Lower respiratory viral illnesses - Improved diagnosis by molecular methods and clinical impact
Lower respiratory viral illnesses - Improved diagnosis by molecular methods and clinical impact
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DOI：
10.1164/rccm.200406-781oc
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发表时间：
2004-12-01
影响因子：
24.7
通讯作者：
Kaiser, L
中科院分区：
文献类型：
--
作者：
Garbino, J;Gerbase, MW;Kaiser, L
我们评估了呼吸道病毒对因急性呼吸道感染而接受支气管肺泡灌洗（BAL）的住院患者和肺移植受者的疾病结果的频率和潜在作用。通过逆转录聚合酶链反应分析 BAL 样本 (148) 中是否存在 11 种不同病毒，以及肺炎支原体、肺炎衣原体和嗜肺军团菌。在疑似呼吸道感染患者的 117 份 BAL 样本中，有 34 份 (29%) 被鉴定出呼吸道病毒，而 31 名对照受试者中仅 2 份 (7%) (p < 0.01)。在另外五例病例中也发现了肺炎支原体。通过分子方法检测病毒呈阳性的病例中，只有 30% 通过细胞培养分析也呈阳性。鼻病毒是最常见的病毒（占病例的 56%），其次是呼吸道合胞病毒（27%）。在肺移植受者中，有呼吸道症状的病例中病毒感染率为 55%，而对照组仅为 4%（p < 0.001）。在这些病例中，呼吸道病毒感染与显着的肺功能异常相关。通过使用逆转录聚合酶链反应检测，我们经常在因下呼吸道感染住院的患者的 BAL 标本中鉴定出呼吸道病毒。这些病毒与高发病率相关，特别是在肺移植受者中。
We assessed the frequency and the potential role of respiratory viruses on disease outcomes in hospitalized patients and lung transplant recipients who underwent a bronchoalveolar lavage (BAL) for an acute respiratory infection. BAL specimens (148) were analyzed by reverse transcription-polymerase chain reaction for the presence of 11 different viruses, as well as Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila. Respiratory viruses were identified in 34 of 117 BAL specimens (29%) obtained in patients with a suspected respiratory infection and in only 2 of 31 control subjects (7%) (p < 0.01). M. pneumoniae was identified in five additional cases. Only 30% of cases that were virus positive by molecular methods were also positive by cell culture analysis. Rhinovirus was the most frequently identified virus (56% of cases) followed by respiratory syncytial virus (27%). In lung transplant recipients, the rate of viral infections was 55% in cases with respiratory symptoms compared with only 4% in control subjects (p < 0.001). In these cases, respiratory viral infections were associated with significant lung function abnormalities. By using reverse transcription-polymerase chain reaction assays, we frequently identified respiratory viruses in BAL specimens of patients hospitalized with lower respiratory tract infections. These viruses were associated with high morbidity, particularly in lung transplant recipients.