Kumar M L, Super D M, Lembo R M, Thomas F C, Prokay S L
J Clin Microbiol. 1987 May;25(5):873-5. doi: 10.1128/jcm.25.5.873-875.1987.
With the availability of ribavirin therapy for serious respiratory syncytial virus (RSV) infections, rapid diagnostic tests for the detection of RSV antigen are increasingly important. Efficacies of a commercially available enzyme immunoassay (EIA) (Abbott Laboratories, North Chicago, Ill.) and a fluorescent-antibody assay (FA) were evaluated in a study involving 135 specimens from children with respiratory symptoms. A nasal wash specimen was cultured immediately on RSV-sensitive A549 cells; the nasal wash was also used for EIA. FA was performed on a nasopharyngeal swab specimen with bovine anti-RSV and anti-bovine immunoglobulin G antisera (Burroughs Wellcome Co., Research Triangle Park, N.C.). A total of 39 specimens (28%) were tissue culture positive, including 35 EIA-positive and 37 FA-positive samples (sensitivities, 90 and 95%, respectively). All 96 tissue culture-negative specimens were EIA negative (specificity, 100%); 94 of these 96 specimens were FA negative (specificity, 98%). Positive and negative predictive values for the tests were as follows: 100 and 96% for EIA, respectively, and 95 and 98% for FA, respectively. Other viruses, including influenza A virus, adenovirus, enterovirus, and herpes simplex virus, were isolated in nine cases. One adenovirus-positive specimen had a false-positive RSV FA result; all nine specimens were RSV EIA negative. Both tests performed well in our study and provide cost-effective alternatives to tissue culture. The RSV EIA, in particular, uses standard serologic techniques and equipment and does not require expertise in virology. More widespread availability of rapid diagnostic tests for RSV will hopefully result in early and appropriate use of antiviral therapy in patients at risk for serious RSV infections.
随着利巴韦林疗法可用于治疗严重的呼吸道合胞病毒（RSV）感染，检测RSV抗原的快速诊断测试变得越来越重要。在一项涉及135例有呼吸道症状儿童的标本的研究中，评估了一种市售酶免疫测定法（EIA）（雅培实验室，伊利诺伊州北芝加哥）和荧光抗体测定法（FA）的效能。鼻洗液标本立即接种于对RSV敏感的A549细胞上进行培养；鼻洗液也用于EIA检测。使用牛抗RSV和抗牛免疫球蛋白G抗血清（伯勒斯·韦尔科姆公司，北卡罗来纳州研究三角园）对鼻咽拭子标本进行FA检测。共有39份标本（28%）组织培养呈阳性，其中包括35份EIA阳性和37份FA阳性样本（敏感性分别为90%和95%）。所有96份组织培养阴性的标本EIA均为阴性（特异性为100%）；这96份标本中有94份FA为阴性（特异性为98%）。这些测试的阳性和阴性预测值如下：EIA分别为100%和96%，FA分别为95%和98%。在9例病例中分离出了其他病毒，包括甲型流感病毒、腺病毒、肠道病毒和单纯疱疹病毒。1份腺病毒阳性标本的RSV FA结果为假阳性；所有9份标本的RSV EIA均为阴性。在我们的研究中，这两种测试表现良好，并且为组织培养提供了经济有效的替代方法。特别是RSV EIA，它使用标准的血清学技术和设备，不需要病毒学方面的专业知识。RSV快速诊断测试的更广泛应用有望使有严重RSV感染风险的患者能够早期且适当地使用抗病毒治疗。
