Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China.
Department of Pediatrics, Suzhou Municipal Hospital, Suzhou, China.
J Med Virol. 2016 Feb;88(2):211-5. doi: 10.1002/jmv.24338. Epub 2015 Oct 5.
To compare the presence of human bocavirus (HBoV) in nasopharyngeal aspirates (NPA) versus broncho-alveolar lavage fluids (BAL) in children with lower respiratory tract infections (LRTIs), as revealed by real-time PCR, in order to confirm the diagnostic validity of NPA samples. A retrospective 5-year study was performed from 2009 to 2014 in 1,194 patients under the age of 17 years (mean age of 3 years) that were diagnosed with LRTIs and from whom both NPA and BAL were obtained. Clinical and demographic data were recorded, and NPA and BAL samples were analyzed for HBoV-positivity by real-time PCR. Of the 1,194 patients enrolled, 65 (5.4%) patients had HBoV detected from NPA, and 61 (5.1%) had HBoV detected from BAL. For HBoV, there was a significant association between the NPA and BAL samples (P < 0.001), but the diagnostic validity was relatively low (kappa = 0.414). When real-time PCR-positivity for HBoV in BAL was used as a reference for diagnosis, NPA had a good specificity and better positive predictive validity in male patients or those younger than 3 years of age. NPA has a similar yield and a good specificity for diagnosis of LRTIs with HBoV compared to BAL. The best diagnostic validity for NPA was detected in male patients or those younger than 3 years old.
为了比较实时聚合酶链反应（PCR）检测鼻咽抽吸物（NPA）与支气管肺泡灌洗液（BAL）中人类博卡病毒（HBoV）在下呼吸道感染（LRTIs）患儿中的存在情况，以确认 NPA 样本的诊断有效性，我们进行了一项回顾性 5 年研究，研究对象为 2009 年至 2014 年间年龄在 17 岁以下（平均 3 岁）的 1194 例 LRTIs 患儿，这些患儿均同时获得了 NPA 和 BAL 样本。记录了临床和人口统计学数据，并通过实时 PCR 分析 NPA 和 BAL 样本中 HBoV 的阳性情况。在纳入的 1194 例患者中，65 例（5.4%）患者的 NPA 检测到 HBoV，61 例（5.1%）患者的 BAL 检测到 HBoV。对于 HBoV，NPA 和 BAL 样本之间存在显著相关性（P<0.001），但诊断有效性相对较低（kappa=0.414）。当 BAL 中 HBoV 的实时 PCR 阳性作为诊断参考时，NPA 在男性或 3 岁以下患儿中具有良好的特异性和更好的阳性预测值。NPA 与 BAL 相比，在下呼吸道感染合并 HBoV 的诊断中具有相似的阳性率和良好的特异性。NPA 的最佳诊断有效性在男性或 3 岁以下患儿中检测到。
