Diagnostic value of respiratory virus detection in symptomatic children using real-time PCR

Huijskens, Elisabeth G. W.; Biesmans, Renée C; Buiting, A. G. M.; Obihara, C C; Rossen, John W. A.

doi:10.1186/1743-422x-9-276

Cited by 48 publications

(56 citation statements)

References 31 publications

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“…In the ICU setting however, viral detection would not tend to alter antibiotic use due to concerns of secondary bacterial infection. 244,255 On the other hand, rapidly detecting a bacterial pathogen may aid a clinician's decision to prescribe and/or continue particular antibiotics earlier, in both settings. 255 The fast turn-around of PCR results compared to culture, may have also contributed to a reduction in healthcare costs.…”

Section: Resultsmentioning

confidence: 99%

“…Where a diagnosis is quickly obtained, additional (often unnecessary) laboratory tests and/or diagnostic imaging may be avoided. 244,256,257 Furthermore, rapid diagnosis in a hospital/ICU setting would allow appropriate infection control measures to be enforced, limiting the likelihood of nosocomial infections. 244,257 In conclusion, PCR has become the preferred diagnostic method in influenza and pertussis-related ICU admissions.…”

Section: Resultsmentioning

confidence: 99%

“…[286][287][288] Where B. pertussis was identified as the pathogen, appropriate antibiotics could be prescribed, which have the most benefit when commenced early during the course of illness. 289 In the hospital and ICU settings, although viral detection may not alter antibiotic use due to concerns of secondary bacterial infection, 244,255,290 rapidly detecting a bacterial pathogen such as B. pertussis would aid a clinician's decision to prescribe and/or continue particular antibiotics. 255 In hospital settings, rapid diagnosis of pertussis or another infectious respiratory pathogen would also accelerate the implementation of appropriate infection control measures, limiting the likelihood of nosocomial infections.…”

Section: Clinicalmentioning

confidence: 99%

“…255 In hospital settings, rapid diagnosis of pertussis or another infectious respiratory pathogen would also accelerate the implementation of appropriate infection control measures, limiting the likelihood of nosocomial infections. 244,257 Furthermore, when a diagnosis is obtained quickly, additional (often unnecessary) laboratory tests and diagnostic imaging (such as chest x-rays) may be avoided, therefore reducing healthcare costs. 244,256,257 …”

Section: Clinicalmentioning

confidence: 99%

“…243 In the last decade, polymerase chain reaction (PCR) has largely replaced traditional diagnostic methods, such as culture and immunofluorescence, for routine testing of respiratory samples. 244,245 In Australia, influenza and pertussis are notifiable conditions under public health legislation, and all cases that meet the case definitions must be reported to State and Territory Health Departments. 175,203 Influenza and pertussis are the two most common vaccine preventable notifiable diseases in Australia, 21,245 and the increasing use of PCR has, in part, been linked to better case recognition and magnification of the number of notifications.…”

Section: Introductionmentioning

confidence: 99%

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The diagnosis and epidemiology of pertussis in Australia

Kaczmarek¹

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Pertussis, more commonly known as whooping cough, is one of the most common vaccine-preventable infections reported in Australia. In the last decade, pertussis incidence has increased in Australia and overseas, with large sustained epidemics occurring most notably in developed countries. Australia had a pertussis epidemic between 2009 and 2012, which peaked during 2011 with 38,602 notified cases. The role of improved diagnostic methods, particularly the use of polymerase chain reaction (PCR) testing, has been hypothesised to have led to improved case ascertainment and superior detection of disease activity. This Thesis is comprised of five distinct studies contributing to the investigation of this hypothesis.In Australia, the incidence of pertussis is predominantly monitored using notification data, with the case definition for notifications heavily reliant on laboratory confirmation. By analysing pertussis notifications between 1991 and 2013 by diagnostic test method, I was able to demonstrate that PCR quickly replaced all other laboratory methods for pertussis diagnosis from 2005 onwards, with the exception of persisting serology use in a proportion of adolescents and adults. In addition, a change in the age distribution of notifications was observed over time, with increasing pertussis incidence among older children and adolescents.As notification data can be biased by changes in testing practices, awareness, and definitions, my next study investigated pertussis testing trends in the general practice (GP, primary care) setting between 2000 and 2011 using data from the Bettering the Evaluation And Care of Health (BEACH) program. Among a stable set of GP encounters for respiratory illness, it was observed that the likelihood of individuals being tested for pertussis in 2010-2011 was seven times higher compared to ten years earlier. These findings, at least in part, suggest that notifications have been amplified due to increased testing.To gather more information about the contribution of increased testing to the pertussis epidemic, the incidence of severe pertussis cases admitted to intensive care units (ICUs) was reviewed, as the ICU setting is less likely to be biased by changes in diagnostic This Thesis makes an important and original contribution to understanding the recent resurgence of pertussis in Australia and overseas by addressing gaps in knowledge about changes in diagnostic testing. Although a true increase in pertussis incidence occurred in Australia, increasing PCR diagnosis allowed better case detection across all age groups and healthcare settings. Greater understanding of pertussis epidemiology as a result of PCR diagnosis should ultimately improve pertussis immunisation and control programs, through better identification of at-risk groups.iv

