Laboratory diagnosis of SARS
Laboratory diagnosis of SARS
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DOI：
10.3201/eid1005.030682
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发表时间：
2004-05-01
影响因子：
11.8
通讯作者：
Tam, JS
中科院分区：
文献类型：
--
作者：
Chan, PKS;To, WK;Tam, JS
对415例严重急性呼吸综合征（SARS）患者的病毒学检测结果进行了分析。SARS相关冠状病毒的检出率高峰出现在呼吸道标本发病后第2周，粪便或直肠拭子标本在第2至3周，尿液标本在第4周。在患者接受重症监护的第75天收集了通过逆转录-聚合酶链反应（RT-PCR）呈阳性的最新粪便样本。气管抽吸物和粪便样本具有较高的诊断率（RT-PCR前2周平均阳性率：分别为66.7%和56.5%）。合并咽喉和鼻拭子、直肠拭子、鼻拭子、咽喉拭子和鼻咽抽吸物标本的产率中等（29.7%-40.0%），而咽喉洗液和尿液标本的产率较低（17.3%和4.5%）。粪便和混合鼻咽拭子标本的采集程序传播感染的可能性最小，并且组合使用RT-PCR检测冠状病毒的产率最高。患者组中阳性病毒学检测结果与机械通气或死亡相关（p < 0.001），表明病毒载量与疾病严重程度相关。
The virologic test results of 415 patients with severe acute respiratory syndrome (SARS) were examined. The peak detection rate for SARS-associated coronavirus occurred at week 2 after illness onset for respiratory specimens, at weeks 2 to 3 for stool or rectal swab specimens, and at week 4 for urine specimens. The latest stool sample that was positive by reverse transcription-polymerase chain reaction (RT-PCR) was collected on day 75 while the patient was receiving intensive care. Tracheal aspirate and stool samples had a higher diagnostic yield (RT-PCR average positive rate for first 2 weeks: 66.7% and 56.5%, respectively). Pooled throat and nasal swabs, rectal swab, nasal swab, throat swab, and nasopharyngeal aspirate specimens provided a moderate yield (29.7%-40.0%), whereas throat washing and urine specimens showed a lower yield (17.3% and 4.5%). The collection procedures for stool and pooled nasal and throat swab specimens were the least likely to transmit infection, and the combination gave the highest yield for coronavirus detection by RT-PCR. Positive virologic test results in patient groups were associated with mechanical ventilation or death (p < 0.001), suggesting a correlation between viral load and disease severity.