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Le Bars H, Madany N, Lamoureux C, Beauruelle C, Vallet S, Payan C, Pilorgé L. Evaluation of the Performance Characteristics of a New POC Multiplex PCR Assay for the Diagnosis of Viral and Bacterial Neuromeningeal Infections. Diagnostics (Basel) 2023; 13:diagnostics13061110. [PMID: 36980418 PMCID: PMC10047878 DOI: 10.3390/diagnostics13061110] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/05/2023] [Accepted: 03/07/2023] [Indexed: 03/17/2023] Open
Abstract
Point-of-care syndromic PCR (POC SPCR) assays are useful tools for the rapid detection of the most common causative agents of community-acquired infections responsible for meningitis and encephalitis infections. We evaluated the performance characteristics of the new QIAstat-Dx® Meningitis/Encephalitis panel (QS) compared to the laboratory reference methods and the POC SPCR Biofire® FilmArray® Meningitis Encephalitis Panel (FA). Viral (Enterovirus, Parechovirus, HSV-1, HSV-2, HHV-6, VZV) and bacterial (E. coli K1, H. influenzae, L. monocytogenes, encapsulated N. meningitidis, M. pneumoniae, S. agalactiae, S. pneumoniae, S. pyogenes) pathogens were suspended at low concentrations and tested with the POC SPCR systems. The reproducibility, analytical specificity, carryover contamination, interferences and clinical samples were evaluated. All samples tested positive with both QS and FA except for those containing the lowest concentrations of Enterovirus-D68-B3, Echovirus-30 and S. agalactiae which were only detected by FA. In terms of analytical specificity, we observed 3 false positive results out of 48 QS tests versus 1 out of 37 FA tests. For the other studied criteria, both QS and FA performed as expected. Our results suggest that the performance characteristics of QS are close to those of FA. A prospective multicenter study would be useful to complete the performances evaluation of QS.
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Affiliation(s)
- Hervé Le Bars
- Unity of Bacteriology, Department of Bacteriology-Virology-Parasitology-Mycology-Hygiene, Pole of Biology-Pathology, University Hospital of Brest, F-29200 Brest, France
| | - Neil Madany
- Unity of Virology, Department of Bacteriology-Virology-Parasitology-Mycology-Hygiene, Pole of Biology-Pathology, University Hospital of Brest, F-29200 Brest, France
| | - Claudie Lamoureux
- Unity of Bacteriology, Department of Bacteriology-Virology-Parasitology-Mycology-Hygiene, Pole of Biology-Pathology, University Hospital of Brest, F-29200 Brest, France
- Univ Brest, Inserm, EFS, UMR 1078, GGB CEDEX, F-29200 Brest, France
| | - Clémence Beauruelle
- Unity of Bacteriology, Department of Bacteriology-Virology-Parasitology-Mycology-Hygiene, Pole of Biology-Pathology, University Hospital of Brest, F-29200 Brest, France
- Univ Brest, Inserm, EFS, UMR 1078, GGB CEDEX, F-29200 Brest, France
| | - Sophie Vallet
- Unity of Virology, Department of Bacteriology-Virology-Parasitology-Mycology-Hygiene, Pole of Biology-Pathology, University Hospital of Brest, F-29200 Brest, France
- Univ Brest, Inserm, EFS, UMR 1078, GGB CEDEX, F-29200 Brest, France
| | - Christopher Payan
- Unity of Virology, Department of Bacteriology-Virology-Parasitology-Mycology-Hygiene, Pole of Biology-Pathology, University Hospital of Brest, F-29200 Brest, France
- Univ Brest, Inserm, EFS, UMR 1078, GGB CEDEX, F-29200 Brest, France
| | - Léa Pilorgé
- Unity of Virology, Department of Bacteriology-Virology-Parasitology-Mycology-Hygiene, Pole of Biology-Pathology, University Hospital of Brest, F-29200 Brest, France
- Correspondence: ; Tel.: +33-298-347-191; Fax: +33-298-347-193
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Gazeau P, Vallet S, Ansart S, Beauruelle C, Tran-Minoui A, Payan C, Pilorgé L. Rapid multiplex PCR assays in patients with respiratory viral infections: is semi-quantitative data useful? A pilot study. Braz J Microbiol 2021; 52:1173-1179. [PMID: 34105111 PMCID: PMC8187131 DOI: 10.1007/s42770-021-00536-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/26/2021] [Indexed: 11/29/2022] Open
Abstract
Viral respiratory rapid multiplex PCR assays FilmArray® (FA) and ePlex® (eP) provide qualitative results which may not reflect clinical relevance. In a pilot study, we report retrospectively whether the semi-quantitative PCR assay R-GENE® would have facilitated clinical interpretation. Forty-four patients were hospitalized for various respiratory manifestations; all of them have benefited from a respiratory sample during acute symptoms. Among the 44 patients, FA detected 23 positive samples including 31 viruses, 26 of them gave high or moderate R-GENE® scores (cycle threshold < 35), and all but one were consistent with clinical history. Semi-quantitative scores would have allowed for critical interpretation of the results; those are a key additional element for an optimal exploitation of the rapid multiplex PCR assays power.
