Freymuth François, Vabret Astrid, Cuvillon-Nimal Delphine, Simon Sandrine, Dina Julia, Legrand Loïc, Gouarin Stéphanie, Petitjean Joëlle, Eckart Philippe, Brouard Jacques
Laboratory of Human and Molecular Virology, University Hospital, Caen, France.
J Med Virol. 2006 Nov;78(11):1498-504. doi: 10.1002/jmv.20725.
The performances of four multiplex PCR (m-PCR) were compared to direct immunofluorescence assay (DFA) and HuH7 cell culture for the detection of viruses in 263 children admitted to hospital with an acute respiratory illness. One hundred fifty (57.6%) nasal aspirates were found DFA-positive; 188 (72.3%) were found positive by both DFA and HuH7 cell culture, and 242 (92%) were PCR-positive. The m-PCR detected 124 viruses which were not found by conventional methods: 68 rhinovirus, 17 human metapneumovirus, 15 respiratory syncytial virus (RSV), 8 parainfluenza virus (PIV), 5 coronavirus 229E, 3 OC43 and 3 NL63, 4 enterovirus, 2 influenza virus B and C virus. The m-PCR were more sensitive, had the advantages of a shorter delay in specific diagnosis, and a lower cost than DFA and culture. Using these m-PCR, the prevalence of each virus was compared between in-patient and out-patient groups of children attending the emergency unit of the hospital. Nasal aspirates from 411 (91.5%) children were found positive by the PCRs. RSV, rhinovirus, and influenza virus were the most frequent viruses detected in this population, representing 43.6%, 31.8%, and 8.8% of the virus found, respectively, followed by human metapneumovirus (4.4%), coronavirus (3.4%), parainfluenza virus (3.2%), adenovirus (2.3%), and enterovirus (2.1%). RSVs were detected more significantly in the in-patient group than in the out-patient group, and influenza viruses were detected more frequently in the out-patient group than in the in-patient group. Moreover, the use of m-PCR pointed out the frequency of rhinovirus and mixed viral detections in these patients. In conclusion, according to the requirements of speed and low cost of the methods, and to achieve the highest rate of detection of respiratory viruses, the combined use of DFA and m-PCR is today likely to be the best way to improve diagnosis of respiratory illnesses in children.
比较了四种多重聚合酶链反应(m-PCR)与直接免疫荧光测定法(DFA)和HuH7细胞培养法在检测263名因急性呼吸道疾病入院儿童病毒方面的表现。150份(57.6%)鼻吸液DFA检测呈阳性;188份(72.3%)DFA和HuH7细胞培养均呈阳性,242份(92%)PCR检测呈阳性。m-PCR检测出124种传统方法未检测到的病毒:68种鼻病毒、17种人偏肺病毒、15种呼吸道合胞病毒(RSV)、8种副流感病毒(PIV)、5种229E冠状病毒、3种OC43和3种NL63、4种肠道病毒、2种乙型流感病毒和丙型病毒。m-PCR更敏感,具有特异性诊断延迟更短、成本低于DFA和培养法的优势。使用这些m-PCR,比较了该医院急诊科住院和门诊儿童组中每种病毒的流行情况。411名(91.5%)儿童的鼻吸液PCR检测呈阳性。RSV、鼻病毒和流感病毒是该人群中最常检测到的病毒,分别占检测到病毒的43.6%、31.8%和8.8%,其次是人偏肺病毒(4.4%)、冠状病毒(3.4%)、副流感病毒(3.2%)、腺病毒(2.3%)和肠道病毒(2.1%)。住院组中检测到的RSV比门诊组更显著,门诊组中检测到的流感病毒比住院组更频繁。此外,m-PCR的使用指出了这些患者中鼻病毒和混合病毒检测的频率。总之,根据方法对速度和低成本的要求,以及实现呼吸道病毒的最高检出率,联合使用DFA和m-PCR可能是当今改善儿童呼吸道疾病诊断的最佳方法。