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目的:比较鼻拭子和咽拭子在流感样病例(influenza-like illness,ILI)标本检测中的阳性率。方法:平行采集瑞金医院门诊ILI标本鼻拭子和咽拭子各一份,分别使用荧光PCR方法(real-time PCR)和细胞培养(cell culture)方法比较鼻拭子和咽拭子在流感病毒检测中的阳性率。结果:2011年上半年(第1周-第30周)共采集ILI标本393份,其中荧光PCR阳性174份,MDCK细胞接种得到流感毒株114株,主要型别是B型,其次是A(H1N1)pdm09和H3N2亚型。总体上说鼻拭子阳性率高于咽拭子(78.9%vs 73.7%,P<0.01);A(H1N1)pdm09亚型流感标本,咽拭子阳性率高于鼻拭子(86.8%vs 67.9%,P<0.01);B型流感标本鼻拭子阳性率高于咽拭子(89.7%vs 62.1%,P<0.01);H3N2亚型流感标本鼻拭子和咽拭子阳性率没有明显差别(66.7%vs 66.7%,P=0.333)。结论:在流感常规监测工作中,对于不能同时采集鼻咽双份拭子的采样点,应根据当季流行的主要流感病毒亚型来确定采样部位。
Objective: To compare the positive rate of nasal swab and throat swab in the detection of influenza-like illness (ILI) specimens. Methods: Nasopharyngeal swabs and throat swabs were collected in parallel with ILI samples from clinics in Ruijin Hospital. The nasal swabs and throat swabs were compared by real-time PCR and cell culture respectively. Detection of the positive rate. Results: In the first half of 2011 (week 1 - week 30), 393 ILI specimens were collected, of which 174 were positive by fluorescence PCR and 114 strains were obtained by inoculation with MDCK cells. The main type was IL-2, followed by A ( H1N1) pdm09 and H3N2 subtypes. Overall, the positive rate of nasal swab was higher than that of throat swab (78.9% vs 73.7%, P <0.01). The positive rate of influenza A (H1N1) pdm09 was higher than that of nasal swab (86.8% vs 67.9 %, P <0.01). The positive rate of nasal swab in type B influenza was higher than that of throat swab (89.7% vs 62.1%, P <0.01). There was no significant difference in the positive rates of nasal swab and throat swab (66.7% vs 66.7%, P = 0.333). CONCLUSIONS: In the routine surveillance of influenza, the sampling sites should be determined according to the prevalence of major influenza virus subtypes in the sampling points where nasopharyngeal double-swabs can not be collected at the same time.