Zeytinoğlu Ayşın, Erensoy Selda, Sertöz Rüçhan, Altuğlu İmre, Çiçek Candan, Kayın Münevver, Şirin Hadiye, Taner Şafak
Ege University Faculty of Medicine, Department of Medical Microbiology, Izmir, Turkey.
Mikrobiyol Bul. 2017 Apr;51(2):127-135. doi: 10.5578/mb.53825.
The serious diseases of the central nervous system (CNS); encephalitis and meningitis, have high mortality and morbidity rate especially not diagnosed and treated in time. Nucleic acid testing (NAT) is the tool of choice for viral diagnosis in CNS infections. In this study, viral etiological agents found in cerebrospinal fluid (CSF) samples sent to our university hospital virology laboratory for laboratory diagnosis of CNS infections were retrospectively evaluated and results were compared with other reports from our country. Viral etiological agents found in cerebrospinal fluid (CSF) samples sent to Ege University Faculty of Medicine Department of Medical Microbiology Virology Laboratories for laboratory diagnosis of CNS infection between 01.01.2009-31.12.2015 were evaluated retrospectively. A total of 3778 CSF tests were performed for cell culture of enterovirus (EV) in 487 samples and 3291 tests for nucleic acid testing (NAT) by real time polymerase chain reaction (PCR) in herpes simplex virus 1 (HSV1), herpes simplex virus 2 (HSV2), varicella zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpes virus 6 (HHV6) and EV. VZV and EV NAT's were performed during the last one and five years period, respectively. NAT positive results for HSV1, HSV2, CMV, EBV, VZV, HHV6 and EV were 1.80% (24/1333), 0.08% (1/1333), 3.28% (19/580), 4.35% (22/506), 0.46% (1/216), 1.05% (5/478) and 3.37% (6/178), respectively. EV was isolated in 30 (6.20%) of 487 CSF samples by viral culture. Positive samples were mainly from pediatric, neurology and infectious diseases clinics as expected. The number of higher positive results were found in samples sentin december (35.3%), july (12.9%) and november (10.6%). Overall 80% of positive samples belonged to patients over 18 years old. When the results of other studies reported from Turkey are examined, although the positivity rates are generally similar, it is seen that the rates specific to certain factors are higher in selected smaller patient groups like HSV1 and EV. Rapid nucleic acid tests like multiplex PCR and microarray will provide more practical and effective laboratory diagnosis approach in CNS infections, since many more microorganisms may be causative agents.
中枢神经系统（CNS）的严重疾病，如脑炎和脑膜炎，具有很高的死亡率和发病率，尤其是未及时诊断和治疗时。核酸检测（NAT）是中枢神经系统感染病毒诊断的首选工具。在本研究中，回顾性评估了送至我校医院病毒学实验室用于中枢神经系统感染实验室诊断的脑脊液（CSF）样本中发现的病毒病原体，并将结果与我国其他报告进行了比较。回顾性评估了2009年1月1日至2015年12月31日期间送至伊兹密尔艾杰大学医学院医学微生物学病毒学实验室用于中枢神经系统感染实验室诊断的脑脊液（CSF）样本中发现的病毒病原体。对487份样本进行了3778次肠道病毒（EV）细胞培养检测，对单纯疱疹病毒1型（HSV1）、单纯疱疹病毒2型（HSV2）、水痘带状疱疹病毒（VZV）、爱泼斯坦-巴尔病毒（EBV）、巨细胞病毒（CMV）、人类疱疹病毒6型（HHV6）和EV进行了3291次实时聚合酶链反应（PCR）核酸检测（NAT）。VZV和EV的NAT检测分别在过去1年和5年期间进行。HSV1、HSV2、CMV、EBV、VZV、HHV6和EV的NAT阳性结果分别为1.80%（24/1333）、0.08%（1/1333）、3.28%（19/580）、4.35%（22/506）、0.46%（1/216）、1.05%（5/478）和3.37%（6/178）。通过病毒培养在487份脑脊液样本中的30份（6.20%）中分离出EV。阳性样本主要来自儿科、神经科和传染病科门诊，这在意料之中。12月（35.3%）、7月（12.9%）和11月（10.6%）送检的样本中阳性结果较多。总体而言，80%的阳性样本属于18岁以上患者。当查看土耳其其他研究报告的结果时，尽管阳性率总体相似，但在某些选定的较小患者群体中，如HSV1和EV，特定因素的比率更高。由于可能有更多微生物是病原体，多重PCR和微阵列等快速核酸检测将为中枢神经系统感染提供更实用有效的实验室诊断方法。
