Adenovirus respiratory infection: significant increase in diagnosis using PCR comparing with antigen detection and culture methods

Abstract

SUMMARYAdenovirus (AdV) respiratory infections are usually described as being associated with high mortality rates. Laboratory diagnosis is essential for the establishment of the appropriate therapy, and for guiding the implementation of preventive measures in order to prevent the spread of the infection. Aiming to analyze the sensitivity and specificity of the laboratorial diagnosis methods available, we compared antigen detection by indirect immunofluorescence assay (IF), and a specific nested polymerase chain reaction (PCR), to detect AdV in respiratory samples collected from patients admitted to hospital with acute respiratory disease. Positive samples were inoculated into a cell culture to confirm the results. We analyzed 381 samples from the nasopharyngeal aspirates collected during the year 2008; of these, 2.6% tested were positive for adenovirus through IF and 10% through PCR; positive isolation was obtained in 40% and 26% of these cases, respectively. Most infected patients were children under six months of age, and despite of the fact that a significant number of patients required intensive care, the mortality rate was low (5%). In conclusion, molecular methods were found to be useful for rapid diagnosis of adenovirus infections with higher sensitivity than antigen detection; their introduction permitted a significant increase in diagnoses of adenovirus infections.

Poor Outcome of Acute Respiratory Infection in Young Children with Underlying Health Condition in Brazil

“…Studies that compare the sensitivity of the different diagnostic methods, demonstrated that PCR increased the number of positive cases by three to four times when compared to immunofluorescent assays. 25,26 Nevertheless, local epidemiological characteristics, such as overcrowding or poor sanitary conditions, may be involved, considering the results published by Moura et al in Brazil, where 26.6% of the positive samples in children hospitalized with LRTI had an adenovirus. They screened for respiratory viruses in a hospital in São Paulo city, during the years of 1995 and 2000 using immunofluorescent assays.…”

Acute gastroenteritis and enteric viruses in hospitalised children in southern Brazil: aetiology, seasonality and clinical outcomes

“…The prevalence of HAdV in prior studies has been variable, ranging from 0.7% to > 30% (Domínguez et al 2009, Stroparo et al. 2010).…”

Adenovirus Respiratory Tract Infections in Peru

“…Studies from Colombia, Chile, Argentina, Brazil, and Cuba found a significantly higher M/F ratio, 2.3 [38], 1.5 [44] and 2.2 [47], 1.8 [48], 1.5 [49], and 2.0 [45], respectively. Other authors in USA, Spain, Taiwan, and Israel also found high M/F ratios, 1.4 [50], 1.5 [25], 1.6 [51], and 1.5 [52], respectively.…”