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首页> 外文期刊>Journal of Clinical Microbiology >Serology Enhances Molecular Diagnosis of Respiratory Virus Infections Other than Influenza in Children and Adults Hospitalized with Community-Acquired Pneumonia
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Serology Enhances Molecular Diagnosis of Respiratory Virus Infections Other than Influenza in Children and Adults Hospitalized with Community-Acquired Pneumonia

机译：血清学可增强社区感染性肺炎住院的儿童和成人的除流感以外的呼吸道病毒感染的分子诊断。

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Both molecular and serological assays have been used previously to determine the etiology of community-acquired pneumonia (CAP). However, the extent to which these methods are correlated and the added diagnostic value of serology for respiratory viruses other than influenza virus have not been fully evaluated. Using data from patients enrolled in the Centers for Disease Control and Prevention (CDC) Etiology of Pneumonia in the Community (EPIC) study, we compared real-time reverse transcription-PCR (RT-PCR) and serology for the diagnosis of respiratory syncytial virus (RSV), human metapneumovirus (HMPV), parainfluenza virus 1 to 3 (PIV1, PIV2, and PIV3), and adenovirus (AdV) infections. Of 5,126 patients enrolled, RT-PCR and serology test results were available for 2,023, including 1,087 children below the age of 18 years and 936 adults. For RSV, 287 (14.2%) patients were positive by RT-PCR and 234 (11.6%) were positive by serology; for HMPV, 172 (8.5%) tested positive by RT-PCR and 147 (7.3%) by serology; for the PIVs, 94 (4.6%) tested positive by RT-PCR and 92 (4.6%) by serology; and for AdV, 111 (5.5%) tested positive by RT-PCR and 62 (3.1%) by serology. RT-PCR provided the highest number of positive detections overall, but serology increased diagnostic yield for RSV (by 11.8%), HMPV (by 25.0%), AdV (by 32.4%), and PIV (by 48.9%). The method concordance estimated by Cohen's kappa coefficient (κ) ranged from good (for RSV; κ = 0.73) to fair (for AdV; κ = 0.27). Heterotypic seroresponses observed between PIVs and persistent low-level AdV shedding may account for the higher method discordance observed with each of these viruses. Serology can be a helpful adjunct to RT-PCR for research-based assessment of the etiologic contribution of respiratory viruses other than influenza virus to CAP.
机译：分子和血清学检测以前都已用于确定社区获得性肺炎（CAP）的病因。然而，尚未充分评估这些方法的相关程度以及血清学对除流感病毒以外的呼吸道病毒的附加诊断价值。利用来自社区疾病控制和预防中心（CDC）肺炎病原学（EPIC）研究的患者数据，我们比较了实时逆转录PCR（RT-PCR）和血清学对呼吸道合胞病毒的诊断（RSV），人间质肺病毒（HMPV），副流感病毒1至3（PIV1，PIV2和PIV3）和腺病毒（AdV）感染。在5126名患者中，有2023名患者获得了RT-PCR和血清学检测结果，包括1,087名18岁以下的儿童和936名成人。对于RSV，RT-PCR阳性287例（14.2％），血清学阳性234例（11.6％）。对于HMPV，通过RT-PCR检测为172（8.5％）阳性，通过血清学检测为147（7.3％）;对于PIV，RT-PCR检测为阳性的有94（4.6％），血清学检测为92（4.6％）。对于AdV，RT-PCR检测为111（5.5％）阳性，血清学检测为62（3.1％）。总体而言，RT-PCR提供了最高的阳性检测数量，但血清学提高了RSV（提高11.8％），HMPV（提高25.0％），AdV（提高32.4％）和PIV（提高48.9％）的诊断率。由Cohen卡伯系数（κ）估算的方法一致性从良好（对于RSV;κ= 0.73）到一般（对于AdV;κ= 0.27）。在PIV和持续的低水平AdV脱落之间观察到的异型血清反应可能解释了每种病毒在方法上的较高不一致性。血清学可以作为RT-PCR的有用辅助，用于基于研究评估除流感病毒以外的呼吸道病毒对CAP的病因学贡献。

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