Morris D J, Bailey A S, Cooper R J, Turner P C, Jackson R, Corbitt G, Tullo A B
Clinical Virology Laboratory, University of Manchester, England.
J Med Virol. 1995 Jun;46(2):126-32. doi: 10.1002/jmv.1890460208.
Adenoviruses are associated with endemic and epidemic acute conjunctivitis, large nosocomial outbreaks reflecting virus transmission on unwashed hands or inadequately sterilised ophthalmic instruments. The polymerase chain reaction (PCR) proved more sensitive than antigen detection by immune dot-blot test for the rapid diagnosis of ocular adenovirus infection (sensitivities in a retrospective study 112/123 (91%) versus 72/123 (59%), P < 0.001). Indeed, in a prospective comparison, DNA amplification and virus isolation generated similar numbers of positive results (34 versus 32), though five PCR positive results were possibly false positives. The sensitivity of the PCR was largely independent of adenovirus subgenus or serotype, though reduced sensitivity with subgenus B strains could not be excluded. Specimen preparation for DNA amplification using a simple lysis buffer proved more effective than phenol-chloroform extraction. The immune dot-blot test gave unavoidable false positive results, but with the PCR this problem could be minimized by technical modifications. The PCR could replace antigen detection and virus isolation as the initial test for adenoviruses in conjunctival swabs, with cell culture only being retained for adenovirus serotyping in PCR positive specimens and for other viruses such as herpes simplex.
腺病毒与地方性和流行性急性结膜炎有关，医院内大规模暴发反映出病毒通过未洗净的手或未充分消毒的眼科器械传播。聚合酶链反应（PCR）在快速诊断眼部腺病毒感染方面比免疫斑点试验抗原检测更敏感（一项回顾性研究中的灵敏度分别为112/123（91%）和72/123（59%），P<0.001）。实际上，在一项前瞻性比较中，DNA扩增和病毒分离产生的阳性结果数量相似（分别为34和32），尽管5个PCR阳性结果可能为假阳性。PCR的灵敏度在很大程度上与腺病毒亚属或血清型无关，不过不能排除B亚属毒株的灵敏度降低情况。使用简单裂解缓冲液进行DNA扩增的标本制备比酚-氯仿提取更有效。免疫斑点试验会出现不可避免的假阳性结果，但通过技术改进，PCR可以将这个问题降到最低。PCR可以取代抗原检测和病毒分离，作为结膜拭子中腺病毒的初始检测方法，细胞培养仅保留用于对PCR阳性标本进行腺病毒血清分型以及检测其他病毒，如单纯疱疹病毒。
