Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu 30071, Taiwan.
Department of Medicine, MacKay Medical College, New Taipei City 25160, Taiwan.
Int J Environ Res Public Health. 2020 Jan 15;17(2):564. doi: 10.3390/ijerph17020564.
Respiratory viruses are a common cause of respiratory tract infection (RTI), particularly in neonates and children. Rapid and accurate diagnosis of viral infections could improve clinical outcomes and reduce the use of antibiotics and treatment sessions. Advances in diagnostic technology contribute to the accurate detection of viruses. We performed a multiplex real-time polymerase chain reaction (PCR) to investigate the viral etiology in pediatric patients and compared the detection rates with those determined using traditional antigen tests and virus cultures. Fifteen respiratory viruses were included in our investigation: respiratory syncytial virus A/B (RSV), influenza virus A (FluA) and influenza virus B (FluB), human metapneumovirus (MPV), enterovirus (EV), human parainfluenza virus (PIV) types 1-4, human rhinovirus (RV), human coronavirus OC43, NL63, and 229E, human adenovirus (ADV), and human bocavirus (Boca). In total, 474 specimens were collected and tested. Respiratory viruses were detected more frequently by PCR (357, 75.3%) than they were by traditional tests (229, 49.3%). The leading pathogens were RSV (113, 23.8%), RV (72, 15.2%), PIV3 (53, 11.2%), FluA (51, 10.8%), and ADV (48, 10.1%). For children younger than 5 years, RSV and RV were most prevalent; for children older than 5 years, FluA and ADV were the most frequently detected. Of the specimens, 25.8% (92/357) were coinfected with two or more viruses. RV, Boca, PIV2, FluB, and PIV4 had higher rates of coinfection; MPV and PIV1 had the lowest rates of coinfection (9.1% and 5.3%). To conclude, the detection power of PCR was better than that of traditional antigen tests and virus cultures when considering the detection of respiratory viruses. RSV and RV were the leading viral pathogens identified in the respiratory specimens. One-quarter of the positive specimens were coinfected with two or more viruses. In the future, further application of PCR may contribute to the rapid and accurate diagnosis of respiratory viruses and could improve patient outcomes.
呼吸道病毒是呼吸道感染(RTI)的常见原因,尤其是在新生儿和儿童中。快速准确地诊断病毒感染可以改善临床结果并减少抗生素和治疗次数的使用。诊断技术的进步有助于准确检测病毒。我们进行了多重实时聚合酶链反应(PCR),以研究儿科患者的病毒病因,并将检测率与传统抗原检测和病毒培养的检测率进行比较。我们的研究包括 15 种呼吸道病毒:呼吸道合胞病毒 A/B(RSV)、甲型流感病毒(FluA)和乙型流感病毒(FluB)、人类偏肺病毒(MPV)、肠病毒(EV)、人类副流感病毒(PIV)1-4 型、人类鼻病毒(RV)、人类冠状病毒 OC43、NL63 和 229E、人类腺病毒(ADV)和人类博卡病毒(Boca)。总共收集和测试了 474 个标本。PCR 检测到的呼吸道病毒(357 个,75.3%)比传统检测(229 个,49.3%)更频繁。主要病原体是 RSV(113 个,23.8%)、RV(72 个,15.2%)、PIV3(53 个,11.2%)、FluA(51 个,10.8%)和 ADV(48 个,10.1%)。对于 5 岁以下的儿童,RSV 和 RV 最为常见;对于 5 岁以上的儿童,FluA 和 ADV 是最常检测到的病毒。在这些标本中,25.8%(92/357)合并感染两种或两种以上病毒。RV、Boca、PIV2、FluB 和 PIV4 的合并感染率较高;MPV 和 PIV1 的合并感染率较低(9.1%和 5.3%)。总之,考虑到呼吸道病毒的检测,PCR 的检测能力优于传统抗原检测和病毒培养。RSV 和 RV 是呼吸道标本中主要的病毒病原体。四分之一的阳性标本合并感染两种或两种以上病毒。在未来,PCR 的进一步应用可能有助于呼吸道病毒的快速准确诊断,并改善患者的预后。