使用定量分子诊断方法来确定儿童腹的原因:GEMS病例对照研究的重新分析

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Jie Liu¹, James A Platts-Mills¹, Jane Juma²

¹Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA.

Lancet (London, England)

|September 28, 2016

概括

定量分子诊断显示,由六种主要病原体引起的儿童腹的负担更高. 这种方法提高了针对感染性腹的干预措施的理解.

科学领域:

全球健康
传染性疾病
分子诊断

背景情况:

腹是全球儿童死亡的主要原因.
由于各种方法和测试变异性,准确的诊断受到挑战.
全球肠多中心研究 (GEMS) 最初使用了多种微生物技术.

研究的目的:

通过定量分子诊断重新评估腹的原因.
将新发现与最初的GEMS诊断方法进行比较.
确定特定病原体的可归因发病率和疾病负担.

主要方法:

使用定量实时PCR (qPCR) 来检测便样本中的32种肠病原体.
分析了GEMS队列中的5304个病例和对照样本.
将qPCR结果与原始GEMS方法 (培养,EIA,RT-PCR) 的比较.

主要成果:

与原始方法相比,qPCR发现大多数病原体的发病率更高.
西格拉种,轮状病毒,腺病毒40/41,ST-ETEC,Cryptosporidium种和坎皮洛巴克特种. 是六个主要的病原体.
在 qPCR 试验中,人口层面的腹负担从 51. 5% 增加到 89. 3%.
在42. 5%的病例中有一种病原体,38. 9%的病原体有两种或更多的病原体,而在混合感染中,西格拉菌和轮状病毒占主导地位.

结论:

定量分子诊断提高了腹原因的特征.
腹的高负担与六种特定的病原体有关.
优先考虑针对这些病原体的干预措施对于减少儿童死亡率至关重要.

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