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在发热门诊整合多重PCR技术用于急性呼吸道病原体特异性诊断。

Integrating multiplex PCR in fever clinics for acute respiratory pathogen-specific diagnosis.

作者信息

He Ruifen, Zhang Jianwen, Tian Yuan, Yan Junxia, Huang Jinjuan, Sun Tingting, Xie Yuxin, Pu Wenjia, Wu Tao

机构信息

Department of Clinical Laboratory Medicine, People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan 750001, China.

Public Health Center, People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan 750001, China.

出版信息

Clin Chim Acta. 2025 May 15;572:120245. doi: 10.1016/j.cca.2025.120245. Epub 2025 Mar 27.

Abstract

The epidemiological patterns of respiratory tract infections (RTIs) have experienced substantial changes due to the influence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with a particular focus on acute respiratory infections (ARIs). Challenges in early diagnosis, inadequate triage strategies, and the inappropriate use of antimicrobials or antivirals have compounded the difficulties in accurately diagnosing and managing ARIs in the post-pandemic context. This study aimed to investigate the efficacy of fever clinics equipped with nucleic acid testing capabilities in the precise triage of ARIs. In a cohort of 604 individuals presenting with symptoms of ARIs, we utilized real-time reverse transcription polymerase chain reaction (RT-PCR) technology available in the fever clinic to perform nucleic acid testing for SARS-CoV-2, influenza A virus (Flu A), influenza B virus (Flu B), respiratory syncytial virus, adenovirus, human rhinovirus, and Mycoplasma pneumoniae. Subsequently, statistical methods were employed to analyze the distribution and types of ARIs associated with these pathogens. In fever clinics, most patients presenting with respiratory pathogen infections were diagnosed with non-SARS-CoV-2 respiratory pathogens, with a higher incidence noted among pediatric patients compared to adults. In contrast, SARS-CoV-2 primarily affected the adult population and was linked to more severe clinical outcomes. Consequently, the swift triage of patients exhibiting ARI symptoms in a fever clinic equipped with nucleic acid testing enables the rapid identification and precise treatment of pathogens. This approach alleviates patient discomfort and enhances the efficiency of healthcare resource utilization.

摘要

由于严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的影响,呼吸道感染(RTIs)的流行病学模式发生了重大变化,尤其关注急性呼吸道感染(ARIs)。早期诊断的挑战、分诊策略不足以及抗菌药物或抗病毒药物的不当使用,使大流行后背景下准确诊断和管理ARIs的难度进一步加大。本研究旨在调查具备核酸检测能力的发热门诊在ARIs精准分诊中的效果。在一组604名出现ARIs症状的个体中,我们利用发热门诊可用的实时逆转录聚合酶链反应(RT-PCR)技术对SARS-CoV-2、甲型流感病毒(Flu A)、乙型流感病毒(Flu B)、呼吸道合胞病毒、腺病毒、人鼻病毒和肺炎支原体进行核酸检测。随后,采用统计方法分析与这些病原体相关的ARIs的分布和类型。在发热门诊,大多数出现呼吸道病原体感染的患者被诊断为非SARS-CoV-2呼吸道病原体感染,儿童患者的发病率高于成人。相比之下,SARS-CoV-2主要影响成年人群,并与更严重的临床结果相关。因此,在具备核酸检测能力的发热门诊对出现ARI症状的患者进行快速分诊,能够快速识别病原体并进行精准治疗。这种方法减轻了患者的不适,提高了医疗资源的利用效率。

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