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Affiliation(s)
- Pierre Gazeau
- Unité Des Maladies Infectieuses Et Tropicales, Centre Hospitalier Régional Et Universitaire de Brest, Brest, France
| | - Sophie Vallet
- Unité de Virologie, Département de Bactériologie-Virologie-Parasitologie-Mycologie-Hygiène, Pôle de Biologie-Pathologie, Centre Hospitalier Régional Et Universitaire de Brest, Brest, France.,Univ Brest, Inserm, EFS, UMR 1078, GGB Génétique, Génomique Fonctionnelle Et Biotechnologies, Brest, France
| | - Séverine Ansart
- Unité Des Maladies Infectieuses Et Tropicales, Centre Hospitalier Régional Et Universitaire de Brest, Brest, France.,Laboratoire de traitement de l'information médicale, LaTIM-UMR 1101, INSERM, Université de Bretagne Occidentale, Brest, France
| | - Clémence Beauruelle
- Univ Brest, Inserm, EFS, UMR 1078, GGB Génétique, Génomique Fonctionnelle Et Biotechnologies, Brest, France.,Unité de Bactériologie, Département de Bactériologie-Virologie-Parasitologie-Mycologie-Hygiène, Pôle de Biologie-Pathologie, Centre Hospitalier Régional Et Universitaire de Brest, Brest, France
| | - Adissa Tran-Minoui
- Unité de Virologie, Département de Bactériologie-Virologie-Parasitologie-Mycologie-Hygiène, Pôle de Biologie-Pathologie, Centre Hospitalier Régional Et Universitaire de Brest, Brest, France
| | - Christopher Payan
- Unité de Virologie, Département de Bactériologie-Virologie-Parasitologie-Mycologie-Hygiène, Pôle de Biologie-Pathologie, Centre Hospitalier Régional Et Universitaire de Brest, Brest, France.,Univ Brest, Inserm, EFS, UMR 1078, GGB Génétique, Génomique Fonctionnelle Et Biotechnologies, Brest, France
| | - Léa Pilorgé
- Unité de Virologie, Département de Bactériologie-Virologie-Parasitologie-Mycologie-Hygiène, Pôle de Biologie-Pathologie, Centre Hospitalier Régional Et Universitaire de Brest, Brest, France.
