The FilmArray Respiratory Panel (RP) multiplexed nucleic acid amplification test (Idaho Technology, Inc., Salt Lake City, UT) was compared to laboratory-developed real-time PCR assays for the detection of various respiratory viruses and certain bacterial pathogens. A total of 215 frozen archived pediatric respiratory specimens previously characterized as either negative or positive for one or more pathogens by real-time PCR were examined using the FilmArray RP system. Overall agreement between the FilmArray RP and corresponding real-time PCR assays for shared analytes was 98.6% (kappa ؍ 0.92 [95% confidence interval (CI), 0.89 to 0.94]). The combined positive percent agreement was 89.4% (95% CI, 85.4 to 92.6); the negative percent agreement was 99.6% (95% CI, 99.2 to 99.8). The mean real-time PCR threshold cycle (C T ) value for specimens with discordant results was 36.46 ؎ 4.54. Detection of coinfections and correct identification of influenza A virus subtypes were comparable to those of realtime PCR when using the FilmArray RP. The greatest comparative difference in sensitivity was observed for adenovirus; only 11 of 24 (45.8%; 95% CI, 27.9 to 64.9) clinical specimens positive for adenovirus by real-time PCR were also positive by the FilmArray RP. In addition, upon testing 20 characterized adenovirus serotypes prepared at high and low viral loads, the FilmArray RP did not detect serotypes 6 and 41 at either level and failed to detect serotypes 2, 20, 35, and 37 when viral loads were low. The FilmArray RP system is rapid and extremely user-friendly, with results available in just over 1 h with almost no labor involved. Its low throughput is a significant drawback for laboratories receiving large numbers of specimens, as only a single sample can be processed at a time with one instrument.A variety of viruses and bacteria are responsible for acute upper and lower respiratory tract infections in children and adults worldwide. Severe and even fatal disease can occur in the very young, the elderly, the immunocompromised, and those individuals with underlying conditions that affect cardiopulmonary function. While certain clinical syndromes are classically associated with specific pathogens, in reality, the syndromes caused by these organisms are often indistinguishable, and rapid and accurate detection is important for appropriate patient management and prevention of nosocomial spread (2,5,6,7,13,23,26,31,35). Through the years, PCR has shown excellent clinical utility over the more traditional laboratory methods of virus culture and direct antigen tests for the sensitive detection of respiratory viruses (8,15,24,25,34), and both laboratory-developed and commercial molecular assays are now available (22). However, because of the complexity of these molecular tests, implementation has been a challenge for the routine clinical laboratory.More recently, significant advances in microfluidics, microelectronics, and microfabrication have paved the way for the development of simplified molecular systems with the possibili...
Acute flaccid myelitis (AFM) is a polio-like disease that results in paralysis in previously healthy persons. Although the definitive cause of AFM remains unconfirmed, enterovirus D68 (EV-D68) is suspected based on 2014 data demonstrating an increase in AFM cases concomitant with an EV-D68 outbreak. We examined the prevalence in children and the molecular evolution of EV-D68 for 2009–2018 in Philadelphia, Pennsylvania, USA. We detected widespread EV-D68 circulation in 2009, rare detections in 2010 and 2011, and then biennial circulation, only in even years, during 2012–2018. Prevalence of EV-D68 significantly correlated with AFM cases during this period. Finally, whole-genome sequencing revealed early detection of the B1 clade in 2009 and continued evolution of the B3 clade from 2016 to 2018. These data reinforce the need to improve surveillance programs for nonpolio enterovirus to identify possible AFM triggers and predict disease prevalence to better prepare for future outbreaks.
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