Department of Infectious Diseases/Clinical Virology, Sahlgrenska University Hospital, Guldhedsgatan 10B, SE-413 46 Gothenburg, Sweden.
J Clin Virol. 2011 Aug;51(4):279-82. doi: 10.1016/j.jcv.2011.05.025. Epub 2011 Jun 16.
Viral agents, especially norovirus, are the most common cause of nosocomial spread of epidemic gastroenteritis (GE). Rapid and reliable detection of these agents could reduce the risk of outbreaks.
To evaluate the diagnostic performance of rectal swab samples compared to standard stool samples for detection of agents causing viral GE by PCR.
Complete pairs of rectal swab and stool samples, obtained simultaneously from patients with symptoms of acute onset GE, were analysed with a multiple real-time PCR targeting six different gastroenteritis agents (astro-, adeno-, rota-, sapo- and norovirus GI and II). Cycle threshold (Ct) values were registered for positive samples. A positive PCR result in either sample for any virus was considered gold standard.
69 sample pairs were included of which 29 were negative in both sample types and 38 were positive in both sample types. One pair was positive in the stool sample only and another pair was positive in the rectal swab sample only. Sensitivity for both sample types was 97.5% (39/40).
Rectal swab samples are as reliable as stool samples for PCR-based diagnosis of viral gastroenteritis in patients with a short duration of symptoms and may be used as a complement to stool samples, especially when immediate sampling is desirable.
病毒病原体，尤其是诺如病毒，是引起医院内流行胃肠炎（GE）的最常见原因。快速可靠地检测这些病原体可以降低爆发的风险。
通过 PCR 评估直肠拭子样本与标准粪便样本检测引起病毒性 GE 的病原体的诊断性能。
对同时从患有急性胃肠炎症状的患者中获得的完整的直肠拭子和粪便样本进行分析，采用针对六种不同胃肠炎病原体（星状、腺病毒、轮状、肠型杯状、诺如病毒 GI 和 II）的多重实时 PCR。记录阳性样本的循环阈值（Ct）值。任何病毒的阳性 PCR 结果均被视为金标准。
共纳入 69 对样本，其中 29 对在两种样本类型中均为阴性，38 对在两种样本类型中均为阳性。一对仅在粪便样本中阳性，另一对仅在直肠拭子样本中阳性。两种样本类型的敏感性均为 97.5%（39/40）。
对于症状持续时间短的患者，直肠拭子样本与基于 PCR 的病毒性胃肠炎的粪便样本诊断一样可靠，并且可以作为粪便样本的补充，特别是在需要立即采样时。
