Diagnosis of Respiratory Syncytial Virus in Adults Substantially Increases When Adding Sputum, Saliva, and Serology Testing to Nasopharyngeal Swab RT-PCR.
Diagnosis of Respiratory Syncytial Virus in Adults Substantially Increases When Adding Sputum, Saliva, and Serology Testing to Nasopharyngeal Swab RT-PCR.
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将痰液、唾液和血清学检测添加到鼻咽拭子 RT-PCR 中，可显着提高成人呼吸道合胞病毒的诊断率。
DOI：
10.1007/s40121-023-00805-1
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发表时间：
2023-06
影响因子：
5.4
通讯作者：
Begier, Elizabeth
中科院分区：
文献类型：
--
作者：
Ramirez, Julio;Carrico, Ruth;Wilde, Ashley;Junkins, Alan;Furmanek, Stephen;Chandler, Thomas;Schulz, Paul;Hubler, Robin;Peyrani, Paula;Liu, Qing;Trivedi, Sonali;Uppal, Sonal;Kalina, Warren V. V.;Falsey, Ann R.;Walsh, Edward E. E.;Yacisin, Kari;Jodar, Luis;Gessner, Bradford D. D.;Begier, Elizabeth
几乎所有现有的呼吸道合胞病毒(RSV)发病率估计都是基于对鼻部或鼻咽(NP)拭子的实时聚合酶链式反应(RT-PCR)测试。在NP拭子RT-PCR中增加对其他样本类型的检测可以增加RSV的检测。然而，以前的研究只进行了成对比较，并且没有量化添加多个样本类型的协同效应。我们比较了单独用NP拭子RT-PCR和NP拭子加唾液、痰和血清学诊断RSV。这是一项前瞻性队列研究，时间跨度为两个研究时期(2021年12月27日至2022年4月1日和2022年8月22日至2022年11月11日)，研究对象为肯塔基州路易斯维尔因急性呼吸道疾病住院的40岁 ≥ 患者。在登记时收集NP拭子、唾液和痰标本，并进行聚合酶链式反应检测(Luminex Aries平台)。在急性期和恢复期(登记和30-60天的访问)获得血清学标本。计算仅用NP拭子和NP拭子加所有其他标本类型/测试的RSV检测率。在登记的1766名患者中，100%有NP拭子，99%有唾液，34%有痰，21%有配对的血清学标本。56例(3.2%)患者仅通过NP拭子诊断RSV，109例(6.2%)患者通过NP拭子加额外标本诊断，相应的比率是1.95倍[95%可信区间(CI)1.62，2.34]。将所有四种标本类型(即NP拭子、唾液、痰和血清学)与150名受试者进行比较，与单独使用NP拭子(3.3%对8.7%)相比，有2.60倍的增加(95%可信区间1.31，5.17)。按标本类型划分的敏感性分别为：NP拭子51%，唾液70%，痰72%，血清学79%。在NP拭子中添加额外的标本类型时，成人RSV的诊断要高出几倍，即使有痰和血清学结果的受试者比例相对较低。仅基于NP拭子RT-PCR的成人住院RSV ARI负荷估计应调整为低估。网上版载有补充材料，可在10.1007/s40121-023-00805-1查阅。
Nearly all existing respiratory syncytial virus (RSV) incidence estimates are based on real-time polymerase chain reaction (RT–PCR) testing of nasal or nasopharyngeal (NP) swabs. Adding testing of additional specimen types to NP swab RT–PCR increases RSV detection. However, prior studies only made pairwise comparisons and the synergistic effect of adding multiple specimen types has not been quantified. We compared RSV diagnosis by NP swab RT–PCR alone versus NP swab plus saliva, sputum, and serology. This was a prospective cohort study over two study periods (27 December 2021 to 1 April 2022 and 22 August 2022 to 11 November 2022) of patients aged ≥ 40 years hospitalized for acute respiratory illness (ARI) in Louisville, KY. NP swab, saliva, and sputum specimens were collected at enrollment and PCR tested (Luminex ARIES platform). Serology specimens were obtained at acute and convalescent timepoints (enrollment and 30–60-day visit). RSV detection rate was calculated for NP swab alone and for NP swab plus all other specimen type/test. Among 1766 patients enrolled, 100% had NP swab, 99% saliva, 34% sputum, and 21% paired serology specimens. RSV was diagnosed in 56 (3.2%) patients by NP swab alone, and in 109 (6.2%) patients by NP swab plus additional specimens, corresponding to a 1.95 times higher rate [95% confidence interval (CI) 1.62, 2.34]. Limiting the comparison to the 150 subjects with all four specimen types available (i.e., NP swab, saliva, sputum, and serology), there was a 2.60-fold increase (95% CI 1.31, 5.17) compared to NP swab alone (3.3% versus 8.7%). Sensitivities by specimen type were: NP swab 51%, saliva 70%, sputum 72%, and serology 79%. Diagnosis of RSV in adults was several-fold greater when additional specimen types were added to NP swab, even with a relatively low percentage of subjects with sputum and serology results available. Hospitalized RSV ARI burden estimates in adults based solely on NP swab RT–PCR should be adjusted for underestimation. The online version contains supplementary material available at 10.1007/s40121-023-00805-1.
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影响因子：
9.4
作者：
Falsey, Ann R.;Formica, Maria A.;Walsh, Edward E.
通讯作者：
Walsh, Edward E.
DOI：
10.1086/650486
发表时间：
2010-03-01
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Talbot HK;Falsey AR
通讯作者：
Falsey AR
影响因子：
4.2
作者：
通讯作者：
--
DOI：
10.1093/infdis/jiad012
发表时间：
2023-07-14
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
通讯作者：
--
影响因子：
5.4
作者：
Li, You;Kulkarni, Durga;Begier, Elizabeth;Wahi-Singh, Pia;Wahi-Singh, Bhanu;Gessner, Bradford;Nair, Harish
通讯作者：
Nair, Harish