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Jeong S, Park MJ, Song W, Kim HS. Advances in laboratory assays for detecting human metapneumovirus. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:608. [PMID: 32566634 PMCID: PMC7290561 DOI: 10.21037/atm.2019.12.42] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Human metapneumovirus (HMPV) is one of the major causes of acute respiratory tract infection (ARI) and shows high morbidity and mortality, particularly in children and immunocompromised patients. Various methods for detecting HMPV have been developed and applied in clinical laboratories. When reviewing the literature, we found that polymerase chain reaction (PCR)-based assays have been most frequently and consistently used to detect HMPV. The most commonly used method was multiplex reverse transcriptase-PCR (RT-PCR; 57.4%), followed by real-time RT-PCR (38.3%). Multiplex RT-PCR became the more popular method in 2011-2019 (69.7%), in contrast to 2001-2009 (28.6%). The advent of multiplex PCR in detecting broader viral pathogens in one run and coinfected viruses influenced the change in user preference. Further, newly developed microarray technologies and ionization mass spectrometry were introduced in 2011-2019. Viral culture (including shell vial assays) and fluorescent immunoassays (with or without culture) were once the mainstays. However, the percentage of studies employing culture and fluorescent immunoassays decreased from 21.4% in 2001-2010 to 15.2% in 2011-2019. Meanwhile, the use of PCR-based methods of HMPV detection increased from 78.6% in 2001-2010 to 84.8% in 2011-2019. The increase in PCR-based methods might have occurred because PCR methods demonstrated better diagnostic performance, shorter hands-on and run times, less hazards to laboratory personnel, and more reliable results than traditional methods. When using these assays, it is important to acquire a comprehensive understanding of the principles, advantages, disadvantages, and precautions for data interpretation. In the future, the combination of nanotechnology and advanced genetic platforms such as next-generation sequencing will benefit patients with HMPV infection by facilitating efficient therapeutic intervention. Analytical and clinical validation are required before using new techniques in clinical laboratories.
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Affiliation(s)
- Seri Jeong
- Department of Laboratory Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Min-Jeong Park
- Department of Laboratory Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Wonkeun Song
- Department of Laboratory Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Hyon-Suk Kim
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
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Biographical Feature: Marie-Louise Landry, M.D. J Clin Microbiol 2019; 57:JCM.01013-19. [PMID: 31413080 DOI: 10.1128/jcm.01013-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Human Metapneumovirus Pediatric Respiratory Infections: Comparing Direct Immunofluorescence versus Polymerase Chain Reaction. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2016. [DOI: 10.5812/pedinfect.39830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Wolf JM, Gregianini TS, Seadi CMF, Tumioto GL, Dambrós BP, Lehmann FKM, Carli SD, Ikuta N, Lunge VR. Performance of direct immunofluorescence assay for the detection of human metapneumovirus under clinical laboratory settings. Rev Soc Bras Med Trop 2016; 48:762-4. [PMID: 26676503 DOI: 10.1590/0037-8682-0107-2015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 06/09/2015] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Human metapneumovirus (hMPV) is an emergent human respiratory pathogen. This study aimed to evaluate the performance of direct immunofluorescence (DIF) to detect hMPV in a clinical laboratory setting. METHODS Nasopharyngeal aspirate samples (448) of children and adults with respiratory illness were used to detect hMPV by using DIF and real time quantitative reverse transcription-polymerase chain reaction (qRT-PCR) assays. RESULTS In all, 36 (8%) samples were positive by DIF and 94 (21%) were positive by qRT-PCR. Direct immunofluorescence specificity was 99% and sensitivity was 38%. CONCLUSIONS DIF is not very sensitive under clinical laboratory settings.
