Performance of virus isolation and Directigen® Flu A to detect influenza A virus in experimental human infection
Performance of virus isolation and Directigen® Flu A to detect influenza A virus in experimental human infection
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DOI：
10.1016/s1386-6532(99)00058-x
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发表时间：
1999-12-01
影响因子：
8.8
通讯作者：
Hayden, FG
中科院分区：
文献类型：
--
作者：
Kaiser, L;Briones, MS;Hayden, FG
背景：在流感病毒感染过程中，很少有资料评估不同标本类型对病毒检测的敏感性。目的：本研究利用酶免疫吸附法（EIA） Directigen(R)甲型流感在不同类型的人感染实验样品中定量复制与抗原可检出性之间的关系。研究设计：14名志愿者接种了甲型流感病毒A/Texas/36/91 （H1N1）。接种后第1 ~ 8天，按顺序收集4种标本进行细胞培养和抗原检测的定量分离。结果：鼻咽冲洗标本培养阳性71例（63%），漱口液标本培养阳性51例（46%），鼻拭子标本培养阳性51例（46%），咽拭子标本培养阳性27例（24%）。所有受试者在鼻咽冲洗中至少有一天出现病毒脱落，86%的受试者在接种后第2天鼻咽冲洗培养阳性。所有标本类型的平均病毒滴度在接种后第2天最高，洗鼻液的平均病毒滴度为3.6 log(10) TCID50/ml，漱口液的平均病毒滴度为1.2 log(10) TCID50/ml，鼻咽拭子的平均病毒滴度为1.8 log(10) TCID50/ml，咽拭子的平均病毒滴度为0.6 log(10) TCID50/ml。鼻洗液中病毒滴度平均值与其他标本相比差异有统计学意义（P < 0.05）。与培养相比，接种后第2天EIA敏感性达到峰值。鼻咽拭子和咽拭子结果合并进行分析，如果其中一个或两个样本均呈阳性，则认为培养呈阳性。因此，在第2天，相对于培养阳性的数量，鼻咽冲洗标本的EIA阳性样本数为9/12(75%)，咽漱液标本的2/9(22%)，咽咽和鼻拭子联合标本的7/11（64%）。结论：鼻咽洗液是检测成人甲型流感病毒最敏感的样品类型。对于快速诊断，与成人实验感染后第2天或第3天对鼻咽标本进行培养相比，Directigen(R) A型流感是一种敏感性为64%至78%的替代方法。然而，如果在其他标本上或在感染过程的后期进行，敏感性较低。(C) 1999 Elsevier Science B.V.版权所有
Background: few data exist to assess the sensitivity of different specimen types for viral detection during the course of influenza virus infection. Objectives: this study assessed the relationships between quantitative influenza A virus replication and antigen detectability by the enzyme immunosorbent assay (EIA) Directigen(R) Flu A in different type of samples during experimental human infection. Study design: fourteen volunteers were inoculated with influenza A virus A/Texas/36/91 (H1N1). Four specimens types were collected in sequence for quantitative isolation in cell culture and antigen testing from days 1 to 8 after inoculation. Results: seventy-one (63%) of nasopharyngeal wash specimens were culture positive, compared to 51 (46%) of throat gargles, 51 (46%) of nasal swabs, and 27 (24%) of throat swabs. All subjects shed virus in their nasopharyngeal wash at least one day and 86% of subjects had a positive nasopharyngeal wash culture on day 2 after inoculation. The mean viral titers were highest on day 2 post inoculation for all specimen types and averaged 3.6 log(10) TCID50/ml for nasal washes, 1.2 log(10) TCID50/ml for throat gargles, 1.8 log(10) TCID50/ml for the nasopharyngeal swabs, and 0.6 log(10) TCID50/ml for the throat swabs. Mean viral titers in the nasal washes were significantly different (P < 0.05) compared to other specimen types. The peak of sensitivity of EIA (compared to culture) was the second day after inoculation. Nasopharyngeal and throat swab results were combined for this analysis and considered positive by culture if positive in either or both samples. Thus, on day 2 the number of EIA positive samples relative to the number culture positive was 9/12 (75%) for nasopharyngeal wash specimens, 2/9 (22%) for throat gargles, and 7/11 (64%) for the combined throat and nasal swabs specimens. Conclusions: nasopharyngeal washes are the most sensitive sample type detecting influenza A virus in adults. For rapid diagnosis the Directigen(R) Flu A is a an alternative with a sensitivity compared to culture ranging between 64 and 78% if performed on nasopharyngeal specimens on day two or three after experimental infection in adults. However, if performed on other specimens or later in the course of infection the sensitivity is lower. (C) 1999 Published by Elsevier Science B.V. All rights reserved.