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Phan T, Tran NYK, Gottlieb T, Siarakas S, McKew G. Evaluation of the influenza and respiratory syncytial virus (RSV) targets in the AusDiagnostics SARS-CoV-2, Influenza and RSV 8-well assay: sample pooling increases testing throughput. Pathology 2022; 54:466-471. [PMID: 35461715 PMCID: PMC9021007 DOI: 10.1016/j.pathol.2022.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 01/09/2022] [Accepted: 02/22/2022] [Indexed: 02/06/2023]
Abstract
During the COVID-19 pandemic, sample pooling has proven an effective strategy to overcome the limitations of reagent shortages and expand laboratory testing capacity. The inclusion of influenza and respiratory syncytial virus (RSV) in a multiplex tandem PCR platform with SARS-CoV-2 provides useful diagnostic and infection control information. This study aimed to evaluate the performance of the influenza and RSV targets in the AusDiagnostics SARS-CoV-2, Influenza and RSV 8-well assay, including the effect of pooling samples on target detection. RSV target detection in clinical samples was compared to the Cepheid Xpert Xpress Flu/RSV assay as a reference standard. Samples were then tested in pools of four and detection rates were compared. Owing to the unavailability of clinical samples for influenza, only the effect of sample pooling on simulated samples was evaluated for these targets. RSV was detected in neat clinical samples with a positive percent agreement (PPA) of 100% and negative percent agreement (NPA) of 99.5% compared to the reference standard, demonstrating 99.7% agreement. This study demonstrates that sample pooling by four increases the average Ct value by 2.24, 2.29, 2.20 and 1.91 cycles for the target's influenza A, influenza A typing, influenza B and RSV, respectively. The commercial AusDiagnostics SARS-CoV-2, Influenza and RSV 8-well assay was able to detect influenza and RSV at an intermediate concentration within the limit of detection of the assay. Further studies to explore the applicability of sample pooling at the lower limit of detection of the assay is needed. Nevertheless, sample pooling has shown to be a viable strategy to increase testing throughput and reduce reagent usage. In addition, the multiplexed platform targeting various respiratory viruses assists with public health and infection control responses, clinical care, and patient management.
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Affiliation(s)
- Thuy Phan
- Department of Microbiology and Infectious Disease, Concord Repatriation General Hospital, NSW Health Pathology, Concord, NSW, Australia
| | - Ngoc Yen Kim Tran
- Department of Microbiology and Infectious Disease, Concord Repatriation General Hospital, NSW Health Pathology, Concord, NSW, Australia,Address for correspondence: Dr Ngoc Yen Kim Tran, Department of Microbiology and Infectious Disease, Concord Repatriation General Hospital, Concord Road, Concord, NSW 2139, Australia
| | - Thomas Gottlieb
- Department of Microbiology and Infectious Disease, Concord Repatriation General Hospital, NSW Health Pathology, Concord, NSW, Australia,Faculty of Medicine and Health, The University of Sydney, Concord, NSW, Australia
| | - Steven Siarakas
- Department of Microbiology and Infectious Disease, Concord Repatriation General Hospital, NSW Health Pathology, Concord, NSW, Australia
| | - Genevieve McKew
- Department of Microbiology and Infectious Disease, Concord Repatriation General Hospital, NSW Health Pathology, Concord, NSW, Australia,Faculty of Medicine and Health, The University of Sydney, Concord, NSW, Australia