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Affiliation(s)
- Jonas Michel Wolf
- Laboratório de Diagnóstico Molecular, Universidade Luterana do Brasil, Canoas, Rio Grande do Sul, Brazil
| | - Tatiana Schäffer Gregianini
- Instituto de Pesquisas Biológicas, Laboratório Central de Saúde Pública do Estado do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Claudete Maria Farina Seadi
- Instituto de Pesquisas Biológicas, Laboratório Central de Saúde Pública do Estado do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Gabriela Luchiari Tumioto
- Instituto de Pesquisas Biológicas, Laboratório Central de Saúde Pública do Estado do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Bibiana Paula Dambrós
- Instituto de Pesquisas Biológicas, Laboratório Central de Saúde Pública do Estado do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Silvia De Carli
- Laboratório de Diagnóstico Molecular, Universidade Luterana do Brasil, Canoas, Rio Grande do Sul, Brazil
| | - Nilo Ikuta
- Laboratório de Diagnóstico Molecular, Universidade Luterana do Brasil, Canoas, Rio Grande do Sul, Brazil
| | - Vagner Ricardo Lunge
- Laboratório de Diagnóstico Molecular, Universidade Luterana do Brasil, Canoas, Rio Grande do Sul, Brazil
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Sanchez JL, Cooper MJ, Myers CA, Cummings JF, Vest KG, Russell KL, Sanchez JL, Hiser MJ, Gaydos CA. Respiratory Infections in the U.S. Military: Recent Experience and Control. Clin Microbiol Rev 2015; 28:743-800. [PMID: 26085551 PMCID: PMC4475643 DOI: 10.1128/cmr.00039-14] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
This comprehensive review outlines the impact of military-relevant respiratory infections, with special attention to recruit training environments, influenza pandemics in 1918 to 1919 and 2009 to 2010, and peacetime operations and conflicts in the past 25 years. Outbreaks and epidemiologic investigations of viral and bacterial infections among high-risk groups are presented, including (i) experience by recruits at training centers, (ii) impact on advanced trainees in special settings, (iii) morbidity sustained by shipboard personnel at sea, and (iv) experience of deployed personnel. Utilizing a pathogen-by-pathogen approach, we examine (i) epidemiology, (ii) impact in terms of morbidity and operational readiness, (iii) clinical presentation and outbreak potential, (iv) diagnostic modalities, (v) treatment approaches, and (vi) vaccine and other control measures. We also outline military-specific initiatives in (i) surveillance, (ii) vaccine development and policy, (iii) novel influenza and coronavirus diagnostic test development and surveillance methods, (iv) influenza virus transmission and severity prediction modeling efforts, and (v) evaluation and implementation of nonvaccine, nonpharmacologic interventions.
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Affiliation(s)
- Jose L Sanchez
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA
| | - Michael J Cooper
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA
| | | | - James F Cummings
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA
| | - Kelly G Vest
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA
| | - Kevin L Russell
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA
| | - Joyce L Sanchez
- Mayo Clinic, Division of General Internal Medicine, Rochester, Minnesota, USA
| | - Michelle J Hiser
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA Oak Ridge Institute for Science and Education, Postgraduate Research Participation Program, U.S. Army Public Health Command, Aberdeen Proving Ground, Aberdeen, Maryland, USA
| | - Charlotte A Gaydos
- International STD, Respiratory, and Biothreat Research Laboratory, Division of Infectious Diseases, Johns Hopkins University, Baltimore, Maryland, USA
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Chang YF, Tsao KC, Liu YC, Chen YC, Yu PC, Huang YC, Chou C. Diagnosis of human metapneumovirus in patients hospitalized with acute lower respiratory tract infection using a metal-enhanced fluorescence technique. J Virol Methods 2014; 213:151-6. [PMID: 25522922 DOI: 10.1016/j.jviromet.2014.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 12/04/2014] [Accepted: 12/05/2014] [Indexed: 11/30/2022]
Abstract
Human metapneumovirus (hMPV) is a common respiratory tract infection in children. However, conventional immunofluorescence assays (IFAs) for detecting hMPV in respiratory samples have limited reliability with a sensitivity and false-negative predictive value of 58.1% and approximately 17.8%, respectively. In this study, hMPV was measured in 91 clinical respiratory samples (55 sputum and 36 nasopharyngeal aspirate samples), which were obtained from children under three years of age, utilizing our previously developed high-throughput metal-enhanced fluorescence (MEF)-based biosensor (HT-MEFB). The sensitivity of HT-MEFB for hMPV detection in the 91 samples was improved by up to 77.4% compared with that obtained with IFAs, and the specificity of HT-MEFB for hMPV detection was 91.7%. In addition, the specificity and accuracy obtained after the selection of 55 sputum samples as the analyzed specimen reached 92.3% and 90.9%, respectively. Thus, in terms of accuracy, high throughput, and sensitivity, HT-MEFB exhibits considerable potential for hMPV detection in clinical settings.
