Falsey Ann R, Criddle Mary C, Walsh Edward E
Department of Medicine, Infectious Diseases Unit, Rochester General Hospital, 1425 Portland Avenue, Rochester, NY 14621, USA.
J Clin Virol. 2006 Jan;35(1):46-50. doi: 10.1016/j.jcv.2005.04.004.
Reverse transcription polymerase chain reaction (RT-PCR) is a powerful tool that allows the detection of minute quantities of viral RNA. Because of the sensitivity of these assays it is possible that the finding of viral RNA indicates not only active infection but also transient colonization or residual nucleic acid from a distant infection. Respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) are two viruses for which RT-PCR is now frequently used for diagnosis in adult disease.
We evaluated nasal secretions from adults with and without respiratory illnesses by nested, one-tube RT-PCR for RSV and hMPV to determine if rates of detectable RNA were significantly higher among ill subjects compared to controls suggesting a causal relationship with respiratory illness.
Adults presenting to a health care provider with complaints of respiratory illness were recruited as "cases" and those visiting for non-respiratory complaints were recruited as "controls". Subjects were enrolled during a 3-month period (January to April) when both viruses were expected to be prevalent in the community. Nasal swab samples were obtained and subjected to one-tube nested RT-PCR for RSV and hMPV.
Of 146 ill subjects, 17 (11.6%) tested positive for RSV and 5 (3.4%) were positive for hMPV. Of the 158 control subjects, one was RT-PCR positive for RSV and none tested positive for hMPV. The rates of RT-PCR positive cases compared to controls were significantly different for RSV (p<.0001) and hMPV (p<.02). Subjects remained RSV RT-PCR positive on average until day 7.1+/-2.8 of symptoms with a range of 3-10 days. No subject had a positive swab on days 14, 21 or 28.
Asymptomatic carriage of RSV or hMPV is uncommon. RT-PCR should be a useful method for the diagnosis of these viral illnesses in adults.
逆转录聚合酶链反应（RT-PCR）是一种强大的工具，可用于检测微量病毒RNA。由于这些检测方法的敏感性，病毒RNA的检测结果不仅可能表明存在活动性感染，还可能提示短暂定植或远处感染残留的核酸。呼吸道合胞病毒（RSV）和人偏肺病毒（hMPV）是两种目前常用于成人疾病诊断的病毒，RT-PCR检测技术也经常被应用。
我们通过巢式单管RT-PCR检测有呼吸道疾病和无呼吸道疾病的成年人鼻分泌物中的RSV和hMPV，以确定患病组中可检测到RNA的比例是否显著高于对照组，从而表明其与呼吸道疾病存在因果关系。
招募因呼吸道疾病就诊的成年人作为“病例组”，因非呼吸道疾病就诊的成年人作为“对照组”。在两种病毒预计在社区流行的3个月期间（1月至4月）招募受试者。采集鼻拭子样本，进行RSV和hMPV的单管巢式RT-PCR检测。
146例患病受试者中，17例（11.6%）RSV检测呈阳性，5例（3.4%）hMPV检测呈阳性。158例对照受试者中，1例RSV的RT-PCR检测呈阳性，hMPV检测均为阴性。与对照组相比，RSV（p<0.0001）和hMPV（p<0.02）的RT-PCR阳性率差异有统计学意义。受试者RSV RT-PCR平均在症状出现后7.1±2.8天呈阳性，范围为3-10天。在第14、21或28天，没有受试者的拭子检测呈阳性。
RSV或hMPV的无症状携带并不常见。RT-PCR应该是诊断成人这些病毒感染的一种有用方法。
