Real-time reverse-transcription PCR in the diagnosis of influenza A (H1N1)v in intensive care unit adult patients 英文参考文献.docVIP

Available online /content/13/6/428 Letter Real-time reverse-transcription PCR in the diagnosis of influenza A (H1N1)v in intensive care unit adult patients Concepción Gimeno1,2 and David Navarro2,3 1Microbiology Service, Consorcio Hospital General Universitario, Spain 2Department of Microbiology, School of Medicine, Valencia, Spain 3Microbiology Service, Hospital Clínico Universitario, Spain Corresponding author: David Navarro, david.navarro@uv.es Published: 7 December 2009 Critical Care 2009, 13:428 (doi:10.1186/cc8164) This article is online at /content/13/6/428 ? 2009 BioMed Central Ltd See related research by Rello et al., /content/13/5/R148 Regarding the interesting article on novel influenza A (H1N1)v infection in intensive care adult patients with severe respiratory failure recently published in Critical Care [1], we should like to make the following comments. The negative results reported by the authors cannot be considered true false negative RT-PCR results, as samples were not tested in parallel by a different assay yielding a posi- tive result – in fact, RT-PCR, which was used at participating centers, is currently the standard method for the diagnosis of influenza. Optimal sensitivity of RT-PCR and rapid antigen tests is achieved when upper tract respiratory specimens are collected within the first few days after the onset of symptoms, as appeared to be the case for the above-men- tioned patients. Inappropriate sampling or specimen process- ing or suboptimal sensitivity of the PCR assay used most probably accounted for the negative results. No speculation on this matter can be made because the microbiological information given to the readers was rather scarce. The authors found that real-time RT-PCR for novel influenza A (H1N1)v virus in nasopharyngeal swabs on intensive care unit (ICU) admission was negative in four patients