Evaluation of two commercial multiplex PCR tests for the diagnosis of acute respiratory infections in hospitalized children

Abstract

Background Acute respiratory tract infections (ARTI), including the common cold, pharyngitis, sinusitis, otitis media, tonsillitis, bronchiolitis and pneumonia are the most common diagnoses among pediatric patients and account for the majority of antibiotic prescriptions. A clear and rapid diagnosis is the key to preventing antibiotic abuse. Recently, based on different detection principles, many multi-target molecular analyses that can simultaneously detect dozens of pathogens have been developed, thereby greatly improving sensitivity and shortening turnaround time. In this work, we conducted a head-to-head comparative study between melting curve analysis (MCA) and capillary electrophoresis assay (CE) in the detection of nine respiratory pathogens in sputum samples collected from hospitalized ARTI childre. Methods Through MCA and CE analysis, nine common respiratory pathogens were tested on hospitalized children under the age of 13 who met the ARTI criteria. Results A total of 237 children with sputum specimens were tested. For all the targets combined, the positive detection rate of XYRes-MCA was significantly higher than ResP-CE (72.2% vs. 63.7%, p = .002). Some pathogens were detected more often with MCA, such as parainfluenza virus, influenza B and coronavirus, and some pathogens do the opposite, such as adenovirus and influenza A (all p < .01). Very good kappa values for most of pathogens were observed, except for Influenza B and coronavirus (both κ = .39). Conclusions Multiplex melting curve and capillary electrophoresis assays performed similarly for the detection of common respiratory pathogens in hospitalized children, except for Influenza B and coronavirus. Higher sensitivity was observed in the melting curve assay. By using this sensitive and rapid test, it may improv patient prognosis and antimicrobial management.