从病例对照研究到用于普通科医生患者检测的诊断性病毒性胃肠炎检测面板。

From a case-control survey to a diagnostic viral gastroenteritis panel for testing of general practitioners' patients.

机构信息

Laboratory of Medical Microbiology and Infectious Diseases, Isala, Zwolle, The Netherlands.

ZGT Academy, Ziekenhuisgroep Twente, Almelo, The Netherlands.

出版信息

PLoS One. 2021 Nov 3;16(11):e0258680. doi: 10.1371/journal.pone.0258680. eCollection 2021.

DOI:10.1371/journal.pone.0258680

PMID:34731182

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8565752/

Abstract

OBJECTIVE

To evaluate the pathogenicity of a broad range of 11 possible gastroenteritis viruses, by means of statistical relationships with cases vs. controls, or Ct-values, in order to establish the most appropriate diagnostic panel for our general practitioner (GP) patients in the Netherlands (2010-2012).

METHODS

Archived stool samples from 1340 cases and 1100 controls were retested using internally controlled multiplex real-time PCRs for putative pathogenic gastroenteritis viruses: adenovirus, astrovirus, bocavirus, enterovirus, norovirus GI and GII, human parechovirus, rotavirus, salivirus, sapovirus, and torovirus.

RESULTS

The prevalence of any virus in symptomatic cases and asymptomatic controls was 16.6% (223/1340) and 10.2% (112/1100), respectively. Prevalence of astrovirus (adjusted odds ratio (aOR) 10.37; 95% confidence interval (CI) 1.34-80.06) and norovirus GII (aOR 3.10; CI 1.62-5.92) was significantly higher in cases versus controls. Rotavirus was encountered only in cases. We did not find torovirus and there was no statistically significant relationship with cases for salivirus (aOR 1,67; (CI) 0.43-6.54)), adenovirus non-group F (aOR 1.20; CI 0.75-1.91), bocavirus (aOR 0.85; CI 0.05-13.64), enterovirus (aOR 0.83; CI 0.50-1.37), human parechovirus (aOR 1.61; CI 0.54-4.77) and sapovirus (aOR 1.15; CI 0.67-1.98). Though adenovirus group F (aOR 6.37; CI 0.80-50.92) and norovirus GI (aOR 2.22, CI: 0.79-6.23) are known enteropathogenic viruses and were more prevalent in cases than in controls, this did not reach significance in this study. The Ct value did not discriminate between carriage and disease in PCR-positive subjects.

CONCLUSIONS

In our population, diagnostic gastroenteritis tests should screen for adenovirus group F, astrovirus, noroviruses GI and GII, and rotavirus. Case-control studies as ours are lacking and should also be carried out in populations from other epidemiological backgrounds.

摘要

目的

通过与病例对照或 Ct 值的统计学关系，评估广泛范围内的 11 种可能的胃肠炎病毒的致病性，以便为荷兰的全科医生（GP）患者建立最合适的诊断小组（2010-2012 年）。

方法

使用内部对照多重实时 PCR 对来自 1340 例病例和 1100 例对照的存档粪便样本进行重新检测，用于检测推定的致病性胃肠炎病毒：腺病毒、星状病毒、博卡病毒、肠道病毒、诺如病毒 GI 和 GII、人肠道病毒、轮状病毒、唾液病毒、沙波病毒和 Torovirus。

结果

在有症状的病例和无症状的对照中，任何病毒的流行率分别为 16.6%（223/1340）和 10.2%（112/1100）。与对照组相比，星状病毒（调整后的优势比（aOR）10.37；95%置信区间（CI）1.34-80.06）和诺如病毒 GII（aOR 3.10；CI 1.62-5.92）的流行率明显更高。轮状病毒仅在病例中发现。我们未发现 Torovirus，唾液病毒与病例之间也没有统计学上的显著关系（aOR 1,67；（CI）0.43-6.54）），腺病毒非 F 组（aOR 1.20；CI 0.75-1.91），博卡病毒（aOR 0.85；CI 0.05-13.64），肠道病毒（aOR 0.83；CI 0.50-1.37），人肠道病毒（aOR 1.61；CI 0.54-4.77）和沙波病毒（aOR 1.15；CI 0.67-1.98）。尽管腺病毒 F 组（aOR 6.37；CI 0.80-50.92）和诺如病毒 GI（aOR 2.22，CI：0.79-6.23）是已知的肠道致病病毒，在病例中比在对照组中更为普遍，但在本研究中未达到显著水平。Ct 值不能区分 PCR 阳性受试者的携带和疾病。