评价三种流感神经氨酸酶抑制检测方法在 2011-2012 流感季节公共卫生实验室中的应用。
Evaluation of three influenza neuraminidase inhibition assays for use in a public health laboratory setting during the 2011-2012 influenza season.
机构信息
State of Maryland Department of Health and Mental Hygiene, Laboratories Administration, Division of Virology and Immunology, Baltimore, MD ; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
出版信息
Public Health Rep. 2013 Sep-Oct;128 Suppl 2(Suppl 2):75-87. doi: 10.1177/00333549131280S212.
OBJECTIVES
We evaluated the implementation of three commercially available neuraminidase inhibition assays in a public health laboratory (PHL) setting. We also described the drug susceptibility patterns of human influenza A and B circulating in Maryland during the 2011-2012 influenza season.
METHODS
From January to May 2012, 169 influenza virus isolates were tested for phenotypic susceptibility to oseltamivir, zanamivir, and peramivir using NA-Fluor(TM), NA-Star®, and NA-XTD(TM) concurrently. A 50% neuraminidase inhibitory concentration (IC50) value was calculated to determine drug susceptibility. We used the standard deviation based on the median absolute deviation of the median analysis to determine the potential for reduced drug susceptibility. We evaluated each assay for the use of resources in high- and low-volume testing scenarios.
RESULTS
One of the 25 2009 influenza A (H1N1) pandemic isolates tested was resistant to oseltamivir and peramivir, and sensitive to zanamivir, on all three platforms. Eighty-two influenza A (H3N2) and 62 B isolates were sensitive to all three drugs in all three assays. For a low-volume scenario, NA-Star and NA-XTD took 120 minutes to complete, while NA-Fluor required 300 minutes to complete. The lowest relative cost favored NA-Star. In a high-volume scenario, NA-Fluor had the highest throughput. Reagent use was most efficient when maximizing throughput. Cost efficiency from low- to high-volume testing improved the most for NA-Star.
CONCLUSIONS
Our evaluation showed that both chemiluminescent and fluorescent neuraminidase inhibition assays can be successfully implemented in a PHL setting to screen circulating influenza strains for neuraminidase inhibitor resistance. For improved PHL influenza surveillance, it may be essential to develop guidelines for phenotypic drug-resistance testing that take into consideration a PHL's workload and available resources.
目的
我们评估了三种市售神经氨酸酶抑制检测法在公共卫生实验室（PHL）环境中的实施情况。我们还描述了 2011-2012 年流感季节马里兰州流行的甲型和乙型流感病毒的药物敏感性模式。
方法
2012 年 1 月至 5 月，使用 NA-Fluor(TM)、NA-Star®和 NA-XTD(TM) 同时检测 169 株流感病毒分离株对奥司他韦、扎那米韦和帕拉米韦的表型敏感性。计算 50%神经氨酸酶抑制浓度（IC50）值以确定药物敏感性。我们使用基于中位数分析的中位数绝对偏差的标准差来确定潜在的药物敏感性降低。我们评估了每个检测法在高、低检测量情况下的资源使用情况。
结果
25 株 2009 年甲型（H1N1）流感大流行分离株中，有 1 株对奥司他韦和帕拉米韦在所有 3 种平台上耐药，对扎那米韦敏感。82 株甲型（H3N2）和 62 株乙型流感分离株在所有 3 种检测法中对所有 3 种药物均敏感。对于低检测量情况，NA-Star 和 NA-XTD 需 120 分钟完成，而 NA-Fluor 需 300 分钟完成。最低相对成本有利于 NA-Star。在高检测量情况下，NA-Fluor 的通量最高。在最大限度提高通量的情况下，试剂使用效率最高。从低到高检测量测试的成本效率提高最多的是 NA-Star。
结论
我们的评估表明，化学发光和荧光神经氨酸酶抑制检测法都可以成功地在 PHL 环境中实施，以筛选循环流感株的神经氨酸酶抑制剂耐药性。为了改善 PHL 流感监测，制定考虑到 PHL 工作量和可用资源的表型药物耐药性检测指南可能至关重要。
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