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[肺炎支原体感染:1997 - 2005年下诺曼底地区的回顾性研究。流行病学——血清学和聚合酶链反应在快速诊断中的诊断效用]

[Mycoplasma pneumoniae infections: retrospective study in Basse-Normandie, 1997-2005. Epidemiology--diagnostic utility of serology and PCR for a rapid diagnostic].

作者信息

Petitjean-Lecherbonnier J, Vabret A, Gouarin S, Dina J, Legrand L, Freymuth F

机构信息

Laboratoire de virologie humaine et moléculaire, hôpital universitaire, avenue Georges-Clémenceau, 14033 Caen, France.

出版信息

Pathol Biol (Paris). 2006 Dec;54(10):603-11. doi: 10.1016/j.patbio.2006.07.038. Epub 2006 Oct 6.

Abstract

OBJECTIVES

The objective of this study was to evaluate the epidemiology of Mycoplasma pneumoniae (Mpn) infections in Basse-Normandie by a retrospective analysis of serological and PCR data, and to confirm the diagnostic utility of PCR and serology.

METHODS

From 1997 to August 2005, 6156 serum samples and 6123 respiratory tract samples were collected from hospitalised patients and evaluated for the diagnosis of Mpn infection by PCR, serological assays, or by the two tests. During the epidemic period (2004-2005), the results of 1489 patients were analysed.

RESULTS

Over the 9-y period, the seroprevalence was 40,4% and we reported on 525 cases with serologically or/and PCR proven Mpn infection, according a cyclic pattern spaced out 7 years. During the epidemic period, the seroprevalence increased to 50,2% and the rate of infections was 8.3%. The analysis of the 124 cases of Mpn infection showed typical epidemiological characteristics: a peak of incidence among the children and young adults, a summer-winter pattern and some coinfections with viral strains. For diagnosis of Mpn infection, the comparison of PCR and serological assays among 36 patients showed a concordance of only 41.7%.

CONCLUSION

Mpn infections were endemic and outbreaks were observed according cyclic pattern with a high incidence specially in the children. Sensitive and specific tests were now available for early and reliable diagnosis. In children, the combination of the PCR on nasopharyngeal samples and the IgM EIA serology test were recommended. In adults, the PCR was privilegiated.

摘要

目的

本研究的目的是通过对血清学和聚合酶链反应(PCR)数据的回顾性分析,评估下诺曼底地区肺炎支原体(Mpn)感染的流行病学情况,并确认PCR和血清学检测的诊断效用。

方法

1997年至2005年8月,从住院患者中收集了6156份血清样本和6123份呼吸道样本,并通过PCR、血清学检测或两种检测方法对Mpn感染进行诊断评估。在流行期间(2004 - 2005年),对1489例患者的结果进行了分析。

结果

在9年期间,血清阳性率为40.4%,我们报告了525例经血清学或/和PCR证实的Mpn感染病例,呈每7年一个周期的模式。在流行期间,血清阳性率增至50.2%,感染率为8.3%。对124例Mpn感染病例的分析显示出典型的流行病学特征:儿童和年轻人发病率最高,呈夏冬模式,且存在一些与病毒株的合并感染。对于Mpn感染的诊断,对36例患者的PCR和血清学检测结果进行比较,一致性仅为41.7%。

结论

Mpn感染呈地方性流行,观察到有周期性爆发,儿童中的发病率尤其高。现在有敏感且特异的检测方法可用于早期可靠诊断。对于儿童,建议联合使用鼻咽样本PCR检测和IgM酶免疫分析血清学检测。对于成人,优先选择PCR检测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ff3/7119118/d541862cabee/gr1.jpg

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