Kehl Sue C, Kumar Swati
Department of Pathology, Medical College of Wisconsin, Milwaukee, WI 53226-0509, USA.
Clin Lab Med. 2009 Dec;29(4):661-71. doi: 10.1016/j.cll.2009.07.008.
Viruses are major contributors to morbidity and mortality from acute respiratory infections in all age groups worldwide. Accurate identification of the etiologic agent of respiratory tract infections is important for proper patient management. Diagnosis can be problematic, because a range of potential pathogens can cause similar clinical symptoms. Nucleic acid amplification testing is emerging as the preferred method of diagnostic testing. Real-time technology and the ability to perform multiplex testing have facilitated this emergence. Commercial platforms for nucleic acid amplification testing of respiratory viruses include real-time polymerase chain reaction (PCR), nucleic acid sequence-based amplification, and loop-mediated isothermal amplification. Multiplex PCR with fluidic microarrays or DNA chips are the most recent diagnostic advance. These assays offer significant advantages in sensitivity over antigen detection methods and in most cases also over traditional culture methods. A limited number of assays, however, are commercially available, thus laboratory developed assays frequently are used. This article reviews the performance of commercially available assays and discusses issues relevant to the development of in-house assays.
病毒是全球所有年龄组急性呼吸道感染发病和死亡的主要原因。准确识别呼吸道感染的病原体对于患者的合理管理很重要。诊断可能存在问题，因为一系列潜在病原体可引起相似的临床症状。核酸扩增检测正成为诊断检测的首选方法。实时技术和进行多重检测的能力推动了这一方法的出现。用于呼吸道病毒核酸扩增检测的商业平台包括实时聚合酶链反应（PCR）、基于核酸序列的扩增和环介导等温扩增。采用微流控芯片或DNA芯片的多重PCR是最新的诊断进展。这些检测方法在灵敏度方面比抗原检测方法以及在大多数情况下比传统培养方法都具有显著优势。然而，市面上可买到的检测方法数量有限，因此实验室自行开发的检测方法经常被使用。本文综述了市售检测方法的性能，并讨论了与内部检测方法开发相关的问题。