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Clinicalmentioning

confidence: 99%

Section: Clinicalmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The diagnosis and epidemiology of pertussis in Australia

Kaczmarek¹

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Respiratory virus infections among children in South China

Cai

Wang

Lin

et al. 2014

Journal of Medical Virology

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Acute respiratory tract infection is an important cause of morbidity and mortality with a worldwide disease burden. This study aimed to determine the prevalence and clinical characteristics of children with viral-induced acute respiratory tract infection, in Southern China. Nasopharyngeal aspirate samples from 1,980 pediatric patients with suspected acute respiratory tract infection, and 82 samples from healthy subject controls were collected for routine examination at the Second Affiliated Hospital of Shantou University Medical College, from October 2007 to August 2011. Specimens were tested by multiplex polymerase chain reaction (mPCR). At least one or more viruses were detected from 1,087 samples (54.9%). These included laboratory confirmations for 446 respiratory syncytial virus (RSV), 386 influenza virus A (FluA), 315 human rhinovirus (HRV), 135 human bocavirus (HBoV), 119 Parainfluenza virus 3 (PIV3), 82 Parainfluenza virus 1 (PIV1), 66 adenovirus (ADV), 53 WU polyomavirus (WUPyV), 52 human metapneumovirus (hMPV), and 29 influenza virus B (FluB) samples. Samples from healthy subjects were negative for any virus. Of the patients with positive specimens, 107 (9.8%) were admitted to pediatric intensive care unit (PICU). Co-infection with at least two of the viral pathogens under study was observed in 325 of the 1,980 patients (16.4% of the total number of cases). These findings may help in the diagnosis of viral infections of the respiratory tract in children, and help to consider current and potential therapeutic approaches for the treatment of acute respiratory tract infection, and further respiratory complications.

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The role of rhinovirus in children hospitalized for acute respiratory disease, Santa Fe, Argentina

Rudi¹,

Molina²,

Díaz³

et al. 2015

J. Med. Virol.

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Human rhinoviruses (HRVs) were historically considered upper airway pathogens. However, they have recently been proven to cause infections in the lower respiratory tract, resulting in hospitalization of children with pneumonia, bronchiolitis, and chronic pulmonary obstruction. In this report, HRV frequency and seasonality are described together with patient clinical-epidemiological aspects. From a total of 452 surveyed samples, the HRV nucleic acids was detected in 172 (38.1%) and found in every month of the study year. 60% of inpatients with acute respiratory infection (ARI) associated with HRV were under 6 months of age and 31% had a clinical history, being preterm birth and recurrent wheezing the prevailing conditions. The most frequent discharge diagnoses were pneumonia (35.2%), bronchiolitis (32.4%), and bronchitis (12.4%). Fifteen point nine percent of patients required admission into intensive care units. The results obtained in this study demonstrated the association between HRV and children hospitalizations caused by ARI.

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Diagnostic value of respiratory virus detection in symptomatic children using real-time PCR

Cited by 48 publications

References 31 publications

The diagnosis and epidemiology of pertussis in Australia

The diagnosis and epidemiology of pertussis in Australia

Respiratory virus infections among children in South China

The role of rhinovirus in children hospitalized for acute respiratory disease, Santa Fe, Argentina

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