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呼吸道标本中肠道病毒D68的检测:与重症疾病的关联

Enterovirus D68 detection in respiratory specimens: Association with severe disease.

作者信息

Engelmann Ilka, Fatoux Marie, Lazrek Mouna, Alidjinou Enagnon K, Mirand Audrey, Henquell Cécile, Dewilde Anny, Hober Didier

机构信息

Univ Lille, Faculté de Médecine, CHU Lille, Laboratoire de Virologie EA3610, Lille, France.

CHU Clermont-Ferrand, Laboratoire de Virologie, Centre National de Référence des Entérovirus et Parechovirus, Laboratoire associé, Clermont-Ferrand Cedex, France.

出版信息

J Med Virol. 2017 Jul;89(7):1201-1207. doi: 10.1002/jmv.24772. Epub 2017 Mar 28.

Abstract

Molecular techniques increased the number of documented respiratory infections. In a substantial number of cases the causative agent remains undetected. Since August 2014, an increase in Enterovirus(EV)-D68 infections was reported. We aimed to investigate epidemiology and clinical relevance of EV-D68. From June to December 2014 and from September to December 2015, 803 and 847 respiratory specimens, respectively, were tested for respiratory viruses with a multiplex RT-PCR. This multiplex RT-PCR does not detect EV-D68. Therefore, 457 (2014) and 343 (2015) specimens with negative results were submitted to an EV-specific-RT-PCR. EV-positive specimens were tested with an EV-D68-specific-RT-PCR and genotyped. Eleven specimens of 2014 tested positive in the EV-specific-RT-PCR and of these seven were positive in the EV-D68-specific-RT-PCR. Typing confirmed these as EV-D68. Median age of EV-D68-positive patients was 3 years (1 month-91 years). Common symptoms included fever (n = 6, 86%), respiratory distress (n = 5, 71%), and cough (n = 4, 57%). All EV-D68-positive patients were admitted to hospital, 4 (57%) were admitted to intensive care units and 6 (86%) received oxygen. One patient suffered from acute flaccid paralysis. Seven specimens of 2015 were positive in the EV-specific-RT-PCR but negative in the EV-D68-specific-RT-PCR. In conclusion, use of an EV-specific-RT-PCR allowed us to detect EV-D68 circulation in autumn 2014 that was not detected by the multiplex RT-PCR and was associated with severe disease.

摘要

分子技术增加了已记录的呼吸道感染病例数量。在相当多的病例中,病原体仍未被检测到。自2014年8月以来,有报告称肠道病毒D68(EV-D68)感染有所增加。我们旨在调查EV-D68的流行病学和临床相关性。2014年6月至12月以及2015年9月至12月,分别对803份和847份呼吸道标本进行了多重逆转录聚合酶链反应(RT-PCR)检测以查找呼吸道病毒。这种多重RT-PCR检测不出EV-D68。因此,将2014年的457份(2015年为343份)检测结果为阴性的标本送去进行EV特异性RT-PCR检测。对EV阳性标本进行EV-D68特异性RT-PCR检测并进行基因分型。2014年的11份标本在EV特异性RT-PCR检测中呈阳性,其中7份在EV-D68特异性RT-PCR检测中呈阳性。基因分型证实这些为EV-D68。EV-D68阳性患者的中位年龄为3岁(1个月至91岁)。常见症状包括发热(n = 6,86%)、呼吸窘迫(n = 5,71%)和咳嗽(n = 4,57%)。所有EV-D68阳性患者均入院治疗,4例(57%)入住重症监护病房,6例(86%)接受了吸氧治疗。1例患者出现急性弛缓性麻痹。2015年的7份标本在EV特异性RT-PCR检测中呈阳性,但在EV-D68特异性RT-PCR检测中呈阴性。总之,使用EV特异性RT-PCR使我们能够检测到2014年秋季EV-D68的传播情况,而多重RT-PCR未能检测到这种情况,且其与严重疾病相关。

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