评估呼吸道病毒感染的两阶段算法
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By LabMedica International staff writers Posted on 01 May 2018 |
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图片：Sofia甲流乙流FIA检验试剂盒（图片蒙Quidel公司惠赐）。
新型按需多重呼吸道病毒分子诊断产品虽然昂贵，且某些平台不能同时处理多份样本，但是性能卓越。
商用组合型分子诊断产品可快速检测阳性血液培养瓶、呼吸道样本、大便和脑脊液中的病原体，最近的发展引起临床微生物检验与临床规程的转变。
美国马萨诸塞州波士顿市塔夫斯医疗中心(www.tuftsmedicalcenter.org)的科学家开展了一项回顾性研究，回顾患者的呼吸道病毒检验结果，之前还对这些患者应用了一套两阶段检验算法，先用美国加利福尼亚州圣迭戈市Quidel公司(www.quidel.com)的Sofia免疫测定产品筛查，再用美国北卡罗莱纳州杜勒姆市生物梅里埃股份有限公司(www.biomerieux-usa.com)的Biofire膜阵列，并与只用膜阵列的时期比较。具体而言，在冬季流感季用两阶段方法处理了1,814份样本。然后与夏季单用膜阵列处理1,162份样本的方案做了比较。
科研小组用Quidel公司的Sofia流感免疫测定通过两阶段方法成功诊断了282例流感。然后他们用膜阵列组合试剂检验了流感免疫测定结果呈阴性的全部鼻咽样本，又发现了单用免疫测定所漏检的163例流感病例。两阶段方法还包括用呼吸道合胞病毒(RSV)免疫测定产品检验五岁以下的儿童以及内科医生送检的成人，共363名患者。约28%的样本Sofia检测RSV的结果为阴性，但是膜阵列检测RSV的结果为阳性，而且膜阵列又发现了未接受免疫测定的患者中的71例RSV病例。虽然冬季检验的样本更多，但是在90分钟内得到诊断的患者人数也多得多，大概节省了36,000美元。
该研究的论文发表于2018年3月12日的《诊断微生物学与传染病》(Diagnostic Microbiology and Infectious Disease)杂志。论文合著者之一、传染病医师Brad J. Gardiner说：“如果你做出的诊断改变了病人的预后，钱就花得值，但如果你正在诊断感染鼻病毒的患者且不会产生差别，则钱最好花在别处。”
塔夫斯医疗中心>>> www.tuftsmedicalcenter.org
Quidel >>> www.quidel.com
生物梅里埃股份有限公司>>> www.biomerieux-usa.com
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