Colonization of severe acute respiratory syndrome-associated coronavirus among health-care workers screened by nasopharyngeal swab.
Colonization of severe acute respiratory syndrome-associated coronavirus among health-care workers screened by nasopharyngeal swab.
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由鼻咽拭子筛查的医疗工人中严重急性呼吸道综合征相关的冠状病毒的定殖。
作者：
Ho HT;Chang MS;Wei TY;Hsieh WS;Hung CC;Yang HM;Lu YT
报告从医务人员鼻咽拭子(NPS)中扩增SARS冠状病毒(SARS CoV)的大规模预防性筛查计划的效果和结果。一项前瞻性的观察研究。台湾的一家医疗中心。230名医务工作者。用两种套式逆转录聚合酶链式反应(RT-PCR)方法检测NPS中SARS冠状病毒的存在。在严重急性呼吸综合征(SARS)暴发期间，采用核糖核酸聚合酶链式反应(NPS-PCR)对医务人员进行SARS-CoV筛查。用两次套式RT-PCR和一次定量RT-PCR检测SARS冠状病毒。用酶免疫法和间接免疫荧光法检测血清特异性抗体。我们监测了230个医务工作者，包括217个第一线的医务工作者和13个非第一线的医务工作者。190名一线医务工作者和13名非一线医务工作者在两次巢式RT-PCR检测中均呈阴性结果。两名一线医务人员在两种巢式RT-PCR检测中均呈阳性，他们都患有SARS。他们在NPS中每毫升有16,900±7,920拷贝(平均值±SD)的RNA，并有可检测到的抗SARS抗体。其余25名一线医务人员第一次套式RT-PCR均为阴性，第二次套式RT-PCR均为阳性。他们的相应滴度为每毫升338±227拷贝的RNA；这25名HCW中没有一人产生抗体。血管紧张素转换酶-2的表达和功能在不同的高血压病患者中没有差异。这项研究表明，在与SARS相关的服务中，217名防护良好的一线卫生工作者中有25人出现了SARS冠状病毒的定植，但他们的血清仍为阴性。用比第一次更灵敏的第二次RT-PCR试验，我们能够显示大约11.5%受到良好保护的接触SARS患者或标本的HCW可以在没有血清转换的情况下定植。只有那些有明显临床症状或疾病的人才会有主动免疫力。因此，定期筛查NPS进行套式RT-PCR检测，结合每日记录所有一线医务人员的体温，可能会提供一种有效的早期检测方法。
To report the efficacy and findings of a large-scale preventive screening program for severe acute respiratory syndrome-associated coronavirus (SARS-CoV) using amplification of the virus from a nasopharyngeal swab (NPS) obtained from the health-care workers (HCWs). A prospective observational study. A medical center in Taiwan. Two hundred thirty HCWs. NPS examination for the presence of SARS-CoV by two nested reverse transcription-polymerase chain reaction (RT-PCR) assays. During the outbreak of severe acute respiratory syndrome (SARS), NPS polymerase chain reaction screening of HCWs for SARS-CoV was performed. SARS-CoV was examined by two nested RT-PCRs and a quantitative RT-PCR. Serum-specific antibodies were assessed by enzyme immunoassay and indirect immunofluorescence. We monitored 230 HCWs, including 217 first-line HCWs and 13 non–first-line HCWs. One hundred ninety first-line HCWs and 13 non–first-line HCWs had negative results in both nested RT-PCR assays. Two first-line HCWs who were positive on both nested RT-PCR assays had SARS. They had 16,900 ± 7,920 copies (mean ± SD) of RNA per milliliter in the NPS and had detectable anti-SARS antibodies. The remaining 25 first-line HCWs were negative for the first nested RT-PCR but positive for the second nested RT-PCR. Their corresponding titers were 338 ± 227 copies of RNA per milliliter; antibodies developed in none of these 25 HCWs. The expression and function of angiotensin-converting enzyme-2 were not different among these HCWs. This study shows that colonization of SARS-CoV occurred in 25 of 217 well-protected first-line HCWs on a SARS-associated service, but they remained seronegative. With the second RT-PCR assay more sensitive than the first RT-PCR assay, we are able to show that approximately 11.5% of well-protected HCWs exposed to SARS patients or specimens may have colonization without seroconversion. Only those with significant clinical symptoms or disease would have active immunity. Thus, regular NPS screening for nested RT-PCR assays in conjunction with a daily recording of body temperature in all first-line HCWs may provide an effective way of early detection.
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影响因子：
64.8
作者：
Li W;Moore MJ;Vasilieva N;Sui J;Wong SK;Berne MA;Somasundaran M;Sullivan JL;Luzuriaga K;Greenough TC;Choe H;Farzan M
通讯作者：
Farzan M
影响因子：
2
作者：
Tzeng, HM
通讯作者：
Tzeng, HM
DOI：
10.1016/s0140-6736(03)13168-6
发表时间：
2003-05-03
期刊：
Lancet (London, England)
影响因子：
--
作者：
Seto WH;Tsang D;Yung RW;Ching TY;Ng TK;Ho M;Ho LM;Peiris JS;Advisors of Expert SARS group of Hospital Authority
通讯作者：
Advisors of Expert SARS group of Hospital Authority
影响因子：
--
作者：
CALLOW, KA
通讯作者：
CALLOW, KA
影响因子：
7.3
作者：
Hamming, I;Timens, W;van Goor, H
通讯作者：
van Goor, H