Department of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Influenza Other Respir Viruses. 2014 Jul;8(4):397-405. doi: 10.1111/irv.12247. Epub 2014 May 23.
Respiratory tract infections are a major cause of outpatient visits, yet only a portion is tested to determine the etiologic organism. Multiplex reverse transcriptase polymerase chain reaction (MRT-PCR) assays for detection of multiple viruses are being used increasingly in clinical settings.
During January-April 2012, outpatients with acute respiratory illness (≤ 7 days) were tested for influenza using singleplex RT-PCR (SRT-PCR). A subset was assayed for 18 viruses using MRT-PCR to compare detection of influenza and examine the distribution of viruses and characteristics of patients using multinomial logistic regression.
Among 662 participants (6 months-82 years), detection of influenza was similar between the MRT-PCR and SRT-PCR (κ = 0.83). No virus was identified in 267 (40.3%) samples. Commonly detected viruses were human rhinovirus (HRV, 15.4%), coronavirus (CoV, 10.4%), respiratory syncytial virus (RSV, 8.4%), human metapneumovirus (hMPV, 8.3%), and influenza (6%). Co-detections were infrequent (6.9%) and most commonly occurred among those <18 years old. In regression analyses, compared with non-viral illnesses, RSV and hMPV were significantly more frequent in children and less frequent in 18- to 49-year-olds than in those ≥ 50 years (P = 0.01), fever was more common in hMPV and influenza infections (P = 0.008), nasal congestion was more frequent in CoV, HRV, hMPV, influenza and RSV infections (P = 0.001), and body mass index was higher among those with influenza (P = 0.036).
Using MRT-PCR, a viral etiology was found in three-fifths of patients with medically attended outpatient visits for acute respiratory illness during the influenza season; co-detected viruses were infrequent. Symptoms varied by viral etiology.
呼吸道感染是导致门诊就诊的主要原因，但只有一部分会进行检测以确定病原体。多重逆转录酶聚合酶链反应（MRT-PCR）检测用于检测多种病毒，在临床环境中应用越来越广泛。
在 2012 年 1 月至 4 月期间，对患有急性呼吸道疾病（≤7 天）的门诊患者使用单重 RT-PCR（SRT-PCR）检测流感。一部分患者使用 MRT-PCR 检测 18 种病毒，以比较流感的检测情况，并通过多项逻辑回归分析病毒的分布和患者特征。
在 662 名参与者（6 个月至 82 岁）中，MRT-PCR 和 SRT-PCR 检测流感的结果相似（κ=0.83）。267 份（40.3%）样本未检出病毒。常见的病毒包括人类鼻病毒（HRV，15.4%）、冠状病毒（CoV，10.4%）、呼吸道合胞病毒（RSV，8.4%）、人偏肺病毒（hMPV，8.3%）和流感（6%）。共检出率较低（6.9%），且最常见于<18 岁的人群。在回归分析中，与非病毒感染相比，RSV 和 hMPV 在儿童中更为常见，而在 18 至 49 岁人群中较 50 岁以上人群中更为少见（P=0.01），发热在 hMPV 和流感感染中更为常见（P=0.008），鼻塞在 CoV、HRV、hMPV、流感和 RSV 感染中更为常见（P=0.001），流感患者的体重指数较高（P=0.036）。
在流感季节，通过 MRT-PCR 检测，五分之三的急性呼吸道疾病门诊就诊患者有病毒病因；共检出的病毒较少。症状因病毒病因而异。