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3
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Cardot-Martin E, Guillou-Guillemette HL, Berre RL, Ramel S, Bihan JL, Grenet D, Farfour E, Troussier F, Urban T, Billard L, Pilorgé L, Minoui-Tran A, Payan C, Munck MR, Héry-Arnaud G, Vallet S. Sputum versus nasopharyngeal samples for the molecular diagnosis of respiratory viral infection in cystic fibrosis: A pilot study. J Cyst Fibros 2020; 20:432-435. [PMID: 32943334 PMCID: PMC7489228 DOI: 10.1016/j.jcf.2020.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 08/26/2020] [Accepted: 09/06/2020] [Indexed: 11/29/2022]
Abstract
Viruses are important agents in lung function deterioration in Cystic Fibrosis (CF). To date, no standard operating procedures (SOPs) have been established to determine which sampling method is the most effective for an optimal virological diagnosis of respiratory viral infections in CF. Here we investigated the performances of two sampling sites, sputum samples versus nasopharyngeal (NP) swabs, for thirty participants from three CF centres presenting an acute respiratory infection. Sputum and NP samples were simultaneously collected and multiplex PCR targeting 16 to 18 viruses were performed. Viruses were detected for 18/30 patients (60%). A high concordance between the sputum and NP samples was observed in 25 (83%) paired samples of which 13 tested positive and 12 tested negative. These results highlighted the relevance of sputum sampling for diagnostic of respiratory viruses in CF, which is less invasive and better accepted by CF patients than NP, and allows accurate bacterial detection.
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Affiliation(s)
| | | | - Rozenn Le Berre
- Univ Brest, Inserm, EFS, UMR 1078, GGB Génétique, Génomique Fonctionnelle et Biotechnologies, F-29200 Brest, France; Département de Médecine Interne et Pneumologie, Centre Hospitalier Régional et Universitaire de Brest, France.
| | - Sophie Ramel
- Centre de Ressources et de Compétences de la Mucoviscidose, Presqu'île de Perharidy, Ildys, 29648 Roscoff, France.
| | - Jean Le Bihan
- Centre de Ressources et de Compétences de la Mucoviscidose, Presqu'île de Perharidy, Ildys, 29648 Roscoff, France.
| | | | - Eric Farfour
- Service de Biologie Clinique, Hôpital Foch, 92151 Suresnes, France.
| | - Françoise Troussier
- Pôle femme mère, enfant, centre Robert Debré, CHU d'Angers, 4 rue Larrey, 49993 Angers cedex 09, France.
| | - Thierry Urban
- Département de Pneumologie, CHU d'Angers, 4 rue Larrey, 49933 Angers Cedex 1, France.
| | - Lisa Billard
- Univ Brest, Inserm, EFS, UMR 1078, GGB Génétique, Génomique Fonctionnelle et Biotechnologies, F-29200 Brest, France
| | - Léa Pilorgé
- Unité de Virologie, Département de Bactériologie-Virologie-Parasitologie-Mycologie-Hygiène, Pôle de Biologie-Pathologie, Centre Hospitalier Régional et Universitaire, 29609 Brest cedex, France
| | - Adissa Minoui-Tran
- Unité de Virologie, Département de Bactériologie-Virologie-Parasitologie-Mycologie-Hygiène, Pôle de Biologie-Pathologie, Centre Hospitalier Régional et Universitaire, 29609 Brest cedex, France
| | - Christopher Payan
- Univ Brest, Inserm, EFS, UMR 1078, GGB Génétique, Génomique Fonctionnelle et Biotechnologies, F-29200 Brest, France; Unité de Virologie, Département de Bactériologie-Virologie-Parasitologie-Mycologie-Hygiène, Pôle de Biologie-Pathologie, Centre Hospitalier Régional et Universitaire, 29609 Brest cedex, France
| | - Marie-Reine Munck
- Service de Pédiatrie générale, Centre Hospitalier Régional Universitaire, 29609 Brest cedex, France.
| | - Geneviève Héry-Arnaud
- Univ Brest, Inserm, EFS, UMR 1078, GGB Génétique, Génomique Fonctionnelle et Biotechnologies, F-29200 Brest, France; Unité de Bactériologie, Département de Bactériologie-Virologie-Hygiène-Parasitologie-Mycologie, Pôle de Biologie-Pathologie, Centre Hospitalier Régional Universitaire, 29609 Brest cedex, France.
| | - Sophie Vallet
- Univ Brest, Inserm, EFS, UMR 1078, GGB Génétique, Génomique Fonctionnelle et Biotechnologies, F-29200 Brest, France; Unité de Virologie, Département de Bactériologie-Virologie-Parasitologie-Mycologie-Hygiène, Pôle de Biologie-Pathologie, Centre Hospitalier Régional et Universitaire, 29609 Brest cedex, France.
