Diagnostic value of respiratory virus detection in symptomatic children using real-time PCR.
Diagnostic value of respiratory virus detection in symptomatic children using real-time PCR.
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DOI：
10.1186/1743-422x-9-276
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发表时间：
2012-11-19
期刊：
影响因子：
4.8
通讯作者：
Rossen JW
中科院分区：
文献类型：
--
作者：
Huijskens EG;Biesmans RC;Buiting AG;Obihara CC;Rossen JW
急性呼吸道感染是一个重要的公共卫生问题。灵敏和快速的诊断技术已经开发出来，并在日常临床实践中使用。在这里，我们评估了在普通儿科诊所用分子方法检测20种常见呼吸道病原体的临床意义。采用实时定量聚合酶链式反应技术，对18岁 <； 儿童鼻咽标本进行了19种病毒和肺炎支原体的检测。在这项回顾性研究的177名患者中，73%的患者至少有一种病毒呈阳性。最常见的是呼吸道合胞病毒(36.6%)和人鼻病毒(24%)。与没有检测到呼吸道病原体的患者相比，检测到呼吸道病毒或肺炎支原体的患者更年轻(6个月比24个月；p <； 0.001)，住院频率更高(116比34；p = 0.001)。此外，与没有呼吸道病原体的患者相比，他们更有可能出现喂养问题、呼吸困难、鼻漏和喘息(均为p <； 0.05)。在大多数病例中，临床医生在检测到病毒呼吸道病原体后没有改变他们的抗生素治疗。有一种呼吸道病原体的患者和有呼吸道病原体的患者之间的平均CT值没有差异(30.5vs31.2p = 0.573)。对常见呼吸道病原体的常规检测可以更好地了解它们在有呼吸道症状的儿童疾病中的作用。
Acute respiratory tract infections are an important public health problem. Sensitive and rapid diagnostic techniques have been developed and are used in daily clinical practice. Here we evaluate the clinical relevance of detecting 20 common respiratory pathogens by molecular methods in a general pediatric clinic. Nasopharynx samples of children < 18 years of age with respiratory symptoms referred to a general pediatric clinic were tested for the presence of 19 viruses and Mycoplasma pneumoniae, using real-time polymerase chain reaction. Of 177 patients included in this retrospective study, 73% were positive for at least one virus. Respiratory syncytial virus (36.6%) and human rhinovirus (24%) were most frequently detected. Patients in whom a respiratory virus or Mycoplasma pneumoniae was detected, were younger (6 versus 24 months; p < 0.001) and more often hospitalized (116 versus 34; p = 0.001) than patients in whom no respiratory pathogen was detected. Also they were more likely to present with feeding problems, dyspnea, rhinorrhea and wheezing (all p < 0.05) than patients without a respiratory pathogen. In the majority of cases, clinicians did not change their antibiotic management after detecting a viral respiratory pathogen. No difference in mean Ct value was found between patients with one respiratory pathogen and those with >1 respiratory pathogen (30.5 versus 31.2; p = 0.573). Routine testing of common respiratory pathogens could lead to a better understanding of their role in disease in children with respiratory symptoms.