Practical recommendations for the detection of pediatric respiratory syncytial virus infections

Abstract

In our private clinic-hospital setting, respiratory syncytial virus (RSV) was isolated from infants more frequently and sooner from nasal washes (84%; 4.2 days) than from throat swabs (45%; 5.5 days) or nasopharyngeal swabs (39%; 5.7 days). Immunofluorescence of nasal wash cells identified 72% of the infants with virus isolations from nasal washes in less than one day. We therefore recommend the combination of isolation and immunofluorescence on nasal wash specimens for optimal detection of RSV-infected infants. Immunofluorescence of respiratory tract cells was also useful for monitoring the presence of RSV antigen in intubation secretions during ribavirin antiviral therapy. RSV infectivity was maintained in phosphate-buffered saline at room temperature for 6 h. Transport and inoculation of specimens in less than 6 h yielded RSV isolates from 50% of sampled infants during the two RSV seasons examined. For optimal RSV isolation, we recommend inoculation of HEp-2 tubes less than or equal to 4 days old. Replacing medium after 3 days as compared with 7 days did not increase recovery of RSV and provided little practical reduction in time to detection of cytopathology.

Detection of respiratory syncytial virus in children in the 1993‐94 winter season in Izmir, Turkey, by two diagnostic methods

“…However, the availability of specific therapy for RSV infections and the necessity of monitoring these infections with regard to epidemiological measures underlines the importance of rapid and efficient diagnostic methods. Direct or indirect immunofluorescent staining preferably with monoclonal antibodies has been successfully used until now in the diagnosis of RSV (2,11,12). With regard to rapidity, DFA tests have the potential advantage of eliminating the unnecessary use of antibiotics and shortening the hospitalization period, by cutting down the time spent reaching the right diagnosis.…”

“…Moreover, DFA tests are stated to be more sensitive than cell culture (2,8). The factors that contribute to the inefficiency of cell culture are as follows: the significant loss of infectivity of RSV in stored specimens, the lability of the virus, the sensitivity of the host cell line to the virus, the duration of the disease at the time material is collected, the presence of RSV-specific secretory antibodies which can neutralize the virus in specimens, and the type of material used for inoculation (8,11,12). Furthermore, DFA staining provides the opportunity to make a diagnosis even if the culture is contaminated, such as was the case in the present study.…”

Comparison of nasopharyngeal aspirate and nasal swab specimens for detection of respiratory syncytial virus in different settings in a developing country

“…Earlier studies in developed countries have indicated that the source of specimens influences the likelihood of RSV detection (Hall & Douglas 1975; McIntosh et al . 1982; Treuhaft et al . 1985; Ahluwalia et al .…”

Detection, pathogenesis, and therapy of respiratory syncytial virus infections.

“…Nasal swabs, throat swabs, tracheal aspirates, nasal washes, and nasopharyngeal aspirates have all been tested for their efficiency of recovery of virus in cell culture. Nasal washes have been shown to be superior to swabs or aspirates of tracheal secretions (84). Direct aspiration of secretions into polyethylene catheters is also an effective method of obtaining secretions (23).…”