Stefańska Ilona, Romanowska Magdalena, Brydak Lidia B
Zakład Badania Wirusów Grypy. Krajowy Ośrodek ds. Grypy, Narodowy Instytut Zdrowia Publicznego - Państwowy Zakład Higieny w Warszawie.
Postepy Hig Med Dosw (Online). 2012 Jun 28;66:452-60. doi: 10.5604/17322693.1001898.
Respiratory viruses contribute to significant morbidity and mortality in healthy and immunocompromised individuals and are considered as a significant economic burden in the healthcare system. The similar clinical symptoms in the course of different viral and bacterial respiratory infections make the proper diagnosis difficult. An accurate and prompt diagnostics is crucial for infection control and patient management decisions, especially regarding the use of antibacterial or antiviral therapy and hospitalization. Moreover, the identification of the causative agent eliminates inappropriate use of antibiotics and may reduce the cost of healthcare. A wide variety of diagnostic procedures is applied for the detection of viral agents responsible for respiratory tract infections. For many years, the viral antigen detection and standard isolation technique in cell culture was the main method used in routine diagnostics. However, in recent years the nucleic acid amplification techniques have become widely used and have significantly improved the sensitivity of viral detection in clinical specimens. Molecular diagnostic assays have contributed to revealing high rates of co-infection (multiplex reactions) and allow identification of agents that are difficult to culture. This paper discusses a number of technical aspects of the current most commonly used techniques, their general principles, main benefits and diagnostic value, but also some of their limitations.
呼吸道病毒会导致健康人群和免疫功能低下者出现严重发病和死亡情况,被视为医疗系统的重大经济负担。不同病毒和细菌引起的呼吸道感染在病程中具有相似的临床症状,这使得准确诊断变得困难。准确、及时的诊断对于感染控制和患者管理决策至关重要,特别是在使用抗菌或抗病毒治疗以及住院治疗方面。此外,确定病原体可避免不恰当使用抗生素,并可能降低医疗成本。多种诊断程序被用于检测引起呼吸道感染的病毒病原体。多年来,病毒抗原检测和细胞培养中的标准分离技术一直是常规诊断中使用的主要方法。然而,近年来核酸扩增技术已得到广泛应用,并显著提高了临床标本中病毒检测的灵敏度。分子诊断检测有助于揭示高比例的合并感染(多重反应),并能鉴定出难以培养的病原体。本文讨论了当前最常用技术的一些技术方面、其一般原理、主要优点和诊断价值,以及它们的一些局限性。