COVID-19 Enfeksiyonunda Mikrobiyolojik Tanı

Year 2020, Volume: 1 Issue: 1, 12 - 17, 30.06.2020

Bengül Durmaz

Abstract

COVID-19’un tanı ve tedavisinde, mikrobiyoloji laboratuvarı kritik öneme sahiptir. Akut COVID-19 enfeksiyonunu belirlemek için güncel olan tanı testi gerçek zamanlı, reverse-transkripsiyon polimeraz zincir reaksiyonu real-time reverse-transcription polymerase chain reaction, rRT-PCR testidir. Bu testin özgüllüğü yüksek >%95 , duyarlılığı nispeten düşüktür ∼%70 . Pozitif sonuçları negatif sonuca göre daha fazla güvenilirdir. Şüpheli vakalarda negatif sonuç, ikinci bir örnekle tekrarlanmalıdır. Testin duyarlılığını arttırmak için viral RNA nın en az iki hedef gen bölgesi kullanılması gereklidir. Sonuçların güvenilirliği için her testte pozitif ve negatif kontroller yanında iç kontrol de kullanmak gerekmektedir. COVID-19 pandemisi yayılmaya devam ettikçe ve vakalar biriktikçe, serolojik testler pandeminin geçmişini anlamak ve geleceğini tahmin etmek için giderek önemli hale gelmektedir. Serolojik analizler, halk sağlığı pratiğinde vakaları bulma, yakın temaslıları izleme ve karantina tavsiyesi için faydalıdır. Doğru zamanda yapıldıklarında moleküler testleri destekleyici olabilirler. Ancak serolojik yöntemlerin güçlü ve sınırlayıcı yönlerini iyi bilmek gerekir. SARS CoV-2 virüsünün farklı antijen bölgelerini hedefleyen serolojik testlere gereksinim vardır. Antijen testleri, monoklonal antikorlar kullanılarak hazırlandıklarında, bugün için duyarlılığına ilişkin problemler giderilebilir ve COVID-19’un hızlı tanısında kullanılabilir. Virüslerin hücre kültürlerinde üretilmesi ise bu yeni koronavirüsünün daha ayrıntılı analizi ve aşı çalışmaları için gereklidir.

Keywords

SARS-CoV-2 , COVID-19 , mikrobiyolojik analizler , gerçek zamanlı-revers transkriptaz polimeraz zincir reaksiyonu (PZR) , serolojik test

Microbiological Diagnosis in COVID-19 Infection

Abstract

Microbiology laboratory has critical importance in the diagnosis and treatment of infectious diseases. The current diagnostic test to determine COVID-19 infection is a real-time reverse-transcription polymerase chain reaction rRT-PCR test. The specificity of this test is high > 95% , the sensitivity is relatively low ∼70% . Positive results are more reliable than negative results. In suspicious cases, the negative result should be repeated with a second sample. To increase the sensitivity of the test, it is necessary to use at least two target genes of viral RNA. In order to ensure the reliability of the results, it is necessary to use positive and negative controls as well as internal control in each test. As the COVID-19 pandemic continues to spread and cases accumulate, serological tests are becoming increasingly important to understand the past of the pandemic and predict its future. Serological analyzes can be useful for finding cases in public health practice, monitoring close contacts, and quarantine advice. They can support molecular tests when done at the right time. However, it is necessary to know their strengths and limitations. The serological tests targeting different antigen regions of the SARS CoV-2 virus are needed. When antigen tests are prepared using monoclonal antibodies, problems related to their sensitivity can be eliminated and they can be used in the rapid diagnosis of COVID-19. The growth of viruses in cell cultures is essential for detail analysis of this new coronavirus and for vaccination studies.

Keywords

SARS-CoV-2 , COVID-19 , microbiological analyses , realtime reverse transcriptase polymerase chain (RT-PCR) , serological test

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