Fecal detection of influenza A virus in patients with concurrent respiratory and gastrointestinal symptoms
Fecal detection of influenza A virus in patients with concurrent respiratory and gastrointestinal symptoms
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DOI：
10.1016/j.jcv.2009.06.011
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发表时间：
2009-07-01
影响因子：
8.8
通讯作者：
Sung, Joseph J. Y.
中科院分区：
文献类型：
--
作者：
Chan, Martin C. W.;Lee, Nelson;Sung, Joseph J. Y.
背景：季节性流感患者有时会出现胃肠道症状，如腹泻、呕吐和腹痛，尤其是在幼儿中。然而，关于季节性流感病毒的粪便排泄的研究却很少。目的：了解有肠胃炎症状的患者粪便标本中是否存在甲型流感病毒。研究设计：一项回顾性研究，收集了在12个月期间（2004年12月- 2005年11月）出现肠胃炎症状的627名所有年龄组患者的651份粪便标本。采用传统的靶向基质基因的聚合酶链反应（PCR）检测甲型流感病毒RNA。采用多重H1和h3特异性PCR进行病毒分型。采用TaqMan (R)实时荧光定量PCR法测定粪便病毒浓度。复习阳性病例的临床记录。结果：在6例患者的7份粪便标本中检测到季节性甲型流感（H3N2）病毒RNA。他们出现的时间正好是当地的流感季节。所有患者均为老年（60岁）或有潜在合并症，并伴有呼吸道和胃肠道症状。所有患者均需住院治疗，1例死亡。两名淋巴瘤患者的粪便标本中病毒浓度最高。结论：6例伴有呼吸道和胃肠道症状的流感高危患者粪便标本中检出甲型流感病毒RNA。需要进一步调查季节性流感对胃肠道的影响。(C) 2009 Elsevier B.V.版权所有
Background: In seasonal influenza, gastrointestinal symptoms such as diarrhea, vomiting, and abdominal pain are sometimes observed, especially among young children. However, fecal excretion of seasonal influenza virus has seldom been studied.Objective: To investigate the presence of human influenza A virus in stool specimens of patients presented with symptoms of gastroenteritis.Study design: A retrospective study on 651 stool specimens collected from 627 patients of all age groups presented with symptoms of gastroenteritis during a 12-month period (December 2004-November 2005). Influenza A viral RNA was detected by conventional polymerase chain reaction (PCR) targeting the matrix gene. Virus subtyping was performed by multiplexed H1 - and H3-specific PCR. Fecal viral concentration was estimated by TaqMan (R)-based real-time PCR. Clinical records of positive cases were reviewed. Results: Seasonal influenza A (H3N2) viral RNA was detected in 7 stool specimens collected from 6 patients. Their time of presentation coincided with local influenza season. All patients were at the extreme of ages (60 years) or had underlying comorbidities, and had concurrent respiratory and gastrointestinal symptoms. All required hospitalization and 1 patient died. Two patients with underlying lymphoma had the highest viral concentrations in their stool specimens.Conclusions: Influenza A viral RNA can be detected in stool specimens of 6 high-risk influenza patients with concurrent respiratory and gastrointestinal symptoms. Further investigation on the gastrointestinal involvement of seasonal influenza is required. (C) 2009 Elsevier B.V. All rights reserved.