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Jiang L, Lee VJM, Cui L, Lin R, Tan CL, Tan LWL, Lim WY, Leo YS, Low L, Hibberd M, Chen MIC. Detection of viral respiratory pathogens in mild and severe acute respiratory infections in Singapore. Sci Rep 2017; 7:42963. [PMID: 28218288 PMCID: PMC5317157 DOI: 10.1038/srep42963] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 01/17/2017] [Indexed: 11/09/2022] Open
Abstract
To investigate the performance of laboratory methods and clinical case definitions in detecting the viral pathogens for acute respiratory infections (ARIs) from a prospective community cohort and hospital inpatients, nasopharyngeal swabs from cohort members reporting ARIs (community-ARI) and inpatients admitted with ARIs (inpatient-ARI) were tested by Singleplex Real Time-Polymerase Chain Reaction (SRT-PCR), multiplex RT-PCR (MRT-PCR) and pathogen-chip system (PathChip) between April 2012 and December 2013. Community-ARI and inpatient-ARI was also combined with mild and severe cases of influenza from a historical prospective study as mild-ARI and severe-ARI respectively to evaluate the performance of clinical case definitions. We analysed 130 community-ARI and 140 inpatient-ARI episodes (5 inpatient-ARI excluded because multiple pathogens were detected), involving 138 and 207 samples respectively. Detection by PCR declined with days post-onset for influenza virus; decrease was faster for community-ARI than for inpatient-ARI. No such patterns were observed for non-influenza respiratory virus infections. PathChip added substantially to viruses detected for community-ARI only. Clinical case definitions discriminated influenza from other mild-ARI but performed poorly for severe-ARI and for older participants. Rational strategies for diagnosis and surveillance of influenza and other respiratory virus must acknowledge the differences between ARIs presenting in community and hospital settings.
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Affiliation(s)
- Lili Jiang
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore
| | - Vernon Jian Ming Lee
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore.,Biodefence Centre, Singapore Armed Forces, Singapore
| | - Lin Cui
- National Public Health Laboratory, Ministry of Health, Singapore
| | - Raymond Lin
- National Public Health Laboratory, Ministry of Health, Singapore.,Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore
| | - Chyi Lin Tan
- Department of Infectious Diseases, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore
| | - Linda Wei Lin Tan
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore
| | - Wei-Yen Lim
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore
| | - Yee-Sin Leo
- Department of Infectious Diseases, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore
| | - Louie Low
- Genome Institute Singapore, Singapore
| | | | - Mark I-Cheng Chen
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore.,Department of Clinical Epidemiology, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore
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Influenza infection in ICU. Enferm Infecc Microbiol Clin 2016; 34:468. [DOI: 10.1016/j.eimc.2015.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 06/03/2015] [Indexed: 11/18/2022]
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