Rovida Francesca, Percivalle Elena, Zavattoni Maurizio, Torsellini Maria, Sarasini Antonella, Campanini Giulia, Paolucci Stefania, Baldanti Fausto, Revello M Grazia, Gerna Giuseppe
Servizio di Virologia, IRCCS Policlinico San Matteo, Pavia, Italy.
J Med Virol. 2005 Feb;75(2):336-47. doi: 10.1002/jmv.20276.
In the winter season 2001-2002, 239 nasopharyngeal aspirate and 15 bronchoalveolar lavage samples from 208 patients (135 pediatric and 73 adults, including 19 lung transplant recipients) admitted to hospital because of an acute respiratory tract infection were examined for rapid diagnosis of respiratory viruses by two diagnostic approaches: immunological, using specific monoclonal antibodies (MAb); and molecular, using specific reverse transcription (RT)-PCR assays. Both methods detected influenza viruses A (H1N1 and H3N2) and B, human parainfluenza virus types 1 to 3, human respiratory syncytial virus (hRSV) types A and B, and human adenoviruses. In addition, human coronavirus (hCoV) groups I (229E-like) and II (OC43-like), as well as the new human metapneumovirus (hMPV), types A and B, were searched for by RT-PCR alone. When results obtained by both methods were added, the overall percentage of patients positive for at least one respiratory virus peaked at 44.2%, involving 92/208 patients (81 pediatric, and 11 adults), while 116 patients (55.8%) were negative for any respiratory virus tested. The most common circulating virus was hRSV, infecting 54 (25.9%) patients (24 type A, and 30 type B strains), followed by hMPV, infecting 12 (5.8%) patients (7 type A and 5 type B strains). Coinfections by two respiratory viruses interested 11 (5.3%) patients, and 9 (81.8%) of these were infected by hRSV in association with another respiratory virus. In the great majority of infected children, hRSV and hMPV were associated with lower respiratory tract infections. In lung transplant recipients, viruses present in bronchoalveolar lavage appeared to be associated frequently with lower respiratory tract infections.
the combination of immunological and molecular assays is the most sensitive approach to the diagnosis of respiratory viral infections; and infections caused by the less investigated hCoVs and hMPVs represent a fair proportion of respiratory infections.
在2001 - 2002年冬季，对因急性呼吸道感染入院的208例患者（135例儿童和73例成人，包括19例肺移植受者）的239份鼻咽抽吸物和15份支气管肺泡灌洗样本，采用两种诊断方法进行呼吸道病毒的快速诊断：免疫学法，使用特异性单克隆抗体（MAb）；分子学法，使用特异性逆转录（RT）-PCR检测。两种方法均检测到甲型（H1N1和H3N2）和乙型流感病毒、1至3型人副流感病毒、A和B型人呼吸道合胞病毒（hRSV）以及人腺病毒。此外，仅通过RT-PCR检测I组（229E样）和II组（OC43样）人冠状病毒（hCoV）以及新型A和B型人偏肺病毒（hMPV）。当两种方法的结果相加时，至少一种呼吸道病毒检测呈阳性的患者总体百分比最高达到44.2%，涉及92/208例患者（81例儿童和11例成人），而116例患者（55.8%）对所检测的任何呼吸道病毒均呈阴性。最常见的流行病毒是hRSV，感染54例（25.9%）患者（24例A型和30例B型毒株），其次是hMPV，感染12例（5.8%）患者（7例A型和5例B型毒株）。两种呼吸道病毒的合并感染涉及11例（5.3%）患者，其中9例（81.8%）是hRSV与另一种呼吸道病毒合并感染。在绝大多数受感染儿童中，hRSV和hMPV与下呼吸道感染相关。在肺移植受者中，支气管肺泡灌洗中存在的病毒似乎经常与下呼吸道感染相关。
免疫学法和分子学法相结合是诊断呼吸道病毒感染最敏感的方法；较少研究的hCoV和hMPV引起的感染在呼吸道感染中占相当比例。
