RESUMO
The analytical performance of the new Alere(TM) i Influenza A&B kit (AL-Flu) assay, based on isothermal nucleic acids amplification, was evaluated and compared with an antigen detection method, SD Bioline Influenza Virus Antigen Test (SDB), and an automated real-time RT-PCR, Simplexa(TM) Flu A/B & VRS Direct assay (SPX), for detection of influenza viruses. An in-house RT-PCR was used as the reference method. Sensitivity of AL-Flu, SDB, and SPX was 71.7%, 34.8%, and 100%, respectively. Specificity was 100% for all techniques. The turnaround time was 13min for AL-Flu, 15min for SDB, and 75min for SPX. The Alere(TM) i Influenza A&B assay is an optimal point-of-care assay for influenza diagnosis in clinical emergency settings, and is more sensitive and specific than antigen detection methods (AU)
Se evaluó el nuevo ensayo Alere(TM) i Influenza A&B kit (AL-Flu), basado en la amplificación isotérmica de ácidos nucleicos, y se comparó con un método de detección de antígeno, SD Bioline Influenza Virus Antigen Test (SDB), y con una RT-PCR en tiempo real automática, Simplexa(TM) Flu A/B & VRS Direct assay (SPX), para la detección de virus de la gripe. Se utilizó una RT-PCR en tiempo real casera como método de referencia. La sensibilidad de AL-Flu, SDB y SPX fue del 71,7%, del 34,8% y del 100%, respectivamente. Se obtuvo una especificidad del 100% con todos los métodos. El tiempo de realización fue de 13min para AL-Flu, de 15min para SDB y de 75min para SPX. El ensayo Alere(TM) i Influenza A&B es óptimo para el diagnóstico de gripe en unidades de urgencias, al ser más sensible y específico que las técnicas de detección de antígeno (AU)
Assuntos
Humanos , Influenzavirus A/isolamento & purificação , Influenzavirus B/isolamento & purificação , Influenza Humana/microbiologia , Infecções Respiratórias/microbiologia , Diagnóstico Precoce , Estudos Retrospectivos , Técnicas de Diagnóstico Molecular/métodosRESUMO
Introducción: La gripe es una enfermedad mundialmente vigilada a través de las redes centinela (RC) que predicen el comportamiento epidemiológico y comunican los datos clínicos y virológicos. Objetivos: Evaluar la rentabilidad de las muestras respiratorias pediátricas en la RC de las Islas Baleares en las últimas 5 temporadas gripales. Material y pacientes: Se tomó un frotis faríngeo para cultivo vírico de los pacientes que cumplían los criterios de gripe. Se inocularon las muestras en la línea celular MDCK. Se revisaron los datos epidemiológicos de cada paciente con cultivo positivo para los virus gripales A y B. Resultados: Durante el período de estudio se analizaron 338 frotis faríngeos de la RC. De éstos, 65 (19,3%) pertenecían a menores de 14 años. El 44,6% de estas muestras fueron positivas frente al 39,1% de las muestras de adultos. El virus gripal A se aisló en 24 muestras pediátricas (82,7%) y el virus gripal B se aisló en 5 muestras (17,3%). La edad media de los pacientes positivos de la RC fue de 8,5 años. En el grupo de 0 a 4 años sólo fueron positivos 3 pacientes (10,3%) y en el grupo de 5 a 14 años fueron positivos 26 pacientes (89,7%). Conclusiones: A pesar de que los pediatras sólo representan el 22% de los médicos de la RC y aportan el 19,3% de las muestras, el porcentaje de positividad y rentabilidad de éstas es superior al de la población adulta (AU)
Introduction: Influenza disease is subjected to surveillance by national networks (RC) that predict the epidemic behaviour by reporting clinical and virological data. Objectives: To evaluate the effectiveness of the paediatric respiratory samples in the Balearic Islands RC in the last five epidemic seasons. Material and patients: A breath sample was taken from paediatric patients in the RC who had flu symptoms. The samples were inoculated in the MDCK cell line. We reviewed the epidemiological data of patients with a culture positive to influenza A and B. Results: A total of 338 pharyngeal swabs from the RC were analysed during the study period. Of these, 65 (19.3%) belonged to <14 years old patients, and 44.6% of the samples were positive as opposed to 39.1% of adult respiratory samples. The influenza A virus was isolated in 24 paediatric samples (82.7%) and the influenza B virus in 5 (17.3%). The mean age of the paediatric patients of the RC who were positive was 8.5 years. Only 3 patients in the 04 year old group were positive (10.3%) and 26 patients (89.7%) in the 514 years old group. Conclusions: In spite that paediatricians represented only 22% of the RC doctors and obtain the 19.3% of all respiratory samples, the percentage and effectiveness of these is higher that obtained in the adult population (AU)
