New York State Department of Health, Albany, NY, USA.
J Med Virol. 2011 Dec;83(12):2172-81. doi: 10.1002/jmv.22169.
The etiology of encephalitis and meningitis, serious diseases of the central nervous system (CNS), in most cases remains unknown. The importance of establishing a diagnosis however, becomes even more important as advances are made in effective therapy. Molecular methods of detection, in particular, PCR, are being used routinely and have established a place in the arsenal of tools for diagnosis of CNS infections. In this study a viral etiological agent was detected by PCR in 340 of the total 2,357 specimens from patients who exhibited symptoms of encephalitis or meningitis. The detection rate increased from 8.9% during the first year of the study to 14.8% during the second year of the study with improved methodology and an expanded panel of viral agents. Methods were enhanced by developing real-time PCR assays (some multiplexed), using increased automation, superior nucleic acid extraction, and reverse transcription (RT) methods, and incorporation of an internal extraction control. Additionally, adenovirus and human herpes virus 6 (HHV-6) were added to the original panel of 10 viruses that included enteroviruses, herpesviruses, and arboviruses. The most common viruses detected were enteroviruses (129; 5.5%), Epstein-Barr virus (EBV) (85; 3.6%), herpes simplex viruses (HSVs) 1 and 2 (67; 2.8%), and varicella zoster virus (VZV) (44; 1.9%).
脑炎和脑膜炎是中枢神经系统（CNS）的严重疾病，其病因在大多数情况下仍然未知。然而，由于有效的治疗方法不断取得进展，因此确定诊断变得更加重要。特别是，分子检测方法，例如 PCR，已被常规使用，并在 CNS 感染的诊断工具中占据了一席之地。在这项研究中，通过 PCR 从表现出脑炎或脑膜炎症状的患者的总共 2357 个标本中的 340 个中检测到了病毒病因。随着方法学的改进和病毒检测范围的扩大，检测率从研究的第一年的 8.9％上升到第二年的 14.8％。方法的改进包括开发实时 PCR 检测（某些多重检测）、增加自动化程度、使用更先进的核酸提取和逆转录（RT）方法，并纳入内部提取对照。此外，腺病毒和人类疱疹病毒 6（HHV-6）已被添加到最初包括肠道病毒、疱疹病毒和虫媒病毒的 10 种病毒检测面板中。检测到的最常见病毒是肠道病毒（129 个；5.5％）、EB 病毒（85 个；3.6％）、单纯疱疹病毒 1 型和 2 型（67 个；2.8％）和水痘带状疱疹病毒（44 个；1.9％）。
