Objective: Molecular detection and serotyping are rapid, sensitive and accurate techniques for early diagnosis of paediatric dengue. The present study evaluates multiplex real-time polymerase chain reaction (PCR) for diagnosis of dengue virus in children hospitalised with severe dengue (SD) and attempts to establish an association of clinical severity with specific serotypes. Methods: Four hundred and eighty-five samples were received from hospitalised paediatric patients with suspected dengue from March 2019 to February 2020. Multiplex real time PCR was employed for diagnosis. An in-house real-time PCR that combined diagnosis and serotyping was established. Non-structural protein 1 (NS1) assay and real-time PCR were assessed for their accuracy in diagnosing severe paediatric dengue. Results: Three hundred and twenty-five (67%) patients were positive for dengue RNA by real-time PCR. All four serotypes were identified throughout the year; dengue serotype 2 (DEN-2) was predominant (61%) followed by DEN-3, 20%. Compared to the commonly used NS1 testing, multiplex real-time PCR showed greater sensitivity in diagnosing SD. Conclusions: Compared to NS1, multiplex real-time PCR is a rapid and accurate diagnostic test for children hospitalised with SD. DEN-2 was the predominant serotype in severe cases. Continued surveillance of serotypes should be carried out year-round in endemic areas.


中文翻译：

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多重实时聚合酶链反应在重症登革热住院儿童登革热病毒联合检测和血清分型中的应用：来自金奈的报告


目的：分子检测和血清分型是儿童登革热早期诊断的快速、灵敏和准确的技术。本研究评估了多重实时聚合酶链反应 (PCR) 对重症登革热 (SD) 住院儿童登革热病毒的诊断，并试图建立临床严重程度与特定血清型的关联。方法：收集2019年3月至2020年2月期间住院的疑似登革热患儿485份样本，采用多重实时PCR进行诊断。建立了结合诊断和血清分型的内部实时 PCR。评估了非结构蛋白 1 (NS1) 检测和实时 PCR 诊断严重儿科登革热的准确性。结果：通过实时 PCR 检测，325 名 (67%) 患者的登革热 RNA 呈阳性。全年都发现了所有四种血清型；登革热血清型 2 (DEN-2) 占主导地位 (61%)，其次是 DEN-3，占 20%。与常用的 NS1 检测相比，多重实时 PCR 在诊断 SD 方面表现出更高的敏感性。结论：与 NS1 相比，多重实时 PCR 是一种快速、准确的 SD 住院儿童诊断测试。DEN-2 是重症病例的主要血清型。应在流行地区全年进行血清型的持续监测。