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首页> 外文期刊>Journal of Clinical Microbiology >PCR for Detection of Herpes Simplex Virus in Cerebrospinal Fluid: Alternative Acceptance Criteria for Diagnostic Workup
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PCR for Detection of Herpes Simplex Virus in Cerebrospinal Fluid: Alternative Acceptance Criteria for Diagnostic Workup

机译：PCR检测脑脊液中单纯疱疹病毒：诊断性检查的替代接受标准

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The determination of herpes simplex virus (HSV) infection using a PCR assay is one of the most commonly requested tests for analysis of cerebrospinal fluid (CSF), although only a very low proportion of results are positive. A previously reported study showed that selecting only those CSF samples with >5 leukocytes/mm3 or a protein level of >50 mg/dl was adequate for the diagnostic workup. The aim of the present study was to assess the reliability of alternative acceptance criteria based on elevated CSF white blood cell counts (>10 cells/mm3). We analyzed all requests for HSV PCR received between January 2008 and December 2011. CSF samples were accepted for analysis if they had >10 cells/mm3 or if the sample was from an immunocompromised patient or a child aged <2 years. In order to evaluate our selection criteria, we identified those CSF samples with a leukocyte count of 5 to 10 cells/mm3 or protein levels of >50 mg/dl in order to test them for HSV type 1 and 2 (HSV-1 and HSV-2) DNA. During the study period, 466 CSF samples were submitted to the microbiology laboratory for HSV PCR. Of these, 268 (57.5%) were rejected, and 198 (42.5%) were tested according to our routine criteria. Of the tested samples, 11 (5.5%) were positive for HSV DNA (7 for HSV-1 and 4 for HSV-2). Of the 268 rejected specimens, 74 met the criteria of >5 cells/mm3 and/or protein levels of >50 mg/dl. Of these, 70 (94.6%) were available for analysis. None of the samples yielded a positive HSV PCR result. Acceptance criteria based on CSF leukocyte counts, host immune status, and age can help to streamline the application of HSV PCR without reducing sensitivity.
机译：使用PCR测定法确定单纯疱疹病毒（HSV）感染是分析脑脊液（CSF）的最常用方法之一，尽管阳性结果的比例很小。先前报道的一项研究表明，仅选择CSF样本中白细胞> 5或mm 3 或蛋白质水平> 50 mg / dl的样本即可进行诊断。本研究的目的是基于升高的CSF白细胞计数（> 10细胞/ mm 3 ）评估替代接受标准的可靠性。我们分析了2008年1月至2011年12月之间收到的所有HSV PCR要求。如果CSF样本的> 10细胞/ mm 3 或样本来自免疫功能低下的患者或年龄较大的儿童，则接受该分析<2年。为了评估我们的选择标准，我们鉴定了白细胞计数为5至10个细胞/ mm 3 或蛋白水平> 50 mg / dl的CSF样本，以测试其HSV型1和2个（HSV-1和HSV-2）DNA。在研究期间，将466例CSF样品提交给微生物实验室进行HSV PCR。其中，有268件（57.5％）被拒绝，根据我们的常规标准测试了198件（42.5％）。在测试样本中，有11例（5.5％）的HSV DNA呈阳性（HSV-1的7例和HSV-2的4例）。在268个被拒绝的标本中，有74个符合> 5细胞/ mm 3 和/或蛋白质水平> 50 mg / dl的标准。其中有70（94.6％）个可用于分析。没有一个样品产生阳性的HSV PCR结果。基于CSF白细胞计数，宿主免疫状态和年龄的接受标准可以帮助简化HSV PCR的应用，而不会降低灵敏度。

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