The use of multiplex PCR for the diagnosis of viral severe acute respiratory infection in children: a high rate of co-detection during the winter season

Abstract

Respiratory tract infection is a major cause of hospitalization in children. Although most such infections are viral in origin, it is difficult to differentiate bacterial and viral infections, as the clinical symptoms are similar. Multiplex polymerase chain reaction (PCR) methods allow testing for multiple pathogens simultaneously and are, therefore, gaining interest. This prospective case-control study was conducted from October 2013 to February 2014. Nasopharyngeal (NP) and oropharyngeal (throat) swabs were obtained from children admitted with severe acute respiratory infection (SARI) at a tertiary hospital. A control group of 40 asymptomatic children was included. Testing for 16 viruses was done by real-time multiplex PCR. Multiplex PCR detected a viral pathogen in 159/177 (89.9 %) patients admitted with SARI. There was a high rate of co-infection (46.9 %). Dual detections were observed in 64 (36.2 %), triple detections in 17 (9.6 %), and quadruple detections in 2 (1.1 %) of 177 samples. Seventy-eight patients required intensive care unit (ICU) admission, of whom 28 (35.8 %) had co-infection with multiple viruses. AdV, HBoV, HRV, HEV, and HCoV-OC43 were also detected among asymptomatic children. This study confirms the high rate of detection of viral nucleic acids by multiplex PCR among hospitalized children admitted with SARI, as well as the high rate of co-detection of multiple viruses. AdV, HBoV, HRV, HEV, and HCoV-OC43 were also detected in asymptomatic children, resulting in challenges in clinical interpretation. Studies are required to provide quantitative conclusions that will facilitate clinical interpretation and application of the results in the clinical setting.

Bacterial pneumonia and its associated factors in children from a developing country: A prospective cohort study

“…Our findings concur with those from Kenya and the UK where co-infections were found in 15% and 12.5% of cases respectively [3,32] but others have found prevalence of mixed infections as high as 82%. [34,46]. Co-infections have been associated with severe clinical illness in some studies, but not all, with a recent metanalysis finding no significant association with markers of severe illness [47].…”

Respiratory Tract Viral Infections and Coinfections Identified by Anyplex™ II RV16 Detection Kit in Pediatric Patients at a Riyadh Tertiary Care Hospital

“…[6][7][8][9]. Molecular techniques such as multiplex polymerase chain reaction (PCR) are widely used for the detection and identification of respiratory viruses [10][11][12] and are helpful in the management and treatment 2 BioMed Research International of respiratory infections [13]. Diagnosing respiratory viruses by isolation in cell cultures and serology is time consuming, laborious, expensive, and less sensitive in some cases.…”

microRNAs in viral acute respiratory infections: immune regulation, biomarkers, therapy, and vaccines

“…Among the biological functions of miRNAs are maintenance of the epithelial cell barrier in the respiratory tract and regulation of anti-viral host defense [4]. Viral acute respiratory infections (ARIs) are the most common cause of acute respiratory symptoms (e.g., flu and bronchitis), and many of these infections have been linked to the exacerbation of symptoms in chronic respiratory diseases such as asthma [5].…”