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首页> 外文期刊>Egyptian Journal of Medical Human Genetics >Comparison of multiplex reverse transcription-PCR-enzyme hybridization assay with immunofluorescence techniques for the detection of four viral respiratory pathogens in pediatric community acquired pneumonia
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Comparison of multiplex reverse transcription-PCR-enzyme hybridization assay with immunofluorescence techniques for the detection of four viral respiratory pathogens in pediatric community acquired pneumonia

机译：免疫荧光技术与多重逆转录-PCR-酶杂交检测在小儿社区获得性肺炎中检测四种病毒性呼吸道病原体的比较

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The burden of illness due to viral respiratory pathogens in the pediatric population is increasingly being recognized. Children are considered among the groups at highest risk for viral pneumonia-associated morbidity and mortality. Clinical discrimination between different causative agents is extremely difficult. The main problems have been the lack of ‘gold standard’ method for obtaining viral etiology (Liolios et al., 2001). We believe that the identification of these viruses as causes of respiratory disease in these patients is the first step in determining how frequently they may cause serious problems and, hence, how hard we should push with accepted treatments. In this study, our aim was to compare between two modalities for diagnosis of viral illness among children with community-acquired pneumonia (CAP). Multiplex reverse transcription-PCR-enzyme hybridization assay and immunofluorescence antigen detection techniques for the detection of four viral respiratory pathogens (Influenza viruses A & B and Respiratory Syncitial Viruses A & B) were targeted to evaluate their diagnostic yield for these patients in our study. Among 56 respiratory samples were evaluated from children with clinical and radiological criteria of CAP; twenty-one patients had viral pneumonia proved by multiplex RT-PCR and/or IF technique with disease prevalence 35% (95% CI: 23:49). All 21 specimens were positive by multiplex RT-PCR, while 20 out of them were positive by IF. All results showed no discordance of detected viral pathogen. Initial comparison of IF results to those of RT-PCR generated a sensitivity 100% (95% CI: 83:100), a specificity 97.2% (95% CI: 85:99.9), a positive predictive value 95% (95% CI: 23:49.6), and a negative predictive value of 100% (95% CI: 74:99). Conclusion Multiplex reverse transcription PCR has an excellent potentials for diagnosis of viral pneumonia with a cost effective advantage in assessing simultaneously multiple clinically significant viruses. Rapid antigen tests for diagnosis of variable respiratory viruses, can be useful in etiological diagnosis of community acquired lower respiratory tract infection as well specially with the proved high sensitivity and predectivity in our study.
机译：儿科人群中由于病毒性呼吸道病原体引起的疾病负担越来越多。儿童被认为是与病毒性肺炎相关的发病和死亡风险最高的人群。不同致病因素之间的临床区分非常困难。主要问题是缺乏获得病毒病原学的“金标准”方法（Liolios等，2001）。我们相信，在确定这些病毒可能导致严重问题的频率以及因此我们应如何努力接受公认的治疗方法中，确定这些病毒是导致这些患者呼吸系统疾病的第一步。在这项研究中，我们的目的是比较两种在社区获得性肺炎（CAP）儿童中诊断病毒性疾病的方法。多重逆转录-PCR-酶杂交测定和免疫荧光抗原检测技术可用于检测四种病毒性呼吸道病原体（甲型和乙型流感病毒和呼吸性乙型和乙型呼吸道病毒），以评估其在本研究中对这些患者的诊断率。从符合CAP临床和放射学标准的儿童中评估了56份呼吸样本。通过多重RT-PCR和/或IF技术证实21例病毒性肺炎患病率35％（95％CI：23:49）。通过多重RT-PCR，所有21个样品均为阳性，而其中20个通过IF呈阳性。所有结果均显示未检测到病毒病原体。 IF结果与RT-PCR的初步比较得出灵敏度100％（95％CI：83：100），特异性97.2％（95％CI：85：99.9），阳性预测值95％（95％CI） ：23：49.6），并且阴性预测值为100％（95％CI：74：99）。结论多重逆转录PCR在诊断病毒性肺炎方面具有极好的潜力，在同时评估多种具有临床意义的病毒方面具有成本优势。快速抗原测试可用于诊断可变呼吸道病毒，特别是在我们的研究中已证明具有较高的敏感性和预防性，可用于社区获得性下呼吸道感染的病因诊断。

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