Additional molecular testing of saliva specimens improves the detection of respiratory viruses.
Additional molecular testing of saliva specimens improves the detection of respiratory viruses.
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DOI：
10.1038/emi.2017.35
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发表时间：
2017-06-07
影响因子：
13.2
通讯作者：
Yuen KY
中科院分区：
文献类型：
--
作者：
To KK;Lu L;Yip CC;Poon RW;Fung AM;Cheng A;Lui DH;Ho DT;Hung IF;Chan KH;Yuen KY
人类新发传染病通常由呼吸道病毒引起，如大流行性流感病毒或禽流感病毒和新型冠状病毒。呼吸道病毒的微生物检测对于患者管理、感染控制和流行病学研究非常重要。鼻咽标本经常进行测试，但其灵敏度是次优的。本研究评估了使用分子检测法检测痰液中呼吸道病毒的增量效益。共纳入258例疑似呼吸道感染的住院成人患者。他们吐出的唾液是在没有使用任何特殊设备的情况下收集的。在第一个队列的159例患者的鼻咽吸出物（NPA）检测阳性的呼吸道病毒在常规检测中，病毒载量进行了测量，使用定量逆转录PCR。17%的患者（27/159）唾液中的病毒载量高于NPA。第二个队列包括99名患者，其NPA使用直接免疫荧光测定法检测呼吸道病毒呈阴性。他们的NPA和唾液标本进行了额外的测试，使用多重PCR。在这些患者中，NPA与唾液的多重PCR符合率为83.8%。多重PCR在16名患者的唾液样本中检测到病毒，其中9名（56.3%）至少有一种NPA中未检测到的病毒。在6名患者中，抗病毒或隔离预防措施的决定将受到唾液检测的影响。虽然NPA具有高病毒载量，并且仍然是大多数呼吸道病毒感染患者的首选标本，但唾液的补充分子检测可以改善这些患者的临床管理。
Emerging infectious diseases in humans are often caused by respiratory viruses such as pandemic or avian influenza viruses and novel coronaviruses. Microbiological testing for respiratory viruses is important for patient management, infection control and epidemiological studies. Nasopharyngeal specimens are frequently tested, but their sensitivity is suboptimal. This study evaluated the incremental benefit of testing respiratory viruses in expectorated saliva using molecular assays. A total of 258 hospitalized adult patients with suspected respiratory infections were included. Their expectorated saliva was collected without the use of any special devices. In the first cohort of 159 patients whose nasopharyngeal aspirates (NPAs) tested positive for respiratory viruses during routine testing, the viral load was measured using quantitative reverse transcription PCR. Seventeen percent of the patients (27/159) had higher viral loads in the saliva than in the NPA. The second cohort consisted of 99 patients whose NPAs tested negative for respiratory viruses using a direct immunofluorescence assay. Their NPA and saliva specimens were additionally tested using multiplex PCR. In these patients, the concordance rate by multiplex PCR between NPA and saliva was 83.8%. Multiplex PCR detected viruses in saliva samples from 16 patients, of which nine (56.3%) had at least one virus that was not detected in the NPA. Decisions on antiviral or isolation precautions would be affected by salivary testing in six patients. Although NPAs have high viral loads and remain the specimen of choice for most patients with respiratory virus infections, supplementary molecular testing of saliva can improve the clinical management of these patients.
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影响因子：
5.8
作者：
Hansen, Karin B.;Westin, Johan;Nilsson, Anna C.
通讯作者：
Nilsson, Anna C.
DOI：
10.1016/j.diagmicrobio.2015.08.001
发表时间：
2015-12
影响因子：
2.9
作者：
Gelfer G;Leggett J;Myers J;Wang L;Gilbert DN
通讯作者：
Gilbert DN
DOI：
10.1093/cid/cit278
发表时间：
2013-08
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Baron EJ;Miller JM;Weinstein MP;Richter SS;Gilligan PH;Thomson RB Jr;Bourbeau P;Carroll KC;Kehl SC;Dunne WM;Robinson-Dunn B;Schwartzman JD;Chapin KC;Snyder JW;Forbes BA;Patel R;Rosenblatt JE;Pritt BS
通讯作者：
Pritt BS
影响因子：
9.4
作者：
Azadeh, Natalya;Sakata, Kenneth K.;Grys, Thomas E.
通讯作者：
Grys, Thomas E.
影响因子：
9.6
作者：
Hung, Ivan F. N.;To, Kelvin K. W.;Yuen, Kwok-Yung
通讯作者：
Yuen, Kwok-Yung