Molecular techniques should not now replace cell culture in diagnostic virology laboratories.
The value of molecular techniques for virology is not in dispute; the issue debated here is whether or not to abandon virus isolation altogether. Modern clinical virology relies on rapid virus detection for timely infection control and antiviral therapy. The role of virus isolation, inevitably a slower process as it involves replication in cell cultures, is most significant in providing epidemiological data, in the diagnosis of new or unexpected infection, and in yielding infectious virus for further study. Examples include identification of enterovirus serotypes in outbreaks, diagnosis of atypical virus infections, and provision of virus isolates for phenotypic antiviral susceptibility assays. Many viruses can be detected after overnight culture using the centrifugation-enhanced (shell vial) technique. In contrast to this established track record, the commercial development of molecular assays has been concentrated on blood-borne viruses, and standardisation of procedures for other viruses is lacking. Accreditation of molecular techniques is just beginning, and few external quality assurance schemes are available yet. In my view, it is premature to abandon routine virus isolation, although as molecular diagnosis expands, the facilities for cell culture and isolation work may become more centralised to retain expertise and to provide the range and quality of service required.
Ogilvie
M
M
Regional Clinical Virology Laboratory, Lothian University Hospitals NHS Trust, Edinburgh, UK. marie.ogilvie@ed.ac.uk
D018929:Cell Culture Techniques; D019937:Diagnostic Techniques and Procedures / Q000191:economics / Q000592:standards*; D006801:Humans; D009696:Nucleic Acids / Q000737:chemistry / Q000302:isolation & purification; D014773:Virology / Q000379:methods*; D014777:Virus Diseases / Q000175:diagnosis*
D009696:Nucleic Acids