Yield of Sputum for Viral Detection by Reverse Transcriptase PCR in Adults Hospitalized with Respiratory Illness
Yield of Sputum for Viral Detection by Reverse Transcriptase PCR in Adults Hospitalized with Respiratory Illness
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DOI：
10.1128/jcm.05841-11
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发表时间：
2012-01-01
影响因子：
9.4
通讯作者：
Walsh, Edward E.
中科院分区：
文献类型：
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作者：
Falsey, Ann R.;Formica, Maria A.;Walsh, Edward E.
呼吸道病毒感染的诊断试验传统上是在鼻咽拭子或洗液上进行的。逆转录酶PCR（RT-PCR）是快速，敏感和特异性的病毒感染诊断，但很少应用于痰标本。因此，我们评估了RT-PCR检测9种病毒类型的诊断产率，通过使用鼻和喉拭子（NTS）和痰液样本从急性呼吸道疾病住院患者。2008年和2009年冬季招募了因急性呼吸道疾病住院的成年人。在入组时，采集鼻、咽拭子和痰液样本进行RT-PCR检测9种常见呼吸道病毒类型。共入组了532例因556种呼吸系统疾病入院的受试者。共鉴定出189株病毒。NTS RT-PCR和痰液RT-PCR对任何病毒的检出率分别为23%（126/556）和36%（146/404）。189例病毒检测中，两种方法均为阳性的有83例（44%），单独NTS检测为阳性的有43例（23%），仅痰标本检测为阳性的有63例（33%）。纳入对痰液样本进行的RT-PCR显著增加了成人呼吸道病毒感染的诊断率。需要进一步的研究，以适应商业RT-PCR呼吸道病毒检测的痰液样本的使用。
Diagnostic tests for respiratory viral infections have traditionally been performed on nasopharyngeal swabs or washings. Reverse transcriptase PCR (RT-PCR) is rapid, sensitive, and specific for viral infection diagnosis but is rarely applied to sputum samples. Thus, we evaluated the diagnostic yield of RT-PCR for detection of nine virus types by the use of nose and throat swabs (NTS) and sputum samples from patients admitted to the hospital with acute respiratory tract illnesses. Adults hospitalized with acute respiratory tract illnesses were recruited during the winters of 2008 and 2009. At enrollment, combined nose and throat swabs and sputum samples were collected for RT-PCR for detection of nine common respiratory virus types. A total of 532 subjects admitted for 556 respiratory illnesses were enrolled. A total of 189 virus strains were identified. The diagnostic yields for detection of any virus were 23% (126/556) for NTS RT-PCR and 36% (146/404) for sputum RT-PCR. A total of 83 (44%) of 189 viral detections were positive by both methods, 43 (23%) were positive by NTS alone, and 63 (33%) were positive only with sputum samples. The inclusion of RT-PCR performed with sputum samples significantly increased the diagnostic yield for respiratory viral infections in adults. Further studies designed to adapt the use of sputum samples for commercial RT-PCR respiratory virus assays are needed.