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Tschernin D, Fruchtman Y, Sergienko R, David O, Leibovitz R, Mazar J, Leibovitz E. The etiologic, microbiologic, clinical and outcome characteristics of immunocompetent young children <2 years of age hospitalized with acute neutropenia. Pediatr Neonatol 2021; 62:26-35. [PMID: 32847741 PMCID: PMC7419265 DOI: 10.1016/j.pedneo.2020.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/20/2020] [Accepted: 08/05/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND To describe the etiologic, microbiologic, clinical and outcome characteristics of acute neutropenia (absolute neutrophil count, ANC, <1.5 × 109/L) in hospitalized immunocompetent children. METHODS Serious bacterial infections (SBI) were defined as culture-positive blood, urine, cerebrospinal fluid, articular fluid or stool infections, alveolar pneumonia, Brucellosis and Rickettsiosis. RESULTS 431/671 (64.2%) healthy infants and children hospitalized with acute neutropenia were <2 years of age; 176 (40.8%), 167 (38.8%) and 88 (20.4%) patients were aged 0-3, 4-12 and 13-24 months, respectively. There were 19 (4.4%), 53 (12.3%), 140 (32.5%) and 209 (50.8%) patients with ANC count <200, 200-500, 501-1000 and 1001-1500 × 109 cells/L, respectively. Severe neutropenia (<500 × 109/L) was recorded in 72 (16.7%) patients. Fever >38 °C was present in 208/431 (48.3%) patients. Blood cultures were positive in 10 (2.3%), with Brucella melitensis, Staphylococcus aureus and Enterobacter spp. identified in 4, 3 and 2 patients, respectively; 5/10 patients with positive blood cultures were <3 months of age. Overall, 55/431 (12.7%) and 65/431 (15.1%) patients were diagnosed with SBIs and bacterial infections, respectively. Nasal washings-PCR for respiratory viruses was positive in 139/293 (47.4%) patients tested. An infectious etiology (bacterial and/or viral) was diagnosed in 190/431 (44.1%) patients. Three patients were diagnosed with acute lymphocytic leukemia. Resolution of neutropenia was achieved in 111/208 (53.4%) evaluable patients (63%, 50.6% and 48% of patients aged 0-3, 4-12 and >12 months, respectively and 56.8%, 53.5% and 52% of patients with severe, moderate and mild neutropenia, respectively). CONCLUSION Acute neutropenia is common in immunocompetent children <2 years of age and is frequently associated with viral infections. We showed a substantial involvement of bacterial infections and particularly SBIs in the etiology of acute neutropenia. After a 1-month follow-up, resolution of neutropenia occurred in half of the patients, without association with age subgroups and with neutropenia severity.
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Affiliation(s)
- Dov Tschernin
- Division of Pediatrics, Ben-Gurion University, Israel,Soroka University Medical Center, Ben-Gurion University, Israel,Faculty of Health Sciences, Ben-Gurion University, Israel
| | - Yariv Fruchtman
- Division of Pediatrics, Ben-Gurion University, Israel,Soroka University Medical Center, Ben-Gurion University, Israel,Faculty of Health Sciences, Ben-Gurion University, Israel
| | - Ruslan Sergienko
- Department of Public Health, Ben-Gurion University, Israel,Faculty of Health Sciences, Ben-Gurion University, Israel
| | - Odeya David
- Division of Pediatrics, Ben-Gurion University, Israel,Soroka University Medical Center, Ben-Gurion University, Israel,Faculty of Health Sciences, Ben-Gurion University, Israel
| | - Ron Leibovitz
- Faculty of Health Sciences, Ben-Gurion University, Israel
| | - Julia Mazar
- Laboratory of Hematology, Ben-Gurion University, Israel,Soroka University Medical Center, Ben-Gurion University, Israel,Faculty of Health Sciences, Ben-Gurion University, Israel
| | - Eugene Leibovitz
- Division of Pediatrics, Ben-Gurion University, Israel; Soroka University Medical Center, Ben-Gurion University, Israel; Faculty of Health Sciences, Ben-Gurion University, Israel.
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Abstract
This chapter describes the diagnosis of COVID-19 infection in the general population with special consideration to diagnosis in pregnant women. Diagnosis includes the clinical characteristics including symptoms and signs of infection, similarities and differences between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and other viral infections particularly influenza, and diagnostic investigations including nucleic acid amplification test, SARS-CoV-2 virus antigen detection, and antibodies against the virus testing. WHO recommendations for testing were discussed. The value of different laboratory investigations in diagnosis and prognosis was highlighted. Explanation of data related to chest imaging and discussion of indications of imaging and different findings were assessed.
