RESUMEN
AIM: To evaluate the contribution of a multiplex PCR for respiratory viruses on antibiotic and antiviral prescription, ancillary test prescription, admission and length of stay of patients. METHODS: Two hundred ninety-one adult and pediatric patients visiting the emergency department during the 2015-2016 influenza epidemic were prospectively included and immediately tested 24/7 using the FilmArray Respiratory Panel. The results were communicated to the practitioner in charge as soon as they became available. Clinical and biological data were gathered and analyzed. FINDINGS: Results from the FilmArray Respiratory Panel do not appear to impact admission or antibiotic prescription, with the exception of a lower admission rate for children who tested positive for influenza B. Parameters that account for the clinical decisions evaluated are CRP level, white blood cell count, suspected or proven bacterial infection and, for adult patients only, signs of respiratory distress. Length of stay is also not significantly different between patients with a positive and a negative result. A rapid influenza test result permits a more appropriate prescription of oseltamivir.
Asunto(s)
Epidemias , Gripe Humana/diagnóstico , Reacción en Cadena de la Polimerasa Multiplex/métodos , Infecciones del Sistema Respiratorio/virología , Adolescente , Adulto , Anciano , Antibacterianos/uso terapéutico , Antivirales/uso terapéutico , Niño , Preescolar , Servicio de Urgencia en Hospital , Femenino , Humanos , Lactante , Gripe Humana/tratamiento farmacológico , Gripe Humana/epidemiología , Tiempo de Internación , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Tiempo , Adulto JovenRESUMEN
AIM: To compare the performances of molecular and non-molecular tests to diagnose respiratory viral infections and to evaluate the pros and contras of each technique. METHODS: Two hundred ninety-nine respiratory samples were prospectively explored using multiplex molecular techniques (FilmArray Respiratory Panel, Clart Pneumovir), immunological techniques (direct fluorescent assay, lateral flow chromatography) and cell cultures. FINDINGS: Molecular techniques permitted the recovery of up to 50% more respiratory pathogens in comparison to non-molecular methods. FilmArray detected at least 30% more pathogens than Clart Pneumovir which could be explained by the differences in their technical designs. The turnaround time under 2 hours for the FilmArray permitted delivery of results when patients were still in the emergency room.
Asunto(s)
Técnica del Anticuerpo Fluorescente/normas , Técnicas de Diagnóstico Molecular/normas , Infecciones del Sistema Respiratorio/diagnóstico , Virosis/diagnóstico , Virus/aislamiento & purificación , Técnicas de Cultivo de Célula , Línea Celular , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Infecciones del Sistema Respiratorio/virología , Sensibilidad y Especificidad , Virosis/virología , Virus/genéticaRESUMEN
PURPOSE: Evaluation of the performance of two rapid (15') antigen detection tests (RAT), BinaxNOW Influenza A&B and Coris Influ-A&B Respi-Strip for the detection of A(H1N1)v2009. STUDY DESIGN: Between July 2009 and November 2009, 4105 respiratory specimens from patients with influenza-like illness attending seven public hospitals in Brussels were prospectively examined by two immunochromatographic RAT, followed by viral culture and/or specific real-time RT-PCR. RESULTS: Samples consisted predominantly of nasopharyngeal aspirates (NPA-41%), nasopharyngeal (NPS-37%) and throat swabs (TS-14%). The sensitivity and specificity of Coris RAT and BinaxNOW RAT were 36.6% and 99.7%, and 47% and 98.7% respectively compared to culture; and 33.7% and 99.6%; and 46.5% and 98.8% compared to RT-PCR. Significant differences in sensitivity could be observed when splitting up the samples by sample type and patient's age. NPA gave by far the highest sensitivities: 51.1- 62% for Coris compared to culture and 62.6-78.4% for BinaxNOW. Sensitivities in paediatric NPS varied less between different hospitals (34-41.9%) being still much higher than in adult NPS (11.4-20%). TS resulted in unsatisfactory results: 13% sensitivity in children and 10.5% in adults. CONCLUSIONS: Both RAT showed excellent specificities, but insufficient sensitivities. Consequently, negative results should be confirmed. NPA are clearly superior to NPS orTS, and they stay the sample of choice for viral diagnosis.
Asunto(s)
Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/diagnóstico , Juego de Reactivos para Diagnóstico , Adolescente , Adulto , Anciano , Bélgica , Niño , Preescolar , Cromatografía de Afinidad , Humanos , Lactante , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Reacción en Cadena en Tiempo Real de la Polimerasa , Sensibilidad y Especificidad , Adulto JovenAsunto(s)
Antígenos HLA-DQ/análisis , Neoplasias del Cuello Uterino/inmunología , Femenino , Cadenas beta de HLA-DQ , Humanos , Papillomaviridae , Estudios Retrospectivos , Infecciones Tumorales por Virus/inmunología , Neoplasias del Cuello Uterino/microbiología , Neoplasias del Cuello Uterino/patologíaRESUMEN
A commercial enzyme immunomembrane filter assay (EIFA) for respiratory syncytial virus (RSV) was compared prospectively with isolation in cell culture and an enzyme immunoassay. A total of 595 respiratory specimens, mostly from pediatric patients, were examined. The EIFA was 70.96% sensitive and 72.40% specific in comparison with cell culture. Results for 40 specimens (6.72%) were uninterpretable, mainly due to filtration difficulties. Twenty-one (25%) of 84 specimens whose results were initially considered false-positive were subsequently confirmed positive after a blocking test with bovine anti-RSV serum. On the basis of the total number of confirmed positive results, the sensitivity and the specificity of the test were 87.90% and 75.77%, respectively.
Asunto(s)
Técnicas para Inmunoenzimas , Virus Sincitiales Respiratorios/aislamiento & purificación , Infecciones por Respirovirus/diagnóstico , Células Cultivadas , Estudios de Evaluación como Asunto , Reacciones Falso Positivas , Humanos , Sensibilidad y EspecificidadRESUMEN
HSV1 suspensions were pre-incubated in a lactoperoxidase thiocyanate oxidizing system before inoculation in MRC5 fibroblast cultures. This pre-treatment could either delay or even abolish the HSV1 cytopathic potentiality. The effect was found to be time-dependent.