Azhar Iman Rezaee, Mohraz Minoo, Mardani Masoud, Tavakoli Mohammad Ali, Afshar Amin Ehteshami, Zamani Mohammad, Sadeghpoor Simin, Safari Saeid, Dadashpoor Roozbeh, Rezaee Mahsa, Shirvani Fariba, Azimi Shohreh, Heydarifard Zahra, Ranjbar Hamidreza Hagh, Lotfi Amir Hossain, Mosadegh Farhad, Hashemnejad Farhad, Jazayeri Seyed Mohammad
Genetic Laboratory and Molecular Diagnosis, Laleh Hospital, Tehran.
Infection Control Office, Laleh Hospital, Tehran.
Infect Dis Rep. 2020 Apr 15;12(1):8139. doi: 10.4081/idr.2020.8139. eCollection 2020 Feb 25.
The introduction of polymerase chain reaction (PCR) techniques has improved the detection of respiratory viruses, particularly with the use of multiplex real-time technique with the capability of simultaneous detection of various pathogens in a single reaction. The aim of this study was to apply the above technology for the diagnosis of influenza infections and at the same time to differentiate between common flu species between hospitalized patients in Laleh hospital (Iran) between two flu seasons (2016-2017 and 2017-2018). Different respiratory specimens were collected from 540 patients from a period of December 2016 to May 2018 and were sent to the laboratory for molecular diagnosis. RNAs were extracted and subsequently, a multiplex real time PCR identifying flu A, flu B and typing flu A (H1N1) was carried out. The mean age of patients was 47.54±23.96. 216 (40%) and 321 (60%) of subjects were male and female, respectively. 219 out of 540 (40.5%) were positive for influenza infection including flu A (n=97, 44.3%), flu A (H1N1) (n=45, 20.7%) and flu B (n=77, 35%). Flu A was the dominant species on 2016-2017 and flu B was the major species on 2017-2018. Flu A (H1N1) was comparable in both time periods. Flu infections were most frequently diagnosed in age groups 21-40. Flu-positive patients suffered more from body pain and sore throat than flunegative patients with significant statistical difference (P values <0.001). The mean duration of hospitalization was shorter for flu-positive patients (P value = 0.016). Application of multiplex real time PCR could facilitate the influenza diagnosis in a short period of time, benefiting patients from exclusion of bacterial infections and avoiding unnecessary antibiotic therapy. Influenza diagnosis was not achieved in up to 60% of flu-like respiratory infections, suggesting the potential benefit of adopting the same methodology for assessing the involvement of other viral or/and bacterial pathogens in those patients.
聚合酶链反应（PCR）技术的引入改善了呼吸道病毒的检测，特别是使用多重实时技术能够在单个反应中同时检测多种病原体。本研究的目的是应用上述技术诊断流感感染，同时区分拉莱医院（伊朗）两个流感季节（2016 - 2017年和2017 - 2018年）住院患者中常见的流感病毒种类。从2016年12月至2018年5月期间的540名患者中收集了不同的呼吸道标本，并送往实验室进行分子诊断。提取RNA，随后进行多重实时PCR以鉴定甲型流感、乙型流感并对甲型流感（H1N1）进行分型。患者的平均年龄为47.54±23.96岁。受试者中分别有216名（40%）男性和321名（60%）女性。540名患者中有219名（40.5%）流感感染呈阳性，包括甲型流感（n = 97，44.3%）、甲型流感（H1N1）（n = 45，20.7%）和乙型流感（n = 77，35%）。2016 - 2017年甲型流感是主要类型，2017 - 2018年乙型流感是主要类型。两个时间段内甲型流感（H1N1）的比例相当。流感感染在21 - 40岁年龄组中最常被诊断出来。流感阳性患者比流感阴性患者更多地遭受身体疼痛和喉咙痛，差异具有统计学意义（P值<0.001）。流感阳性患者的平均住院时间较短（P值 = 0.016）。应用多重实时PCR可以在短时间内促进流感诊断，使患者受益于排除细菌感染并避免不必要的抗生素治疗。在高达60%的流感样呼吸道感染中未实现流感诊断，这表明采用相同方法评估这些患者中其他病毒或/和细菌病原体的参与可能具有潜在益处。