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Affiliation(s)
- Ying-Feng Chang
- Chang Gung University, Graduate Institute of Electro-Optical Engineering, Taoyuan 33371, Taiwan; National Taiwan University, Department of Biochemical Science and Technology, Taipei 10617, Taiwan
| | - Kuo-Chien Tsao
- Linkou Chang Gung Memorial Hospital, Department of Laboratory Medicine, Taoyuan 33305, Taiwan; Chang Gung University, College of Medicine, Department of Medical Biotechnology and Laboratory Science, Taoyuan 33371, Taiwan
| | - Yi-Chun Liu
- Linkou Chang Gung Memorial Hospital, Department of Laboratory Medicine, Taoyuan 33305, Taiwan
| | - Yu-Chi Chen
- Chang Gung University, Graduate Institute of Electro-Optical Engineering, Taoyuan 33371, Taiwan
| | - Pei-Chun Yu
- Chang Gung University, Graduate Institute of Electro-Optical Engineering, Taoyuan 33371, Taiwan
| | - Yhu-Chering Huang
- Linkou Chang Gung Memorial Hospital, Division of Pediatric Infectious Diseases, Taoyuan 33305, Taiwan; Chang Gung University, College of Medicine, Department of Medicine, Taoyuan 33371, Taiwan
| | - Chien Chou
- Chang Gung University, Graduate Institute of Electro-Optical Engineering, Taoyuan 33371, Taiwan; Chang Gung University, Healthy Aging Research Center, Taoyuan 33302, Taiwan.
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Fraire AE, Woda BA, Welsh RM, Kradin RL. Human Metapneumovirus. VIRUSES AND THE LUNG 2014. [PMCID: PMC7122877 DOI: 10.1007/978-3-642-40605-8_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Name of Virus: Human metapneumovirus
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Affiliation(s)
- Armando E. Fraire
- Department of Pathology, University of Massachusetts Medical School, Worcester, Massachusetts USA
| | - Bruce A. Woda
- Department of Pathology, University of Massachusetts Medical School, Worcester, Massachusetts USA
| | - Raymond M. Welsh
- Department of Pathology, University of Massachusetts Medical School, Worcester, Massachusetts USA
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Jaton-Ogay K, Bille J. Microbiological diagnosis of community-acquired respiratory tract infections by nucleic acid detection. ACTA ACUST UNITED AC 2013; 2:947-61. [PMID: 23495868 DOI: 10.1517/17530059.2.8.947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Microbiological diagnostic procedures have changed significantly over the last decade. Initially the implementation of the polymerase chain reaction (PCR) resulted in improved detection tests for microbes that were difficult or even impossible to detect by conventional methods such as culture and serology, especially in community-acquired respiratory tract infections (CA-RTI). A further improvement was the development of real-time PCR, which allows end point detection and quantification, and many diagnostic laboratories have now implemented this powerful method. OBJECTIVE At present, new performant and convenient molecular tests have emerged targeting in parallel many viruses and bacteria responsible for lower and/or upper respiratory tract infections. The range of test formats and microbial agents detected is evolving very quickly and the added value of these new tests needs to be studied in terms of better use of antibiotics, better patient management, duration of hospitalization and overall costs. CONCLUSIONS Molecular tools for a better microbial documentation of CA-RTI are now available. Controlled studies are now required to address the relevance issue of these new methods, such as, for example, the role of some newly detected respiratory viruses or of the microbial DNA load in a particular patient at a particular time. The future challenge for molecular diagnosis will be to become easy to handle, highly efficient and cost-effective, delivering rapid results with a direct impact on clinical management.
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Affiliation(s)
- Katia Jaton-Ogay
- Institute of Microbiology, University Hospital Center of Lausanne and University of Lausanne, 1011 Lausanne, Switzerland +41 21 314 40 76 ; +41 21 314 40 60 ;
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Curtis N, Finn A, Pollard AJ. Elucidation and clinical role of emerging viral respiratory tract infections in children. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2013; 764:191-204. [PMID: 23654068 PMCID: PMC7123406 DOI: 10.1007/978-1-4614-4726-9_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 03/29/2024]
Abstract
Acute respiratory viral infections (ARVI's) are the most common infectious disease in humans. With the appearance of molecular techniques the recovery of viruses has dramatically increased. Nowadays virologists can quickly discriminate virological families and related viruses from emerging viruses and consequently identify novel viruses. Many new respiratory viruses have been identified in children in the past 15 years. In this review we shortly discuss novel respiratory viruses and their pathogenic role in pediatric respiratory disease. Advantages and drawbacks of the technique and our current knowledge will be discussed. We will conclude this review with a general discussion on the future role of molecular diagnostic virology in the clinic.
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Affiliation(s)
- Nigel Curtis
- Royal Children's Hospital, Dept. Pediatrics, University of Melbourne, Flemington Road, Parkville, 3052 Victoria Australia
| | - Adam Finn
- Institute of Child Life and Health, UBHT Education Centre, University of Bristol, Upper Maudlin Street, Bristol, BS28AE UK
| | - Andrew J. Pollard
- University of Oxford, Level 4,John Radcliffe Hospital, Oxford, OX3 9DU UK
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Abstract
It has been 10 years since human metapneumovirus (HMPV) was identified as a causative agent of respiratory illness in humans. Since then, numerous studies have contributed to a substantial body of knowledge on many aspects of HMPV. This review summarizes our current knowledge on HMPV, HMPV disease pathogenesis, and disease intervention strategies and identifies a number of areas with key questions to be addressed in the future.
