使用综合性传染病检测研究免疫功能低下患者的病毒参与,包括FilmArray呼吸系统面板 2.1 支气管镜检查:一项回顾性研究
Tomoaki Nakamura1, Ryosuke Imai1, Atsushi Kitamura1
1Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, JPN.
Cureus
|June 12, 2023
概括
在FilmArray Respiratory Panel 2.1 (FARP) 中,使用支气管支气管洗样本在免疫抑制患者中发现病毒性肺炎的检测率较低. 综合测试显示,其他病原体比FARP检测到的病毒更为普遍.
科学领域:
- 传染性疾病 传染性疾病
- 临床微生物学 临床微生物学
- 肺部病理学 肺部病理学
背景情况:
- 下呼吸道感染 (LRTI) 在免疫抑制患者中很常见.
- 支气管支气管洗 (BAL) 是这一群体中LRTI的关键诊断工具.
- 多重PCR面板的实用性,如FilmArray呼吸面板2.1 (FARP) 对于BAL标本的实用性,尚未得到充分证实.
研究的目的:
- 评估FARP对来自免疫抑制患者的BAL样本中的病毒病原体的诊断产量.
- 将FARP的结果与其他综合性传染病检测方法进行比较.
- 评估FARP作为更广泛的肺炎诊断策略的一部分在免疫受损患者中的作用.
主要方法:
- 从23名接受支气管镜检查的免疫抑制患者的BAL样本进行了回顾性分析.
- 样品使用FARP,针对特定病毒的RT-PCR,针对Pneumocystis jirovecii的PCR,针对真菌的抗原测试,以及针对军团菌的LAA进行了测试.
- 临床和放射学数据,包括CT扫描,与诊断结果相关.
主要成果:
- 只有2/23 (9%) 患者通过FARP检测出SARS-CoV-2和腺病毒阳性.
- 在4/23 (17%) 个患者中,通过RT-PCR检测出了细胞巨乳病毒,但不是通过细胞学检测.
- 通过PCR检测出了9/23 (39%) 患者的肺囊菌 jirovecii,细胞学只证实了一个病例.
结论:
- 在这个免疫抑制患者队列中,FARP证明了肺炎病毒原因的低阳性检测率.
- 对BAL样本进行的综合性传染病检测显示,与FARP可检测的病毒相比,Pneumocystis jirovecii和cytomegalovirus的流行率更高.
- 目前的FARP病毒标可能不是需要BAL分析的免疫功能低下患者肺炎的主要驱动因素.
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