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Archives de pédiatrie
Volume 14, n° S4
pages 197-202 (décembre 2007)
Doi : 10.1016/S0929-693X(07)78706-7
Virologie : l’apport de la biologie moléculaire dans le diagnostic microbiologique en pneumopédiatrie
Microbiological approaches with molecular biological diagnosis to paediatric respiratory viral infections
 

J. Brouard 1, , A. Vabret 2, S. Perrot 2, D. Nimal 1, N. Bach 1, A. Outteryck 1, V. Trippey 1, F. Freymuth 2
1 Service de pédiatrie, avenue Clémenceau, CHU de Caen, 14033 Caen cedex, France 
2 Laboratoire de virologie humaine et moléculaire, CHU de Caen, avenue Clémenceau, 14033 Caen cedex, France 

Auteur correspondant. J. Brouard.
Résumé

Les outils traditionnels du diagnostic virologique comprennent la recherche antigénique directe par immunofluorescence (IF) ou test immunoenzymatique (EIA), et l’isolement en culture. Les techniques d’IF ou EIA ont une sensibilité en général légèrement inférieure à celle de la culture, mais elles permettent de détecter également une fraction d’échantillons faussement négatifs en culture. Les résultats de plusieurs équipes, utilisant des techniques de reverse transcription-polymerase chain reaction (RT-PCR), montrent que les méthodes moléculaires détectent plus d’échantillons positifs que les méthodes traditionnelles. Le travail est en cours pour élargir le nombre de virus identifiés par des RT-PCR multiplex et découvrir de nouveaux virus, tels le métapneumovirus humain, en cause dans les atteintes respiratoires de l’enfant. En conclusion, afin de concilier rapidité, contrôle des coûts et un fort taux de détection des virus respiratoires, l’utilisation combinée de l’IF et de la RT-PCR multiplex semble ce jour la meilleure façon de progresser dans le diagnostic des maladies respiratoires de l’enfant.

The full text of this article is available in PDF format.
Summary

The conventionnal tools used for virological diagnosis include direct antigen detection by immunofluorescence (IFA) or an immunoenzymatic test (EIA), and viral isolation technique (VIT). In most cases, IFA and EIA have a slightly lower sensitivity than VIT but are also able to detect some VIT-negative samples. Results of several teams using RT-PCR technologies show that the molecular methods detect more positive cases than the conventional tools. Work is under way to expand the number of viruses detected by multiplex RT-PCR and to determine wether newly discovered viruses, such as human metapneumovirus, contribute to burden of paediatric lower respiratory infections. In conclusion, according to requirements of speed, low cost of the methods, and to achieve the highest rate of detection of respiratory viruses, the combined use of IFA and multiplex RT-PCR is today likely to be the best way to improve diagnosis of respiratory illnesses in children.

The full text of this article is available in PDF format.

Mots-clés : Diagnostic biologique, Infections respiratoires, Maladies virales, Reverse transcription-polymerase chain reaction




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