Department of Pathology, University of Utah, Salt Lake City, Utah, USA.
ARUP Laboratories, Salt Lake City, Utah, USA.
J Clin Microbiol. 2022 Dec 21;60(12):e0133622. doi: 10.1128/jcm.01336-22. Epub 2022 Nov 29.
While the practice of viral culture has largely been replaced by nucleic acid amplification tests, circumstances still exist in which the availability of viral culture will allow for the diagnosis of infections not included in a provider's differential diagnosis. Here, we examine the cytopathic effects (CPE) and clinical data associated with 18 cases of monkeypox virus (MPXV) isolated from 19 clinical samples submitted for viral culture. During the study period, a total of 3,468 viral cultures were performed with herpes simplex virus (HSV) most commonly isolated (646/3,468; 18.6%), followed by MPXV (19/3,468; 0.6%) and varicella-zoster virus (VZV) (12/3,468; 0.4%). Most MPXV-positive samples were obtained from males (14/19) and taken from genital (7/19) or rectal lesions (5/19). Cycle threshold values of tested samples ranged from 15.3 to 29.0. Growth of MPXV in cell culture was rapid, yielding detectable CPE at a median of 2 days (range: 1 to 4) often with >50% of the monolayer affected in RMK, BGM, A549, and MRC-5 cell lines. As clinical features of MPXV, HSV, and VZV lesions may overlap, CPE patterns were compared between viruses. HSV CPE developed in a similar time frame (median: 2 days, range: 1 to 7) but was more often negative in RMK cells relative to MPXV. VZV grew more slowly (median: 9 days, range: 5 to 11) and demonstrated CPE affecting ≤25% of cell monolayers when positive. Viral culture remains an important tool for the detection of rare or emerging viral pathogens, particularly when high viral load specimens are easily obtained.
虽然病毒培养的做法在很大程度上已被核酸扩增测试所取代，但在某些情况下，病毒培养的可用性将允许诊断未包含在提供者鉴别诊断中的感染。在这里，我们检查了 19 份临床样本中分离的 18 株猴痘病毒（MPXV）的细胞病变效应（CPE）和临床数据，这些样本是为病毒培养而提交的。在研究期间，共进行了 3468 次病毒培养，其中单纯疱疹病毒（HSV）的分离率最高（646/3468；18.6%），其次是 MPXV（19/3468；0.6%）和水痘-带状疱疹病毒（VZV）（12/3468；0.4%）。大多数 MPXV 阳性样本来自男性（14/19），取自生殖器（7/19）或直肠病变（5/19）。测试样本的循环阈值值范围为 15.3 至 29.0。MPXV 在细胞培养中的生长迅速，在中位时间为 2 天（范围：1 至 4）即可检测到 CPE，在 RMK、BGM、A549 和 MRC-5 细胞系中，常超过 50%的单层受到影响。由于 MPXV、HSV 和 VZV 病变的临床特征可能重叠，因此比较了病毒之间的 CPE 模式。HSV 的 CPE 发展时间相似（中位时间：2 天，范围：1 至 7），但相对于 MPXV，RMK 细胞中更常为阴性。VZV 的生长速度较慢（中位时间：9 天，范围：5 至 11），当为阳性时，CPE 仅影响≤25%的细胞单层。病毒培养仍然是检测罕见或新兴病毒病原体的重要工具，特别是在容易获得高病毒载量标本时。