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Ek P, Böttiger B, Dahlman D, Hansen KB, Nyman M, Nilsson AC. A combination of naso- and oropharyngeal swabs improves the diagnostic yield of respiratory viruses in adult emergency department patients. Infect Dis (Lond) 2019; 51:241-248. [PMID: 30760088 DOI: 10.1080/23744235.2018.1546055] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Along with the current development of molecular diagnostic methods of respiratory viruses, the bedside patient sampling techniques need to be evaluated. We here asked the question whether the addition of an oropharynx swab to the traditional nasopharynx swab might improve the diagnostic yield of multiplex PCR analysis. Ct values from the two sampling sites were compared as well as patient tolerability. METHODS In an emergency department in Malmö, Sweden, 98 adult patients with respiratory disease were sampled both from the nasopharynx and oropharynx for virus diagnostics by PCR. RESULTS Influenza (AH1, AH3, B), human metapneumovirus (hMPV) or respiratory syncytial virus (RSV) were detected by PCR in 58 subjects. The diagnostic yield was improved by combining nasopharyngeal and oropharyngeal sampling - a virus was detected in another 6 patients compared to traditional nasopharyngeal sampling (p = .031, McNemar's test). In 38/55 subjects viral load was higher in the nasopharynx than in the oropharynx. Self-reported discomfort was significantly lower from oropharyngeal sampling than from nasopharyngeal sampling. CONCLUSIONS Adding an oropharynx sample to a nasopharynx sample increased the diagnostic yield of respiratory viruses. Oropharyngeal sampling was well tolerated.
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Affiliation(s)
- Peter Ek
- a Infectious Disease Research Unit, Department of Translational Medicine , Lund University , Malmö , Sweden
| | - Blenda Böttiger
- b Department of Clinical Microbiology, Division of Laboratory Medicine , Lund University , Lund , Sweden
| | - Disa Dahlman
- c Division of Psychiatry, Department of Clinical Sciences Lund , Lund University , Lund , Sweden.,d Malmö Addiction Centre , Skåne University Hospital , Malmö , Sweden.,e Center for Primary Health Care Research, Department of Clinical Sciences , Lund University/Region Skåne , Malmö , Sweden
| | - Karin B Hansen
- a Infectious Disease Research Unit, Department of Translational Medicine , Lund University , Malmö , Sweden
| | - Mattias Nyman
- b Department of Clinical Microbiology, Division of Laboratory Medicine , Lund University , Lund , Sweden
| | - Anna C Nilsson
- a Infectious Disease Research Unit, Department of Translational Medicine , Lund University , Malmö , Sweden
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5
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Antalis E, Oikonomopoulou Z, Kottaridi C, Kossyvakis A, Spathis A, Magkana M, Katsouli A, Tsagris V, Papaevangelou V, Mentis A, Tsiodras S. Mixed viral infections of the respiratory tract; an epidemiological study during consecutive winter seasons. J Med Virol 2018; 90:663-670. [PMID: 29244214 PMCID: PMC7167177 DOI: 10.1002/jmv.25006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 11/29/2017] [Indexed: 12/11/2022]
Abstract
The current study aimed to describe the molecular epidemiology of mixed respiratory viral infections during consecutive winter seasons in a tertiary care hospital. Patients with symptoms of respiratory tract infection were evaluated during the 2009‐2011 and 2013‐15 winter seasons. A clinical microarray technique was used for viral detection. Clinical and epidemiological data were correlated with mixed viral detection and the need for hospitalization. In 332 out of 604 (54.4%) evaluated patients (17.6% children) a respiratory virus was identified. Mixed viral infections were diagnosed in 68/332 (20.5%) patients with virus detection (66.2% mixed Influenza‐RSV infections). Mixed viral infections were more commonly detected in children (OR 3.7; 95%CI 1.9‐5.6, P < 0.01) and patients with comorbidities. In logistic regression analyses, mixed viral infections were associated with younger age (mean age 30.4 years vs. 41.8 years, P ≤ 0.001) and increased rates of fever (OR: 2.7; 95%CI 1.04‐7.2, P < 0.05) but no adverse outcomes or increased rates of hospitalization. High rates of mixed viral infections were noted during all winter seasons (especially Influenza and RSV) and were more common in younger patients. The clinical significance of mixed respiratory viral infection needs further elucidation.