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Influenza Humana/diagnóstico , Cultura de Vírus/métodos , Influenzavirus A/isolamento & purificação , Influenzavirus B/isolamento & purificação , Preservação de Amostras de Água/métodos , Faringe/microbiologiaRESUMO
The objective of the present study was to determine the impact of influenza virus on pediatric hospitalized patients. We retrospectively reviewed records of children with laboratory diagnoses, by cell culture and/or indirect immunofluorescence assay, of influenza virus seen in a period of 6 years. A total of 1,033 samples were analyzed, 45 (4.3 percent) of them being reactive to influenza virus. Thirty-one samples were positive to influenza A virus and 14 to influenza B. The frequency of hospitalization in intensive care and medical emergency was found to be high. Three (8.6 percent) patients died, two of them due to respiratory failure. Low frequency of influenza virus infection was observed in the study. The data suggest the need of more efficient epidemiological surveillance measures in order to obtain reliable information to better assess the impact of the virus on our region and determine the need of preventive measures, such as immunization.
Assuntos
Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Influenza Humana/epidemiologia , Influenzavirus A/isolamento & purificação , Influenzavirus B/isolamento & purificação , Brasil/epidemiologia , Influenza Humana/diagnóstico , Influenza Humana/virologia , Prevalência , Estudos Retrospectivos , Índice de Gravidade de DoençaRESUMO
Se ha realizado un estudio prospectivo sobre la evolución de los diferentes grupos de edad y edad media de los pacientes pediátricos (0,05). El subtipado de los virus influenza A ha demostrado que 271 (86,8%) pertenecían al subtipo H3 y 41 (13,2%) al subtipo H1 (p<0,05). La edad media de los pacientes estudiados ha sido de 20,7 meses (intervalo 11 días y 15 años). El 73,8% de los pacientes presentaron una edad situada entre 0-2 años (p<0,05), 14,1% entre 2-5 años, 6,1% entre 6-10 años y 6% entre 11-15 años. El porcentaje medio de pacientes entre 0-5 meses ha sido el 24,8% (intervalo 11,1%-47,3%)y de entre 6-23 meses del 29,9% (intervalo 13,6-58,6%). La circulación del virus influenza B/Hong Kong/330/01 en la temporada 2003-2004 determinó unincremento significativo de la edad media de los pacientes (55,2 meses). La posible aplicación de las nuevas recomendaciones para la vacuna antigripal (mujeres embarazadas en el segundo-tercer trimestre y niños sanos entre 6-23 meses) podría determinar una disminución teórica del 65,2% de todos los casos de infección gripal
We report a prospective study about the evolution of different age groups and median age in pediatric patients (under 15 years) with influenza infection detected in ten consecutive flu epidemics (1995-2005). All respiratory samples were submitted to antigen detection and influenza A and B viral isolation (MDCK cell culture). In this period we studied 10.937 respiratory samples; 4.6% were positive for influenzaciruses (3.5% influenza A and 1.1% influenza B). We studied 414 patients, 234 (56,5%) boys and 180 (43.5%) girls. We detected 312 (75.4%) patients with influenza A and 102 (24.6%) with influenza B (p>0.05). The influenza A subtypes detected were 271 (86.8%) H3 and 41 (13.2%) H1 (p<0.05). The median age of patients was 20.7 months (range 11 days to 15 years (pz0.05)), 14,1% between 2-5 years, 6,1% between 6-10 years and 6% between 11-15 years. the median percentage of patients between 0-5 months was 24.8% (range 11.1%-58.6%). The circulation of influenza B/Hong Kong/330/01 virus in the period 2003-2004 was the main cause of increase in the median age of patients (55.2 months). The application of new anti-flu vaccination recommendations (pregnant women second-third trimester and healthy young children between 6-23 months) could theoretically decrease the 65.2% of all pediatric patients with influenza virus infections
