Childhood acute lower respiratory infections (ALRI) remain as the most important single cause of global burden of disease among pediatric populations and a major cause of child mortality (1-3). It has been estimated that approximately 165 million episodes of ALRI occur globally each year in children aged 0 to 4 years, resulting in 2.1 million deaths (4). Management of these infections requires extensive use of health care and economic resources: viral ALRI alone has been described to account for an expenditure of approximately 2.4 billion dollars annually (3). Rapid etiological diagnosis of ALRI, followed by timely and specific treatment, has the potential to improve clinical outcomes and reduce the duration of hospital stay, as well as reduce unnecessary laboratory testing and antibiotic use (5, 6). 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). The NxTAG respiratory pathogen panel (RPP) RUO (Luminex Molecular Diagnostics, Toronto, Ontario, Canada) is a qualitative reverse transcriptase PCR assay capable of detecting and differentiating the following 22 targets in a single patient sample: adenovirus (ADV), bocavirus (BoV), coronavirus (CoV) types 229E/NL63/OC43/HKU1, influenza A virus (IFV-A; including differentiating subtypes H1/H1N1/H3), influenza B virus (IFV-B), metapneumovirus (MPV), parainfluenza virus (PIV) types 1/2/3/4, respiratory syncytial virus (RSV) types A/B, enterovirus/rhinovirus (EV/RV), Chlamydophila pneumoniae, Mycoplasma pneumoniae, and Legionella pneumophila (16). Similarly, Anyplex II RV16 (Seegene, Inc., Seoul, South Korea) is a qualitative multiplex PCR able to detect 16 targets, including AdV, BoV CoV types 229E/NL63/OC43, EV, IFV-A, IFV-B, MPV, PIV types 1 to 4, RSV types A/B, and RV (17). Both NxTAG RPP and Anyplex II RV16 RUO are Conformité Européene (CE)-marked assays. However, while the former has obtained U.S. Food and Drug Administration clearance (except for the Legionella target), the latter is not available in the United States.The primary objective of this study was to evaluate the diagnostic accuracy of NxTAG RPP RUO in comparison to Anyplex II RV16 using respiratory specimens prospectively collected from pediatric patients hospitalized at a referral medical center out of
MATERIALS AND METHODS
Study design and setting.A cross-sectional study was conducted to analyze nasopharyng...