Diagnosis of influenza virus.
Diagnosis of influenza virus.
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DOI：
10.1007/978-1-61779-621-0_4
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发表时间：
2012-01-01
期刊：
影响因子：
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通讯作者：
George, Kirsten St
中科院分区：
文献类型：
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作者：
George, Kirsten St
流感的实验室诊断使用多种技术，包括快速免疫测定、免疫荧光技术、病毒培养方法和日益复杂的分子测定。多年来，每种方法的潜在效用都发生了变化，最显着的变化可能是随着 2009 年 H1N1 流感病毒的出现。虽然快速免疫分析此前已广泛应用于诊所和急诊科，但其对 2009 亚型的检测灵敏度较差，使其应用受到质疑。人们还担心免疫荧光方法中使用的抗体试剂的检测灵敏度，并且针对新出现的亚型，病毒培养的安全性最初受到质疑。早期的分子检测技术是劳动密集型的，并且需要单独的设施以防止污染。这些技术在很大程度上已被更现代的方法所取代，最引人注目的是实时逆转录 PCR 测定，这是目前许多实验室检测和分型流感病毒的首选方法。悬浮和低密度阵列检测也越来越多地被使用，以便在一次检测中检测大量病毒，并且微阵列已被证明对于疫情分析和病原体发现很有价值。每个实验室必须评估适合其情况的最佳方法以及每种技术的最佳应用，同时考虑许多因素，包括其预算、设备、人员专业知识、所服务的患者群体、提交临床医生的需求以及其监测和公共卫生责任。
The laboratory diagnosis of influenza uses a wide range of techniques including rapid immunoassays, immunofluorescence techniques, virus culture methods, and increasingly sophisticated molecular assays. The potential utility of each of these methods has changed over the years, most dramatically perhaps with the emergence of the pandemic H1N1 2009 influenza virus. While rapid immunoassays had previously been widely used in clinics and emergency departments, their poor detection sensitivity for the 2009 subtype brought their application into question. Concerns were also raised about the detection sensitivities of antibody reagents used in immunofluorescence methods, and the safety of virus culture was initially questioned with regard to the newly emerged subtype. Early molecular detection techniques had been labor intensive, and required separate facilities in order to prevent contamination. Those techniques have largely been supplanted by more modern methods, most notably real-time reverse transcription PCR assays, which are currently the method of choice in many laboratories for the detection and subtyping of influenza viruses. Suspension and low-density array assays are also increasingly used, in an effort to detect larger numbers of viruses in a single assay, and microarrays have proven valuable for outbreak analysis and pathogen discovery. Each laboratory must assess the optimal methods for its situation and the best application of each technique, taking into account numerous factors including its budget, equipment, staff expertise, the patient population that it serves, the needs of its submitting clinicians, and its surveillance and public health responsibilities.