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4
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Nevez G, Guillaud-Saumur T, Cros P, Papon N, Vallet S, Quinio D, Minoui-Tran A, Pilorgé L, de Parscau L, Sizun J, Ochoa TJ, Bustamante B, Ponce C, Vargas SL, Le Gal S. Pneumocystis primary infection in infancy: Additional French data and review of the literature. Med Mycol 2020; 58:163-171. [PMID: 31127850 PMCID: PMC7107579 DOI: 10.1093/mmy/myz040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 04/03/2019] [Accepted: 04/05/2019] [Indexed: 11/12/2022] Open
Abstract
Data on features of Pneumocystis primary infection in infancy are still fragmented. To study Pneumocystis primary infection, 192 infants who were monitored for acute pulmonary disease or fever over a 40-month period were retrospectively investigated. P. jirovecii detection on archival nasopharyngeal aspirates was performed using a qPCR assay. Factors associated with P. jirovecii were assessed using univariate and multivariate analyses. P. jirovecii genotypes in infants and a control group of adults contemporaneously diagnosed with Pneumocystis pneumonia were identified using unilocus, bilocus, and multilocus sequence typing (MLST). P. jirovecii was detected in 35 infants (18.2%). The univariate analysis pointed out four factors: viral infection (P = .035, OR [IC 95], 2.2 [1.1–4.7]), lower respiratory tract infection (P = .032, OR [IC 95], 2.5 [1.1–5.9]), absence of hospital discharge after birth (P = .003, OR (IC 95), 0.1 (0.02–0.5]), and the 63–189-day group (P < .001, OR [IC 95], 42.2 [5.4–332]). The multivariate analysis confirmed these two latter factors (P = .02, OR [IC 95], 0.1 [0.02–0.72]; P = .005, OR [IC 95], 11.5 [2.1–63.5]). Thus, P. jirovecii acquisition mostly takes place in the community. A comparison of these data with those of previously published studies showed that median and interquartile range of positive-infant ages were close to those observed in Chile, Denmark, and Peru, highlighting similar characteristics. Common unilocus or bilocus genotypes were identified in infants and adults, whereas no MLST genotypes were shared. Therefore, a common reservoir made up of infected infants and adults is still hypothetical. Finally, primary infection is a worldwide phenomenon occurring at the same time in childhood regardless of geographical location, rather than an incidental event.
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Affiliation(s)
- Gilles Nevez
- Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Angers-Brest, Université de Bretagne-Loire, France.,Laboratoire de Mycologie et Parasitologie, CHRU de Brest, Brest, France
| | - Thibaud Guillaud-Saumur
- Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Angers-Brest, Université de Bretagne-Loire, France.,Laboratoire de Mycologie et Parasitologie, CHRU de Brest, Brest, France
| | - Pierrick Cros
- Département de Pédiatrie, CHRU de Brest, Brest, France
| | - Nicolas Papon
- Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Angers-Brest, Université de Bretagne-Loire, France
| | - Sophie Vallet
- Laboratoire de Virologie, CHRU de Brest, Brest, France.,UMR INSERM U 1078, Université de Bretagne-Loire, Brest, France
| | - Dorothée Quinio
- Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Angers-Brest, Université de Bretagne-Loire, France.,Laboratoire de Mycologie et Parasitologie, CHRU de Brest, Brest, France
| | | | - Léa Pilorgé
- Laboratoire de Virologie, CHRU de Brest, Brest, France
| | | | - Jacques Sizun
- Département de Pédiatrie, CHRU de Brest, Brest, France
| | - Theresa J Ochoa
- Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Beatriz Bustamante
- Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Carolina Ponce
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago
| | - Sergio L Vargas
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago
| | - Solène Le Gal
- Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Angers-Brest, Université de Bretagne-Loire, France.,Laboratoire de Mycologie et Parasitologie, CHRU de Brest, Brest, France
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5
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Abstract
Although bacteria have historically been considered to play a major role in cystic fibrosis (CF) airway damage, a strong impact of respiratory viral infections (RVI) is also now recognized. Emerging evidence confirms that respiratory viruses are associated with deterioration of pulmonary function and exacerbation and facilitation of bacterial colonization in CF patients. The aim of this review is to provide an overview of the current knowledge on respiratory viruses in CF airways, to discuss the resulting inflammation and RVI response, to determine how to detect the viruses, and to assess their clinical consequences, prevalence, and interactions with bacteria. The most predominant are Rhinoviruses (RVs), significantly associated with CF exacerbation. Molecular techniques, and especially multiplex PCR, help to diagnose viral infections, and the coming rise of metagenomics will extend knowledge of viral populations in the complex ecosystem of CF airways. Prophylaxis and vaccination are currently available only for Respiratory syncytial and Influenza virus (IV), but antiviral molecules are being tested to improve CF patients' care. All the points raised in this review highlight the importance of taking account of RVIs and their potential impact on the CF airway ecosystem.
