Setting up a clinical Virology laboratory
المؤلف:
Patricia M. Tille, PhD, MLS(ASCP)
المصدر:
Bailey & Scotts Diagnostic Microbiology
الجزء والصفحة:
13th Edition , p791-792
2025-12-14
36
The demand for clinical virology laboratory services has skyrocketed during the past two decades. This growth has resulted from the introduction of virus-specific antiviral drugs; the commercial availability of reagents; the development of rapid diagnostic techniques using conventional methods such as fluorescence microscopy and enzyme immunoassays; the ready availability of cell lines for cell culture procedures; and the introduction of real-time polymerase chain reaction (PCR) assays for detecting viral genomes. Ironically, improved medical care, in the form of organ transplantation and immune suppression with cancer therapy, has resulted in an increased number of patients with viral disease. When these factors are considered along with the appearance of emerging viral pathogens that are threatening local and world populations (e.g., SARS, avian influenza, monkey pox), laboratory diagnosis of viral infection becomes far more important than in previous years.
When determining which virology tests to offer, each clinical laboratory should decide whether the test is required for the appropriate care of their patient population and whether techniques are available that provide an accurate, cost-effective test result. Viral diseases that require laboratory diagnosis include sexually transmitted diseases, diarrhea, respiratory disease in adults and children, aseptic meningitis, arbovirus encephalitides, congenital diseases, hepatitis, and infections in immunocompromised individuals. Table 1 presents a representative sample of viruses identified in a community clinical virology laboratory.
Table1. Viruses Detected by Culture, PCR, or Assay for Antigen in a Community Hospital Virology Laboratory *
Laboratory scientists in a clinical virology laboratory must be familiar with cell culture, enzyme immunoassay, immunofluorescence methods, and molecular methods (e.g., PCR), in addition to other common lab oratory techniques. Large equipment needed for a full service virology laboratory includes a laminar flow biologic safety cabinet (BSC), fluorescence microscope, inverted bright field microscope, refrigerated centrifuge, incubator, refrigerator and freezer, roller drum for holding cell culture tubes during incubation, and enzyme or molecular testing instrumentation (Figures 1 to 3).
Fig1. Roller drum used to hold cell culture tubes during incubation. Slow rotation continually bathes the cells in the medium.
Fig2. Inverted microscope used to examine cell monolayers growing attached to the inside surface beneath the liquid medium. Note that the objective is under the glass test tube, facilitating observation of the cell monolayer.
Fig3. Class II biological safety cabinet used in a clinical virology laboratory.
Standard precautions and Biosafety Level 2 conditions are needed for community and most nonretroviral laboratories. Requirements include standard microbiologic practices, training in biosafety, protective clothing and gloves, limited access, decontamination of all infectious waste, and a class I or II BSC. Some viruses should not be propagated in Biosafety Level 2 laboratories, including influenza H5N1, SARS coronavirus, hemorrhagic fever viruses, and smallpox.
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