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Affiliation(s)
- Emmanouil Antalis
- 4th Department of Internal Medicine, University Hospital Attikon, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Zacharoula Oikonomopoulou
- 4th Department of Internal Medicine, University Hospital Attikon, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Christine Kottaridi
- Department of Cytopathology, University Hospital Attikon, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | | | - Aris Spathis
- Department of Cytopathology, University Hospital Attikon, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Maria Magkana
- Department of Cytopathology, University Hospital Attikon, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Aikaterini Katsouli
- 4th Department of Internal Medicine, University Hospital Attikon, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Vassileios Tsagris
- 3rd Department of Pediatrics, University Hospital Attikon, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Vassiliki Papaevangelou
- 3rd Department of Pediatrics, University Hospital Attikon, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | | | - Sotirios Tsiodras
- 4th Department of Internal Medicine, University Hospital Attikon, National and Kapodistrian University of Athens Medical School, Athens, Greece
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Epidemiology of Respiratory Pathogens among Elderly Nursing Home Residents with Acute Respiratory Infections in Corsica, France, 2013-2017. BIOMED RESEARCH INTERNATIONAL 2017; 2017:1423718. [PMID: 29392127 PMCID: PMC5748090 DOI: 10.1155/2017/1423718] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/25/2017] [Accepted: 11/16/2017] [Indexed: 12/02/2022]
Abstract
Background The current study aims to describe the demographical and clinical characteristics of elderly nursing home (NH) residents with acute respiratory infections (ARIs) during four winter seasons (2013/2014–2016/2017), as well as the microbiological etiology of these infections. Methods Seventeen NHs with at least one ARI resident in Corsica, France, were included. An ARI resident was defined as a resident developing a sudden onset of any constitutional symptoms in addition to any respiratory signs. Nasopharyngeal swabs from ARI residents were screened for the presence of 21 respiratory agents, including seasonal influenza viruses. Results Of the 107 ARI residents enrolled from NHs, 61 (57%) were positive for at least one of the 21 respiratory pathogens. Forty-one (38.3%) of the 107 ARI residents had influenza: 38 (92%) were positive for influenza A (100% A(H3N2)) and three (8%) for influenza B/Victoria. Axillary fever (≥38°C) was significantly more common among patients infected with influenza A(H3N2). Conclusion The circulation of seasonal respiratory viruses other than influenza A(H3N2) seems to be sporadic among elderly NH residents. Investigating the circulation of respiratory viruses in nonwinter seasons seems to be important in order to understand better the dynamic of their year-round circulation in NHs.
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Sagi O, Berkowitz A, Codish S, Novack V, Rashti A, Akad F, Shemer-Avni Y. Sensitive Molecular Diagnostics for Cutaneous Leishmaniasis. Open Forum Infect Dis 2017; 4:ofx037. [PMID: 28795077 PMCID: PMC5543577 DOI: 10.1093/ofid/ofx037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 02/22/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Rapid diagnosis of cutaneous leishmaniasis (CL) and identification of Leishmania species is highly important for the disease management. In Israel, CL is caused mainly by Leishmania major and Leishmania tropica species. METHODS We established an easy to handle point of care lesion-swabbing, combined with a highly sensitive multiplex real time PCR (multiplex qPCR) for accurate and rapid diagnosis of Leishmania species. RESULTS Using three probes: one general for: Leishmania species, and two specific for L major, and L tropica, we screened 1783 clinical samples collected during two years. Leishmania species was found in 1086 individuals, 1008 L major, and 70 L tropica. Eight samples positive for Leishmania species only, were further tested using a second set of multiplex qPCR developed, and were found positive for Leishmania braziliensis and Leishmania infantum/donovani (2 and 6 samples, concomitantly). CONCLUSIONS Taken together, the test enabled diagnostics and better treatment of Leishmania infections from the Old World (1078 samples) and the New World (8 samples), and the subtyping of the dominant strains in the region, as well as in returning travelers'.