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Affiliation(s)
- Lisa Billard
- a EA 3882-Laboratoire Universitaire de Biodiversité et Ecologie Microbienne (LUBEM) , Groupe de Bactériologie-Virologie, Faculté de Médecine et des Sciences de la Santé , Université Bretagne Loire , Brest Cedex , France
| | - Rozenn Le Berre
- a EA 3882-Laboratoire Universitaire de Biodiversité et Ecologie Microbienne (LUBEM) , Groupe de Bactériologie-Virologie, Faculté de Médecine et des Sciences de la Santé , Université Bretagne Loire , Brest Cedex , France.,b Département de Médecine Interne et Pneumologie , Centre Hospitalier Régional et Universitaire de Brest, Hôpital de la Cavale Blanche , Brest cedex , France
| | - Léa Pilorgé
- a EA 3882-Laboratoire Universitaire de Biodiversité et Ecologie Microbienne (LUBEM) , Groupe de Bactériologie-Virologie, Faculté de Médecine et des Sciences de la Santé , Université Bretagne Loire , Brest Cedex , France.,c Département de Bacteriologie-Virologie, Hygiène et Parasitologie-Mycologie, Pôle de Biologie-Pathologie , Centre Hospitalier Régional et Universitaire de Brest, Hôpital de la Cavale Blanche , Brest cedex , France
| | - Christopher Payan
- a EA 3882-Laboratoire Universitaire de Biodiversité et Ecologie Microbienne (LUBEM) , Groupe de Bactériologie-Virologie, Faculté de Médecine et des Sciences de la Santé , Université Bretagne Loire , Brest Cedex , France.,c Département de Bacteriologie-Virologie, Hygiène et Parasitologie-Mycologie, Pôle de Biologie-Pathologie , Centre Hospitalier Régional et Universitaire de Brest, Hôpital de la Cavale Blanche , Brest cedex , France
| | - Geneviève Héry-Arnaud
- a EA 3882-Laboratoire Universitaire de Biodiversité et Ecologie Microbienne (LUBEM) , Groupe de Bactériologie-Virologie, Faculté de Médecine et des Sciences de la Santé , Université Bretagne Loire , Brest Cedex , France.,c Département de Bacteriologie-Virologie, Hygiène et Parasitologie-Mycologie, Pôle de Biologie-Pathologie , Centre Hospitalier Régional et Universitaire de Brest, Hôpital de la Cavale Blanche , Brest cedex , France
| | - Sophie Vallet
- a EA 3882-Laboratoire Universitaire de Biodiversité et Ecologie Microbienne (LUBEM) , Groupe de Bactériologie-Virologie, Faculté de Médecine et des Sciences de la Santé , Université Bretagne Loire , Brest Cedex , France.,c Département de Bacteriologie-Virologie, Hygiène et Parasitologie-Mycologie, Pôle de Biologie-Pathologie , Centre Hospitalier Régional et Universitaire de Brest, Hôpital de la Cavale Blanche , Brest cedex , France
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6
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Schuffenecker I, Mirand A, Josset L, Henquell C, Hecquet D, Pilorgé L, Petitjean-Lecherbonnier J, Manoha C, Legoff J, Deback C, Pillet S, Lepiller Q, Mansuy JM, Marque-Juillet S, Antona D, Peigue-Lafeuille H, Lina B. Epidemiological and clinical characteristics of patients infected with enterovirus D68, France, July to December 2014. ACTA ACUST UNITED AC 2017; 21:30226. [PMID: 27195770 DOI: 10.2807/1560-7917.es.2016.21.19.30226] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 02/05/2016] [Indexed: 11/20/2022]
Abstract
