Value of Routine Dengue Diagnostic Tests in Urine and Saliva Specimens
Value of Routine Dengue Diagnostic Tests in Urine and Saliva Specimens
复制标题
DOI：
10.1371/journal.pntd.0004100
复制
发表时间：
2015-09-01
影响因子：
3.8
通讯作者：
Buchy, Philippe
中科院分区：
文献类型：
--
作者：
Andries, Anne-Claire;Duong, Veasna;Buchy, Philippe
背景登革热实验室诊断主要基于对血液样本中病毒、其成分或针对病毒的抗体的检测。然而，某些患者（尤其是儿童）可能难以抽取血液，并且在疫情调查或流行病学研究期间采样可能面临后勤挑战或受试者对侵入性操作的依从性有限。本研究的目的是评估使用唾液和尿液样本代替血液进行登革热诊断的可能性。方法/主要发现在确诊登革热病的儿童入院之日至发烧后三个月之间的几个时间点收集了系列血浆、尿液和唾液样本。对三种体液同时进行定量 RT-PCR、NS1 抗原捕获和抗 DENV 抗体（IgG、IgM 和 IgA）检测的 ELISA 血清学检测。 RT-PCR 和 NS1 测试显示血浆、尿液和唾液样本的总体敏感性分别为 85.4%/63.4%、41.6%/14.5% 和 39%/28.3%。当在同一时间点采集尿液和唾液样本并同时进行检测时，RNA和NS1检测方法的诊断灵敏度分别为69.1%和34.4%。血浆、尿液和唾液样本中 IgG/IgA 检测的总体灵敏度分别为 54.4%/37.4%、38.5%/26.8% 和 52.9%/28.6%。在 38.1% 和 36% 的血浆和唾液样本中检测到 IgM，但在尿液中从未检测到。 结论 尽管不同诊断方法在唾液和尿液中的表现不如血浆样本，但 qRT-PCR 和抗 DENV 抗体 ELISA 获得的结果很好地证明了在以下情况下使用这两种体液检测登革热感染的合理性： 无法采集血液样本。
BackgroundDengue laboratory diagnosis is essentially based on detection of the virus, its components or antibodies directed against the virus in blood samples. Blood, however, may be difficult to draw in some patients, especially in children, and sampling during outbreak investigations or epidemiological studies may face logistical challenges or limited compliance to invasive procedures from subjects. The aim of this study was to assess the possibility of using saliva and urine samples instead of blood for dengue diagnosis.Methodology/Principal FindingsSerial plasma, urine and saliva samples were collected at several time-points between the day of admission to hospital until three months after the onset of fever in children with confirmed dengue disease. Quantitative RT-PCR, NS1 antigen capture and ELISA serology for anti-DENV antibody (IgG, IgM and IgA) detection were performed in parallel on the three body fluids. RT-PCR and NS1 tests demonstrated an overall sensitivity of 85.4%/63.4%, 41.6%/14.5% and 39%/28.3%, in plasma, urine and saliva specimens, respectively. When urine and saliva samples were collected at the same time-points and tested concurrently, the diagnostic sensitivity of RNA and NS1 detection assays was 69.1% and 34.4%, respectively. IgG/IgA detection assays had an overall sensitivity of 54.4%/37.4%, 38.5%/26.8% and 52.9%/28.6% in plasma, urine and saliva specimens, respectively. IgM were detected in 38.1% and 36% of the plasma and saliva samples but never in urine.ConclusionsAlthough the performances of the different diagnostic methods were not as good in saliva and urine as in plasma specimens, the results obtained by qRT-PCR and by anti-DENV antibody ELISA could well justify the use of these two body fluids to detect dengue infection in situations when the collection of blood specimens is not possible.