McCaughey C, O'Neill H J, Wyatt D E, Christie S N, Jackson P T, Coyle P V
Department of Microbiology and Immunobiology, Royal Hospitals Trust, Belfast, UK.
J Infect. 1998 Mar;36(2):145-8. doi: 10.1016/s0163-4453(98)80003-0.
A study was set up to investigate the effect of consistency of routine faecal specimens on the diagnostic yield by electron microscopy (EM) and virus isolation. A total of 3078 specimens were characterized as solid, semisolid, or liquid. Of 2568 specimens processed by EM a virus was demonstrated in 8.6% of liquid, 19.9% of semisolid and 25.2% of solid specimens (Chi-squared for linear trend, P value <0.0001). This observation was valid for both adenovirus (2.4%, 5.0% and 6.6%) and rotavirus (5.2%, 13.6% and 16.6%). Virus isolation was positive in 3.6% of liquid, 17.4% of semisolid and 18.1% of solid specimens. (Chi-squared for linear trend, P value <0.0001). We suggest that solid faecal specimens at the end of an episode of diarrhoea will have a higher diagnostic yield than liquid specimens at the peak of symptoms. Our findings repudiate the commonly held dogma that viruses of gastroenteritis are more likely to be found in liquid than in solid faecal specimens. This finding has important implications for those establishing diagnostic algorithms for the investigation of viral gastroenteritis.
开展了一项研究,以调查常规粪便标本的性状对电子显微镜检查(EM)和病毒分离诊断率的影响。总共3078份标本被分为固体、半固体或液体。在通过EM处理的2568份标本中,液体标本的病毒检出率为8.6%,半固体标本为19.9%,固体标本为25.2%(线性趋势卡方检验,P值<0.0001)。这一观察结果对腺病毒(2.4%、5.0%和6.6%)和轮状病毒(5.2%、13.6%和16.6%)均有效。病毒分离在液体标本中的阳性率为3.6%,半固体标本为17.4%,固体标本为18.1%(线性趋势卡方检验,P值<0.0001)。我们认为,腹泻发作末期的固体粪便标本比症状高峰期的液体标本具有更高的诊断率。我们的研究结果否定了普遍持有的一种观点,即胃肠炎病毒在液体粪便标本中比在固体粪便标本中更易被发现。这一发现对于那些制定病毒性胃肠炎调查诊断算法的人具有重要意义。