Characterization of viral agents causing acute respiratory infection in a San Francisco University medical center clinic during the influenza season
Characterization of viral agents causing acute respiratory infection in a San Francisco University medical center clinic during the influenza season
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DOI：
10.1086/432800
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发表时间：
2005-09-15
影响因子：
11.8
通讯作者：
Drew, WL
中科院分区：
文献类型：
--
作者：
Louie, JK;Hacker, JK;Drew, WL
背景利用聚合酶链反应（PCR）和离心增强的病毒培养方法，我们对流感季节引起成人急性呼吸道感染的病毒进行了鉴定。2002年1 ~ 3月，对266例有呼吸道感染症状的健康成人鼻咽冲洗液标本进行病毒培养和PCR检测急性支气管炎（42例[16%]）、鼻窦炎（23例[9%]）、咽炎（22例[8%]）和肺炎（17例[6%]）。使用瓶壳检测和PCR在103例（39%）患者中鉴定出病原体，包括54例A型或B型流感病毒，28例小核糖核酸病毒（包括鼻病毒24例），呼吸道合胞病毒（RSV）12例，人偏肺病毒4例，人冠状病毒OC 43 2例，腺病毒2例，副流感病毒1型1例，流感病毒与副流感病毒1型混合感染2例。我们的研究结果表明，即使在流感季节，鼻病毒和RSV也很流行，在处方抗病毒药物之前，在成人急性呼吸道感染的鉴别诊断中必须考虑到这两种病毒。人冠状病毒和人偏肺病毒没有发挥实质性作用。聚合酶链反应是一个特别有用的工具，在识别流感和其他病毒病原体不容易发现的传统测试方法。
Background. With use of polymerase chain reaction (PCR) and a centrifugation-enhanced viral culture method, we characterized the viruses causing acute respiratory infection in adults during an influenza season.Methods. During January - March 2002, nasopharyngeal wash specimens from previously healthy adults presenting with respiratory symptoms were evaluated for viral pathogens with centrifugation-enhanced viral culture and PCR.Results The diagnoses in 266 cases included unspecified upper respiratory infection (in 142 [54%] of the cases), acute bronchitis (42 [16%]), sinusitis (23 [9%]), pharyngitis (22 [8%]), and pneumonia (17 [6%]). The use of a shell vial assay and PCR identified a pathogen in 103 (39%) of the patients, including influenza A or B in 54, picornavirus in 28 ( including rhinovirus in 24), respiratory syncytial virus (RSV) in 12, human metapneumovirus in 4, human coronavirus OC43 in 2, adenovirus in 2, parainfluenza virus type 1 in 1, and coinfection with influenza and parainfluenza virus type 1 in 2.Conclusion. Our findings demonstrate that, even during the influenza season, rhinovirus and RSV are prevalent and must be considered in the differential diagnosis of adult acute respiratory infection before prescribing antiviral medication. Human coronavirus and human metapneumovirus did not play a substantial role. PCR was an especially useful tool in the identification of influenza and other viral pathogens not easily detected by traditional testing methods.