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[聚合酶链反应在中枢神经系统感染诊断中的应用]

[Use of polymerase chain reaction for the diagnosis of central nervous system infections].

作者信息

Zambrano Yelitza, Chiarello Anna, Soca Alain, Villalobos Iris, Marrero Miguel, Soler Maritza, Laferte José, Alvarez Maritza

机构信息

Laboratorio Genomik, Maracay, Venezuela.

出版信息

Invest Clin. 2006 Dec;47(4):337-47.

Abstract

In the present work, the polymerase chain reaction (PCR) assay and his variants RT-PCR and Multiplex PCR were applied for the detection of specific sequences of Enterovirus, Human Herpes viruses (Herpes simple virus, Human Herpes virus type 6, Cytomegalovirus, Epstein Barr virus, and Varicella Zoster), Human Immunodeficiency virus, Toxoplasma gondii, Mycobacterium tuberculosis and Mycoplasma pneumoniae in patients' cohorts grouped by medical suspicion of meningoencephalitis. Of 326 samples of processed cerebrospinal fluid (CSF), 93 samples (28.5%) were positive for the different infectious agents. In the group of patients with clinical diagnosis of viral meningoencephalitis (n=212), there was obtained a whole of 73 positive samples (34.4%), of which 37 patients were positive to Enterovirus (50.7%), 19 were positive to VHS (26%) and 10 patients (13.7%) were positive to CMV. Other viral agents as VZV, EBV and HVH6 were detected in minor frequency. The 114 remaining samples were analyzed applying specific PCR to each pathogen for strict medical indication, being able to detect the presence of Human Immunodeficiency Virus (40%), Mycoplasma pneumoniae (40%), Toxoplasma gondii (14%) and Mycobacterium tuberculosis (12%) in CSF samples. The results obtained in this study demonstrate the convenience of the application of the molecular assays in the laboratory diagnosis of the meningoencefalitis of different etiology. Besides this, it is also a very valuable tool for the clinical management of the patients and for the execution of the epidemiological studies.

摘要

在本研究中,聚合酶链反应(PCR)检测及其变体逆转录PCR(RT-PCR)和多重PCR被用于检测因医学怀疑患有脑膜脑炎而分组的患者队列中的肠道病毒、人类疱疹病毒(单纯疱疹病毒、人类疱疹病毒6型、巨细胞病毒、爱泼斯坦-巴尔病毒和水痘带状疱疹病毒)、人类免疫缺陷病毒、弓形虫、结核分枝杆菌和肺炎支原体的特定序列。在326份处理过的脑脊液(CSF)样本中,93份样本(28.5%)对不同的感染因子呈阳性。在临床诊断为病毒性脑膜脑炎的患者组(n = 212)中,总共获得73份阳性样本(34.4%),其中37名患者对肠道病毒呈阳性(50.7%),19名对单纯疱疹病毒呈阳性(26%),10名患者对巨细胞病毒呈阳性(13.7%)。其他病毒因子如水痘带状疱疹病毒、爱泼斯坦-巴尔病毒和人类疱疹病毒6型检测频率较低。其余114份样本根据严格的医学指征对每种病原体进行特异性PCR分析,能够在脑脊液样本中检测到人类免疫缺陷病毒(40%)、肺炎支原体(40%)、弓形虫(14%)和结核分枝杆菌(12%)的存在。本研究获得的结果表明,分子检测方法在不同病因的脑膜脑炎实验室诊断中应用方便。除此之外,它也是患者临床管理和开展流行病学研究的非常有价值的工具。

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