In 2014, the United States (US) experienced a nationwide outbreak of enterovirus D68 (EV-D68) infection with 1,152 cases reported mainly in hospitalised children with severe asthma or bronchiolitis. Following the US alert, 11 laboratories of the French enterovirus (EV) surveillance network participated in an EV-D68 survey. A total of 6,229 respiratory samples, collected from 1 July to 31 December 2014, were screened for EV-D68 resulting in 212 EV-D68-positive samples. These 212 samples corresponded to 200 EV-D68 cases. The overall EV-D68 positivity rates among respiratory samples were of 5% (184/3,645) and 1.1% (28/2,584) in hospitalised children and adults respectively. The maximum weekly EV-D68 positivity rates were of 16.1% for children (n = 24/149; week 43) and 2.6% for adults (n = 3/115; week 42). Of 173 children with EV-D68 infection alone, the main symptoms were asthma (n = 83; 48.0%) and bronchiolitis (n = 37; 21.4%). One child developed acute flaccid paralysis (AFP) following EV-D68-associated pneumonia. Although there was no significant increase in severe respiratory tract infections reported to the French public health authorities, 10.7% (19/177) of the EV-D68 infected children and 14.3% (3/21) of the EV-D68 infected adults were hospitalised in intensive care units. Phylogenetic analysis of the viral protein 1 (VP1) sequences of 179 EV-D68 cases, revealed that 117 sequences (65.4%), including that of the case of AFP, belonged to the B2 variant of clade B viruses. Continuous surveillance of EV-D68 infections is warranted and could benefit from existing influenza-like illness and EV surveillance networks.
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Affiliation(s)
- Isabelle Schuffenecker
- Centre National de Référence des Enterovirus et Parechovirus, Laboratoire de Virologie, Hospices Civils de Lyon, Lyon, France
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7
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Pilorgé L, Chartier M, Méritet JF, Cervantes M, Tsatsaris V, Launay O, Rozenberg F, Krivine A. Rhinoviruses as an underestimated cause of influenza-like illness in pregnancy during the 2009-2010 influenza pandemic. J Med Virol 2013; 85:1473-7. [PMID: 23722328 DOI: 10.1002/jmv.23614] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2013] [Indexed: 11/06/2022]
Abstract
During the 2009-2010 influenza pandemic, pregnant women were identified at high risk for severe infection. In case of influenza-like illness they were systematically treated with oseltamivir. When performed, virological diagnosis showed that some of these women were not influenza-infected. The objectives of the study were to identify viruses which could induce an influenza-like illness in pregnant women during the 2009-2010 pandemic, then to establish possible links between detected viruses and symptoms, and then characterize human rhinoviruses (HRV) strains detected in some samples. Nasal swabs from 78 pregnant women presenting with influenza-like illness and previously tested for influenza virus by RT-PCR in 2009-2010 were further assayed by multiplex RespiFinder assay and bocavirus PCR to search for 13 other viruses. Genotyping of HRV strains was carried out using partial genomic sequencing in the VP4/VP2 region. Influenza A virus infection was confirmed in 33 women (42%). Non-influenza viruses were detected in 18 additional cases (23%). Rhinoviruses were the most numerous (13%) and belonged to 9 different genotypes distributed between the 3 genogroups. When comparing symptoms observed in influenza-infected women and women infected by other viruses, shivers were more frequent in the former group (P=0.02), and expectorations in the latter (P=0.03). During the influenza pandemic 2009-2010, non-influenza viruses and mostly rhinoviruses were an underestimated cause of influenza-like illness in pregnant women. Viral diagnosis should help to stop empiric oseltamivir therapy in influenza-negative patients and antibiotic treatment in patients infected with a non-influenza virus.
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Affiliation(s)
- Léa Pilorgé
- Department of Virology, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
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