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Olofsson S, Brittain-Long R, Andersson LM, Westin J, Lindh M. PCR for detection of respiratory viruses: seasonal variations of virus infections. Expert Rev Anti Infect Ther 2011; 9:615-26. [PMID: 21819328 PMCID: PMC7103711 DOI: 10.1586/eri.11.75] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Real-time PCR and related methods have revolutionized the laboratory diagnosis of viral respiratory infections because of their high detection sensitivity, rapidness and potential for simultaneous detection of 15 or more respiratory agents. Results from studies with this diagnostic modality have significantly expanded our knowledge about the seasonality of viral respiratory diseases, pinpointed the difficulties to make a reliable etiologic diagnosis without the aid of an unbiased multiplex molecular assay for respiratory viruses, and revealed previously unknown details as to possible infections with multiple agents as aggravating factors. The scope of this article is to review and discuss this new knowledge and its implications for diagnostic strategies and other measures essential for the clinical management of respiratory viral infections and for epidemiological surveillance of seasonal respiratory infections.
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Affiliation(s)
- Sigvard Olofsson
- Department of Clinical Virology, University of Gothenburg, Guldhedsgatan 10B, S-413 46 Gothenburg, Sweden.
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Molecular Detection of Respiratory Viruses. Mol Microbiol 2011. [DOI: 10.1128/9781555816834.ch39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Sadeghi CD, Aebi C, Gorgievski-Hrisoho M, Mühlemann K, Barbani MT. Twelve years' detection of respiratory viruses by immunofluorescence in hospitalised children: impact of the introduction of a new respiratory picornavirus assay. BMC Infect Dis 2011; 11:41. [PMID: 21299840 PMCID: PMC3044667 DOI: 10.1186/1471-2334-11-41] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Accepted: 02/07/2011] [Indexed: 12/04/2022] Open
Abstract
Background Direct immunofluorescence assays (DFA) are a rapid and inexpensive method for the detection of respiratory viruses and may therefore be used for surveillance. Few epidemiological studies have been published based solely on DFA and none included respiratory picornaviruses and human metapneumovirus (hMPV). We wished to evaluate the use of DFA for epidemiological studies with a long-term observation of respiratory viruses that includes both respiratory picornaviruses and hMPV. Methods Since 1998 all children hospitalized with respiratory illness at the University Hospital Bern have been screened with DFA for common respiratory viruses including adenovirus, respiratory syncytial virus (RSV), influenza A and B, and parainfluenza virus 1-3. In 2006 assays for respiratory picornaviruses and hMPV were added. Here we describe the epidemiological pattern for these respiratory viruses detected by DFA in 10'629 nasopharyngeal aspirates collected from 8'285 patients during a 12-year period (1998-2010). Results Addition of assays for respiratory picornaviruses and hMPV raised the proportion of positive DFA results from 35% to 58% (p < 0.0001). Respiratory picornaviruses were the most common viruses detected among patients ≥1 year old. The seasonal patterns and age distribution for the studied viruses agreed well with those reported in the literature. In 2010, an hMPV epidemic of unexpected size was observed. Conclusions DFA is a valid, rapid, flexible and inexpensive method. The addition of assays for respiratory picornaviruses and hMPV broadens its range of viral detection. DFA is, even in the "PCR era", a particularly adapted method for the long term surveillance of respiratory viruses in a pediatric population.