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Affiliation(s)
| | | | | | - Victor Novack
- Clinical Research Center, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Aviv Rashti
- Clinical Parasitology.,Clinical Virology, and
| | - Fouad Akad
- Entomology Laboratory, Central Laboratories Jerusalem, Ministry of Health, Israel
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8
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Shemer-Avni Y, Kundu K, Shemesh A, Brusilovsky M, Yossef R, Meshesha M, Solomon-Alemayehu S, Levin S, Gershoni-Yahalom O, Campbell KS, Porgador A. Expression of NKp46 Splice Variants in Nasal Lavage Following Respiratory Viral Infection: Domain 1-Negative Isoforms Predominate and Manifest Higher Activity. Front Immunol 2017; 8:161. [PMID: 28261217 PMCID: PMC5309248 DOI: 10.3389/fimmu.2017.00161] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 01/31/2017] [Indexed: 01/20/2023] Open
Abstract
The natural killer (NK) cell activating receptor NKp46/NCR1 plays a critical role in elimination of virus-infected and tumor cells. The NCR1 gene can be transcribed into five different splice variants, but the functional importance and physiological distribution of NKp46 isoforms are not yet fully understood. Here, we shed light on differential expression of NKp46 splice variants in viral respiratory tract infections and their functional difference at the cellular level. NKp46 was the most predominantly expressed natural cytotoxicity receptor in the nasal lavage of patients infected with four respiratory viruses: respiratory syncytia virus, adenovirus, human metapneumovirus, or influenza A. Expression of NKp30 was far lower and NKp44 was absent in all patients. Domain 1-negative NKp46 splice variants (i.e., NKp46 isoform d) were the predominantly expressed isoform in nasal lavage following viral infections. Using our unique anti-NKp46 mAb, D2-9A5, which recognizes the D2 extracellular domain, and a commercial anti-NKp46 mAb, 9E2, which recognizes D1 domain, allowed us to identify a small subset of NKp46 D1-negative splice variant-expressing cells within cultured human primary NK cells. This NKp46 D1-negative subset also showed higher degranulation efficiency in term of CD107a surface expression. NK-92 cell lines expressing NKp46 D1-negative and NKp46 D1-positive splice variants also showed functional differences when interacting with targets. A NKp46 D1-negative isoform-expressing NK-92 cell line showed enhanced degranulation activity. To our knowledge, we provide the first evidence showing the physiological distribution and functional importance of human NKp46 splice variants under pathological conditions.
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Affiliation(s)
- Yonat Shemer-Avni
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer Sheva , Israel
| | - Kiran Kundu
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel; National Institute for Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Avishai Shemesh
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel; National Institute for Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Michael Brusilovsky
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer Sheva , Israel
| | - Rami Yossef
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer Sheva , Israel
| | - Mesfin Meshesha
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer Sheva , Israel
| | - Semaria Solomon-Alemayehu
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer Sheva , Israel
| | - Shai Levin
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer Sheva , Israel
| | - Orly Gershoni-Yahalom
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer Sheva , Israel
| | - Kerry S Campbell
- Institute for Cancer Research, Fox Chase Cancer Center , Philadelphia, PA , USA
| | - Angel Porgador
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel; National Institute for Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer Sheva, Israel
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9
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Narayanan H, Sankar S, Simoes EAF, Nandagopal B, Sridharan G. Molecular detection of human metapneumovirus and human bocavirus on oropharyngeal swabs collected from young children with acute respiratory tract infections from rural and peri-urban communities in South India. Mol Diagn Ther 2013; 17:107-15. [PMID: 23559038 PMCID: PMC7099897 DOI: 10.1007/s40291-013-0030-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background Acute respiratory tract infections (ARTIs) are one of the major causes of morbidity and mortality among young children in developing countries. Information on the incidence of human metapneumovirus (hMPV) and human bocavirus (HBoV) infections in developing countries, especially among rural children, is very limited. Objectives This study was conducted to identify whether these viruses were associated with ARTI among children ≤5 years of age in rural and peri-urban populations in South India. Methods The study was cross-sectional with prospective sample collection. Oropharyngeal swabs were collected from children ≤5 years of age presenting with ARTI. None of the children in this study were known to have any immunosuppressive conditions. The two viruses, hMPV and HBoV, were identified using semi-nested polymerase chain reaction (PCR) assays and one-step PCR assays, respectively. The lower limits of detection of hMPV and HBoV were 6.69 × 105 plasmid copies and 5.77 × 103 plasmid copies, respectively, per 5 μL PCR reaction input. Results The frequency of hMPV infection in children was higher than that of HBoV infection. The different frequencies of hMPV in patients in various age groups with upper and lower respiratory tract infections were compared, and the variance was found to be insignificant. In the 38 children who were hMPV positive, the majority (73.7 %) were from rural communities. The overall hMPV-positive rate was higher in the rural population than in the peri-urban population, but the difference was statistically insignificant. The youngest age at which hMPV-positive status was recorded was 5 months. Conclusion This study demonstrated that hMPV was associated with a significant number (i.e. >10 %) of ARTIs in children in South India, whereas a relatively smaller number of HBoV infections was observed.
