Salez Nicolas, Vabret Astrid, Leruez-Ville Marianne, Andreoletti Laurent, Carrat Fabrice, Renois Fanny, de Lamballerie Xavier
Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, EPV UMR_D 190 "Emergence des Pathologies Virales", Marseille, France.
Laboratory of Human and Molecular Virology, IFR146 ICORE, University Hospital, Caen, France.
PLoS One. 2015 Jun 24;10(6):e0130378. doi: 10.1371/journal.pone.0130378. eCollection 2015.
Acute Respiratory Infections (ARIs) are responsible for considerable morbidity and mortality worldwide. Documentation of respiratory specimens can help for an appropriate clinical management with a significant effect on the disease progress in patient, the antimicrobial therapy used and the risk of secondary spread of infection. Here, we compared the performances of four commercial multiplex kits used in French University Hospital diagnostic microbiology laboratories for the detection of ARI pathogens (i.e., the xTAG Respiratory Viral Panel Fast, RespiFinder SMART 22, CLART PneumoVir and Fast Track Diagnostics Respiratory Pathogen 33 kits). We used a standardised nucleic acids extraction protocol and a comprehensive comparative approach that mixed reference to well established real-time PCR detection techniques and analysis of convergent positive results. We tested 166 respiratory clinical samples and identified a global high degree of correlation for at least three of the techniques (xTAG, RespiFinder and FTD33). For these techniques, the highest Youden's index (YI), positive predictive (PPV) and specificity (Sp) values were observed for Core tests (e.g., influenza A [YI:0.86-1.00; PPV:78.95-100.00; Sp:97.32-100.00] & B [YI:0.44-1.00; PPV:100.00; Sp:100.00], hRSV [YI:0.50-0.99; PPV:85.71-100.00; Sp:99.38-100.00], hMPV [YI:0.71-1.00; PPV:83.33-100.00; Sp:99.37-100.00], EV/hRV [YI:0.62-0.82; PPV:93.33-100.00; Sp:94.48-100.00], AdV [YI:1.00; PPV:100.00; Sp:100.00] and hBoV [YI:0.20-0.80; PPV:57.14-100.00; Sp:98.14-100.00]). The present study completed an overview of the multiplex techniques available for the diagnosis of acute respiratory infections.
急性呼吸道感染(ARI)在全球范围内导致了相当高的发病率和死亡率。呼吸道标本的检测有助于进行适当的临床管理,对患者的疾病进展、所用的抗菌治疗以及感染的二次传播风险都有显著影响。在此,我们比较了法国大学医院诊断微生物实验室用于检测ARI病原体的四种商用多重检测试剂盒(即xTAG呼吸道病毒检测板快速检测试剂盒、RespiFinder SMART 22试剂盒、CLART PneumoVir试剂盒和快速诊断呼吸道病原体33试剂盒)的性能。我们采用了标准化的核酸提取方案和综合比较方法,结合了成熟的实时PCR检测技术和对趋同阳性结果的分析。我们检测了166份呼吸道临床样本,发现至少三种技术(xTAG、RespiFinder和FTD33)之间存在高度相关性。对于这些技术,核心检测项目(如甲型流感病毒[约登指数(YI):0.86 - 1.00;阳性预测值(PPV):78.95 - 100.00;特异性(Sp):97.32 - 100.00]和乙型流感病毒[YI:0.44 - 1.00;PPV:100.00;Sp:100.00]、人呼吸道合胞病毒(hRSV)[YI:0.50 - 0.99;PPV:85.71 - 100.00;Sp:99.38 - 100.00]、人偏肺病毒(hMPV)[YI:0.71 - 1.00;PPV:83.33 - 100.00;Sp:99.37 - 100.00]、肠道病毒/人鼻病毒(EV/hRV)[YI:0.62 - 0.82;PPV:93.33 - 100.00;Sp:94.48 - 100.00]、腺病毒(AdV)[YI:1.00;PPV:100.00;Sp:100.00]和人博卡病毒(hBoV)[YI:0.20 - 0.80;PPV:57.14 - 100.00;Sp:98.14 - 100.00])观察到了最高的约登指数、阳性预测值和特异性值。本研究完成了对可用于诊断急性呼吸道感染的多重检测技术的概述。