應用R-Mix快速培養系統於臨床呼吸道病毒鑑定

Application of R-mix Shell Vial Culture System on Clinical Diagnosis of Respiratory Tract Viral Infections

以傳統試管培養法進行呼吸道病毒培養時，需使用多種細胞株來提高病毒之檢出率，實驗流程複雜，且培養時間長。為了改善呼吸道病毒培養時效，本院引進運用shell vial culture技術之R-MixTM Ready Cell（R-MixTM SV）呼吸道病毒培養系統；本研究比較二種培養法同時進行8種呼吸道病毒培養之檢驗效能差異。定量病毒感受性評估結果顯示，R-MixTM SV在呼吸道融合病毒及人類肺間質病毒具有良好之敏感度；臨床檢體評估顯示，以二套系統同時執行256例檢體病毒培養，一致性達96.88% （248/256）；病毒培養時間在傳統試管培養法平均為7.6天，而R-MixTM SV平均為2.4天，病毒培養時間具顯著差異 （p值<0.0001）。實際運用R-MixTM SV執行臨床病毒檢驗，統計執行16個月後之病毒培養時間差異可達7.6天（2.7 vs 10.3）。本結果顯示R-MixTM SV系統較傳統細胞培養法有效縮短呼吸道病毒培養時間；尤其對於細胞病變不明顯之副黏液病毒科具有良好之鑑定成效。綜合本實驗室之結果，R-MixTM SV對於呼吸道病毒培養鑑定能力均優於傳統試管培養法，可縮短病毒培養時間，提升副黏液病毒檢出率，是值得推廣之呼吸道病毒培養系統。

Conventional tube culture methods for respiratory tract virus isolation are complicated and labor intensive, and require multiple cell lines to increase the virus detection rate. To improve the turnaround time of respiratory tract virus culture, R-MixTM Ready Cell shell vial (R-MixTM SV) culture has been developed. However, its efficacy for the detection of clinical respiratory tract virus infections is still unclear. Therefore, we aim to compare R-MixTM SV culture with conventional tube culture in the detection of eight common respiratory tract viruses. Parallel comparison of 256 specimens, the culture results were 96.9% (248/256) in agreement between two culture systems, the average detection time for R-MixTM SV culture were significantly shorter than that of tube culture (2.4 days versus 7.6 days, P < 0.0001). Sensitivity evaluations showed that the R-MixTM SV culture had higher sensitivities in the detections of respiratory syncytial virus and human metapneumovirus. After 16-month clinical service, 1191 specimens were collected and compared, the average time difference between R-MixTM SV culture and tube culture were 7.6 days (2.7 versus 10.3, P < 0.0001). In conclusion, our results confirmed that the R-MixTM SV culture can either significantly reduce the overall turnaround time for respiratory tract virus isolation or significantly improve the identification rate, especially for Paramyxoviridae virus, in a clinical setting.