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Affiliation(s)
- Harikrishnan Narayanan
- Sri Sakthi Amma Institute of Biomedical Research, Sri Narayani Hospital and Research Centre, Sripuram, Vellore, 632 055 Tamil Nadu India
| | - Sathish Sankar
- Sri Sakthi Amma Institute of Biomedical Research, Sri Narayani Hospital and Research Centre, Sripuram, Vellore, 632 055 Tamil Nadu India
| | - Eric A. F. Simoes
- Department of Pediatrics, Division of Infectious Diseases, The Children’s Hospital, Aurora, CO USA
| | - Balaji Nandagopal
- Sri Sakthi Amma Institute of Biomedical Research, Sri Narayani Hospital and Research Centre, Sripuram, Vellore, 632 055 Tamil Nadu India
| | - Gopalan Sridharan
- Sri Sakthi Amma Institute of Biomedical Research, Sri Narayani Hospital and Research Centre, Sripuram, Vellore, 632 055 Tamil Nadu India
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10
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Hammitt LL, Murdoch DR, Scott JAG, Driscoll A, Karron RA, Levine OS, O'Brien KL. Specimen collection for the diagnosis of pediatric pneumonia. Clin Infect Dis 2012; 54 Suppl 2:S132-9. [PMID: 22403227 PMCID: PMC3693496 DOI: 10.1093/cid/cir1068] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Diagnosing the etiologic agent of pneumonia has an essential role in ensuring the most appropriate and effective therapy for individual patients and is critical to guiding the development of treatment and prevention strategies. However, establishing the etiology of pneumonia remains challenging because of the relative inaccessibility of the infected tissue and the difficulty in obtaining samples without contamination by upper respiratory tract secretions. Here, we review the published and unpublished literature on various specimens available for the diagnosis of pediatric pneumonia. We discuss the advantages and limitations of each specimen, and discuss the rationale for the specimens to be collected for the Pneumonia Etiology Research for Child Health study.
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Affiliation(s)
- Laura L Hammitt
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
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11
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Hayden RT, Gu Z, Rodriguez A, Tanioka L, Ying C, Morgenstern M, Bankowski MJ. Comparison of two broadly multiplexed PCR systems for viral detection in clinical respiratory tract specimens from immunocompromised children. J Clin Virol 2012; 53:308-13. [PMID: 22296791 PMCID: PMC7108354 DOI: 10.1016/j.jcv.2011.12.020] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 12/14/2011] [Accepted: 12/19/2011] [Indexed: 12/04/2022]
Abstract
Background The detection of viral respiratory tract infections has evolved greatly with the development of PCR based commercial systems capable of simultaneously detecting a wide variety of pathogens. Objectives Evaluate the relative performance of two commercial broad range systems for the detection of viral agents in clinical respiratory tract specimens from immunocompromised children. Study design A total of 176 patient samples were included in the analysis, representing only the first sample collected for each patient, and excluding failed reactions. Samples were de-identified and assayed in parallel using two different, broadly multiplexed PCR systems: ResPlex™ II Panel v2.0 (ResPlex), Qiagen, Hilden, Germany and FilmArray® Respiratory Panel (FilmArray), Idaho Technology Inc., Salt Lake City, UT. Method comparison was based upon pair-wise concordance of results according to patient age, viral target and number of targets detected. Results The two systems showed an overall concordance, by patient, of 83.8% (p = 0.0001). FilmArray detected at least one target in 68.8% of samples, while ResPlex detected at least one target in 56.8%. ResPlex failed to detect 20.7% of FilmArray positives, and FilmArray failed to detect 4% of ResPlex positives. The relative performance of each system (including which system detected a higher number of positive samples) varied when stratified by target viral pathogen. Conclusions Broadly multiplexed PCR is an effective means of detecting large numbers of clinically relevant respiratory viral pathogens.
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Affiliation(s)
- Randall T Hayden
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN 38105, United States.
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12
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Added value of an oropharyngeal swab in detection of viruses in children hospitalized with lower respiratory tract infection. J Clin Microbiol 2011; 49:2318-20. [PMID: 21490188 DOI: 10.1128/jcm.02605-10] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Paired nasopharyngeal and oropharyngeal swabs collected from 533 children hospitalized with lower respiratory tract infection were assessed by multiplex reverse transcription-PCR. Oropharyngeal swabs increased the number of viral infections detected by 15%, compared to collection of a nasopharyngeal swab alone. This advantage was most pronounced for detection of influenza, parainfluenza, and adenovirus.
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