Evidence from multiplex molecular assays for complex multipathogen interactions in acute respiratory infections
Evidence from multiplex molecular assays for complex multipathogen interactions in acute respiratory infections
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DOI：
10.1128/jcm.01117-07
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发表时间：
2008-01-01
影响因子：
9.4
通讯作者：
Thomas, Eva
中科院分区：
文献类型：
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作者：
Brunstein, John D.;Cline, Christy L.;Thomas, Eva
虽然大多数诊断过程停止与第一个相关的感染性病原体的检测，新的多重分子方法，提供多个代理商的同时分析可能会给出一个更准确的代表性，真正的病原体谱在这些样品。为了在呼吸道感染的背景下检查这一点，在2006年春季呼吸道感染高峰季节期间提交给我们的临床诊断微生物学/病毒学实验室用于我们的常规VIRAP诊断方案的急性期呼吸道标本通过Genaco（Qiaqiao）Rescue I和Rescue II分子诊断面板进行分析并行处理。共检查了1，742个样本，每个样本有21个相关目标。由此产生的数据显示，多种感染是频繁的，并提供证据，不同的传染性病原体之间的复杂相互作用。在特定病原体之间观察到统计学相关的关联模式（阳性和阴性）。虽然我们观察到的一些相互作用已被文献中的先前报告证实，但一些特定的模式似乎尚未报道。此外，我们报告的初步临床证据支持这样一种假设，即这些合并感染具有医学相关性，并且严重呼吸道感染的有效治疗将越来越需要诊断所有相关病原体，而不是单一病原体报告。
While most diagnostic processes cease with the detection of the first relevant infectious agent, newer multiplexed molecular methods which provide simultaneous analysis of multiple agents may give a more accurate representation of the true pathogen spectrum in these samples. To examine this in the context of respiratory infections, acute-phase respiratory specimens submitted to our clinical diagnostic microbiology/virology laboratory for our routine VIRAP diagnosis protocol during the spring 2006 peak respiratory infection season were processed in parallel by analysis with Genaco (QiaPlex) ResPlex I and ResPlex II molecular diagnostic panels. A total of 1,742 specimens were examined for 21 relevant targets each. The resulting data reveal that multiple infections are frequent and provide evidence for complex interactions between different infectious agents. Statistically relevant association patterns (both positive and negative) were observed between particular pathogens. While some interactions we observed are substantiated by prior reports in the literature, several specific patterns do not appear to have been reported previously. In addition, we report preliminary clinical evidence which supports a hypothesis that these coinfections are medically relevant and that effective treatment for severe respiratory tract infections will increasingly require diagnosis of all involved pathogens, as opposed to single-pathogen reporting.