Impact of viral multiplex real-time PCR on management of respiratory tract infection: a retrospective cohort study

Mayer, Lena M.; Kahlert, Christian; Rassouli, Frank; Vernazza, Pietro; Albrich, Werner C.

doi:10.1186/s41479-017-0028-z

Cited by 27 publications

(25 citation statements)

References 43 publications

(97 reference statements)

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“…Measuring clinical outcomes and downstream effects were beyond the scope of this study. However, other published studies have demonstrated the clinical impact of various molecular diagnostic tests and have shown earlier antiviral use, decreased ED and hospital length of stay, reduced secondary transmission and decreased antibiotic use (Aoki et al, 2003;Chu et al, 2015;Gelfer et al, 2015;Mayer et al, 2017). We would anticipate a similar impact in our patient population.…”

Section: Discussionmentioning

confidence: 64%

Evaluation of a two-stage testing algorithm for the diagnosis of respiratory viral infections

Gardiner

Parker

Rabson

et al. 2018

Diagnostic Microbiology and Infectious Disease

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New on-demand multiplex molecular respiratory viral diagnostics offer superior performance although can be expensive and some platforms cannot process multiple specimens simultaneously. We performed a retrospective study reviewing results of patients tested for respiratory viruses following introduction of a two-stage testing algorithm incorporating an initial screen with Sofia® immunoassay then secondary Biofire Filmarray®, and compared to a period when only Filmarray® was used. Of 2976 testing episodes, 1814 underwent initial Sofia® then follow-up FilmArray®. A diagnosis of influenza was made by Sofia® in 282 patients, and by FilmArray® in an additional 163 (median time to result 1.12hours versus 3.46hours, P<0.001). Significantly more patients received their diagnosis within 90minutes in winter despite testing more samples (11.1% versus 3.4%, P<0.001), and approximately $36,000 was saved. An algorithmic approach to respiratory viral diagnosis can combine the advantages of accuracy and speed and be cost saving.

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Section: Discussionmentioning

confidence: 64%

Evaluation of a two-stage testing algorithm for the diagnosis of respiratory viral infections

Gardiner

Parker

Rabson

et al. 2018

Diagnostic Microbiology and Infectious Disease

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“…It also allows the choice to avoid antibiotics, even though there may be concerns about bacterial co-infection. In a study of the impact of multiplex real-time PCR, detection of viral aetiology was associated with discontinuation of antibiotics in 6 of 14 children (43%) and overall 18 children (67%) were managed correctly without antibiotics after virus detection (Mayer et al 2017). It was suggested that PCR had an impact on appropriate therapy for clinically defined viral infections.…”

Section: Discussionmentioning

confidence: 99%

Multiplex Real-Time PCR Detection of Respiratory Viruses in Lower Respiratory Tract Infections in Children

Rashid¹,

Lee

Ali³

et al. 2018

JSM

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Acute respiratory infections cause significant morbidity and mortality in children. Several new respiratory viruses have been identified and co-detection of multiple viruses is commonly reported. This is part of a prospective study which aims to detect respiratory viruses by multiplex molecular method and conventional methods. Nasopharyngeal aspirate specimens were taken from hospitalised children aged less than 5 years with lower respiratory tract infections. These were tested using viral culture, immunofluorescence and Seegene Anyplex™ II RV16 real-time polymerase chain reaction. From 102 samples, 69 (67.6%) were positive by PCR, 12 (11.8%) positive by culture method and 13 (12.7%) positive by IF. A single viral pathogen was detected in 48 samples (47.1%), while 21 samples (20.6%) had co-detection of 2 to 4 viral pathogens. Respiratory syncytial virus (RSV) was most common, detected in 17 samples (16.7% of all samples), followed by adenovirus and rhinovirus in 16 (15.7%), respectively. Bocavirus was detected in 15, enterovirus in 15, influenza A in 8 and parainfluenza-4 in 4 samples, with highest occurrences in co-detection (12/15, 10/15, 5/8 and 3/4, respectively). RSV was the least likely detected in co-detection (3/17). In PCR-positive samples, 54/69 (78.3%) were patients aged up to 24 months. Molecular methods detect more viral aetiologies than conventional methods, with simultaneous detection of multiple respiratory viruses. More sensitive, specific and rapid tools to determine aetiological agents could be incorporated into diagnostic algorithms of respiratory tract infections. Interpretations, significance, and applicability in clinical practice could be further explored, particularly for patients up to 2 years old.

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“…Multiple virus detection can considerably improve the correct management of clinical viral infections and reduce unnecessary antibiotic prescriptions (Mayer et al, 2017). A large number of different methods are currently available for the detection of viral infections in clinical laboratories.…”

Section: Introductionmentioning

confidence: 99%

A novel multiplex PCR for virus detection by melting curve analysis

Liu

et al. 2018

Journal of Virological Methods

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A B S T R A C TBackground: Rapid and accurate laboratory diagnoses of viral infections are crucial for the management and treatment of patients with viral infections. Conventional methods for virus detection are labourious, time consuming, and only a single virus can be analysed in one assay. Objectives: The objective of this study was to develop a novel real-time PCR method for multiple virus detection by melting curve analysis using Taqman probes in a single reaction. Study design: As a model, six respiratory viruses were detected in one tube using three fluorophores. The specificity was assessed by cross-reaction tests with other common respiratory pathogens. The analytical sensitivity was assessed by testing the limit of detection of the assay using artificial plasmids as the positive template. The clinical evaluation of the established assay was evaluated for the detection of respiratory viruses in clinical samples, and the results were compared with direct fluorescent antibody testing (DFA). Results: The six respiratory viruses were clearly distinguished by their respective melting temperature values in the corresponding fluorescence detection channels. No cross reactions were observed by cross reaction tests. The detection limits of this assay were 2 to 2 × 10 3 copies per reaction for each virus. The clinical evaluation of this assay was demonstrated by analysing 352 clinical samples, and 67(19.0%) samples were positive for at least one virus. The accordance rate between the established PCR and DFA testing was high, and ranged from 94.57% to 100%. Conclusions: Taqman probe-based melting curve analysis is well suited for detection of multiple viruses in clinical and research laboratories because of its high throughput, reliability, and cost savings.

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Impact of viral multiplex real-time PCR on management of respiratory tract infection: a retrospective cohort study

Cited by 27 publications

References 43 publications

Evaluation of a two-stage testing algorithm for the diagnosis of respiratory viral infections

Evaluation of a two-stage testing algorithm for the diagnosis of respiratory viral infections

Multiplex Real-Time PCR Detection of Respiratory Viruses in Lower Respiratory Tract Infections in Children

A novel multiplex PCR for virus detection by melting curve analysis

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