Nucleic acid amplification-based diagnosis of respiratory virus infections

Abstract

The appearance of eight new respiratory viruses in the human population in the past 9 years, including two new pandemics (SARS coronavirus in 2003 and swine-origin influenza A/H1N1 in 2009), has tested the ability of virology laboratories to develop diagnostic tests to identify these viruses. Nucleic acid amplification tests (NATs) that first appeared two decades ago have been developed for both conventional and emerging viruses and now form the backbone of the clinical laboratory. NATs provide fast, accurate and sensitive detection of respiratory viruses and have significantly increased our understanding of the epidemiology of these viruses. Multiplex PCR assays have been introduced recently and several commercial tests are now available. The final chapter in the evolution of respiratory virus diagnostics will be the addition of allelic discrimination and detection of single nucleotide polymorphisms associated with antiviral resistance to multiplex assays. These resistance assays together with new viral load tests will enable clinical laboratories to provide physicians with important information for optimal treatment of patients.

Evaluation of Simplexa Flu A/B & RSV for Direct Detection of Influenza Viruses (A and B) and Respiratory Syncytial Virus in Patient Clinical Samples

“…Of the human pathogens, respiratory viruses have been shown to be the etiological agents of greater than 70% of RTIs (1). Of interest are the influenza viruses (A and B) and respiratory syncytial virus (RSV), which have been well documented to account for 40% of RTIs (2). Rapid detection of influenza viruses (A and B) and RSV is of utmost importance for patient management and for the prevention of health care-associated viral infections.…”

Comparison of NxTAG Respiratory Pathogen Panel and Anyplex II RV16 Tests for Multiplex Detection of Respiratory Pathogens in Hospitalized Children

“…However, discerning the causal agent of the infection is challenging in younger children, who typically present with nonspecific clinical symptoms (7,8). Frequent occurrence of mixed viral and bacterial-viral infections at early ages (9, 10) makes etiological diagnosis even more difficult.Nucleic acid amplification techniques are widely acknowledged to contribute improved sensitivity and rapidness over traditional methods such as culture and direct fluorescent antibody detection for diagnosing ALRI (11,12). In recent years, the introduction of novel molecular assays that allow the performance of multiple analyses in one reaction has widened the spectrum of detectable respiratory pathogens while increasing throughput and convenience (13)(14)(15).…”

“…Nucleic acid amplification techniques are widely acknowledged to contribute improved sensitivity and rapidness over traditional methods such as culture and direct fluorescent antibody detection for diagnosing ALRI (11,12). In recent years, the introduction of novel molecular assays that allow the performance of multiple analyses in one reaction has widened the spectrum of detectable respiratory pathogens while increasing throughput and convenience (13)(14)(15).…”

Development of a Sensitive Loop-Mediated Isothermal Amplification Assay That Provides Specimen-to-Result Diagnosis of Respiratory Syncytial Virus Infection in 30 Minutes

“…ver the past 15 years there has seen a shift away from traditional testing methods for respiratory viruses, such as culture and antigen detection, and toward more sensitive nucleic acid amplification tests (NAAT) (1,2). PCR amplification has provided diagnostic laboratories with sensitive and specific tools to detect a variety of respiratory viruses, and molecular testing has been widely adopted by clinical laboratories around the world (3)(4)(5).…”

“…Nucleic acid amplification tests, especially PCR tests, have been used extensively to detect RSV, and these tests detect more infections than do traditional methods (2,5). Isothermal amplification has recently been introduced for the detection of respiratory viruses.…”