a variety of other viruses.
流感仍然是发病和死亡的主要原因，尤其是在老年人和患有基础疾病的人群中。病毒分离培养瓶细胞培养和抗原检测技术可能会加快诊断速度，并有助于更好地治疗和管理患者。
使用多种呼吸道标本，比较病毒分离培养瓶离心培养法与市售直接荧光和酶免疫分析试剂盒。
为检测甲型流感病毒，我们将使用巴特尔氏病毒呼吸道检测板的直接荧光抗体（DFA）染色和直接免疫荧光甲型流感病毒酶免疫分析（EIA）与病毒分离培养瓶离心培养法进行了比较。对97份来自各种呼吸道来源的新鲜标本进行了检测，这些标本从美国各地的医院运至我们的国家参考实验室。
15份标本为真阳性：培养阳性或两种抗原检测均为阳性。培养法的敏感性为93%，EIA为67%，DFA为47%。三种方法的特异性均极佳：分别为100%、98%、99%。培养法检测出了其他可引起呼吸道疾病的病毒：单纯疱疹病毒、巨细胞病毒、呼吸道合胞病毒、乙型流感病毒和腺病毒。20份先前甲型流感病毒检测呈阳性的冷冻标本中，有14份（70%）经EIA重新检测呈阳性。使用35份阳性标本，EIA与培养法相比的总体敏感性为69%。
快速EIA可用于筛查甲型流感，但关键的抗原阴性标本应送交病毒学实验室进行培养。病毒分离培养瓶培养可为甲型流感和多种其他病毒提供灵敏且通用的诊断系统。