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Affiliation(s)
- Christine D Sadeghi
- Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, CH-3010 Bern, Switzerland
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Williams JV, Crowe JE. Reply to Schlapbach et al. J Infect Dis 2011. [DOI: 10.1093/infdis/jiq046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Jokela P, Piiparinen H, Luiro K, Lappalainen M. Detection of human metapneumovirus and respiratory syncytial virus by duplex real-time RT-PCR assay in comparison with direct fluorescent assay. Clin Microbiol Infect 2010; 16:1568-73. [DOI: 10.1111/j.1469-0691.2010.03191.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Schindera C, Kraemer AL, Regamey N, Aebi C, Gorgievski-Hrisoho M, Barbani MT. Immunofluorescence versus xTAG multiplex PCR for the detection of respiratory picornavirus infections in children. J Clin Virol 2010; 48:223-5. [PMID: 20471907 PMCID: PMC7172693 DOI: 10.1016/j.jcv.2010.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2009] [Revised: 01/14/2010] [Accepted: 04/09/2010] [Indexed: 11/27/2022]
Abstract
Background Polymerase chain reaction (PCR) is a sensitive tool for detection of respiratory picornaviruses. However, the clinical relevance of picornavirus detection by PCR is unclear. Immunofluorescence (IF), widely used to detect other respiratory viruses, has recently been introduced as a promising detection method for respiratory picornaviruses. Objectives To compare the clinical manifestations of respiratory picornavirus infections detected by IF with those of respiratory picornavirus infections detected by xTAG multiplex PCR in hospitalized children. Study design During a 1-year period, nasopharyngeal aspirates (NPA) from all children hospitalized due to an acute respiratory infection were prospectively analyzed by IF. All respiratory picornavirus positive IF samples and 100 IF negative samples were further tested with xTAG multiplex PCR. After exclusion of children with co-morbidities and viral co-infections, monoinfections with respiratory picornaviruses were detected in 108 NPA of 108 otherwise healthy children by IF and/or PCR. We compared group 1 children (IF and PCR positive, n = 84) with group 2 children (IF negative and PCR positive, n = 24) with regard to clinical manifestations of the infection. Results Wheezy bronchitis was diagnosed more often in group 1 than in group 2 (71% vs. 46%, p = 0.028). In contrast, group 2 patients were diagnosed more frequently with pneumonia (17% vs. 6%, p = 0.014) accompanied by higher levels of C-reactive protein (46 mg/l vs. 11 mg/l, p = 0.009). Conclusions Picornavirus detection by IF in children with acute respiratory infection is associated with the clinical presentation of wheezy bronchitis. The finding of a more frequent diagnosis of pneumonia in picornavirus PCR positive but IF negative children warrants further investigation.
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Affiliation(s)
- Christina Schindera
- University Children's Hospital, Inselspital, and Institute of Infectious Diseases, University of Bern, Freiburgstrasse 3, 3010 Bern, Switzerland
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Abstract
In most hospitals, clinics, and doctor's offices, immunologic assays are the only tests performed on site for the diagnosis of respiratory viruses. More than other methods, immunoassays have been shown to affect patient management and save costs, aiding early administration of antiviral therapy, reduction in unnecessary tests and antibiotics, and earlier discharges. This article discusses the major immunologic methods employed for respiratory virus diagnosis, recent developments in immunoassays and sample collection, and current test algorithms.
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Affiliation(s)
- Marie Louise Landry
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT 06520-8035, USA.
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Wolf DG, Greenberg D, Shemer-Avni Y, Givon-Lavi N, Bar-Ziv J, Dagan R. Association of human metapneumovirus with radiologically diagnosed community-acquired alveolar pneumonia in young children. J Pediatr 2010; 156:115-20. [PMID: 19782998 PMCID: PMC7126976 DOI: 10.1016/j.jpeds.2009.07.014] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2009] [Revised: 05/26/2009] [Accepted: 07/06/2009] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To determine the involvement of human metapneumovirus (HMPV) in childhood community-acquired alveolar pneumonia (CAAP) and compare the demographic, clinical, and laboratory features of HMPV-associated CAAP and CAAP associated with other respiratory viruses. STUDY DESIGN Nasopharyngeal wash specimens obtained prospectively over a 4-year period from children age < 5 years evaluated in the emergency department with radiologically diagnosed CAAP and from healthy controls were tested for HMPV by reverse-transcriptase polymerase chain reaction and for respiratory syncytial virus (RSV), adenovirus, influenza and parainfluenza viruses by direct immunofluorescence and culture. RESULTS HMPV was detected in 108 of 1296 patients (8.3%) versus RSV in 23.1%, adenovirus in 3.4%, influenza A virus in 2.9%, and parainfluenza viruse in 2.9%. During the period of peak activity (November to May), HMPV was detected in 95 of 1017 patients (9.3%) and in 3 of 136 controls (2.2%) (P = .005). The patients with HMPV were older than those with RSV (P < .001) with a more common history of acute otitis media requiring tympanocentesis (P = .032), wheezing (P = .001) and gastrointestinal symptoms (P < .001) and a lower hospitalization rate (P = .005). CONCLUSIONS The high detection rate suggests an important role for HMPV in childhood CAAP. Our findings identify demographic and clinical features of HMPV-positive CAAP and its age-related impact on hospital admissions.
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Key Words
- caap, community-acquired alveolar pneumonia
- crp, c-reactive protein
- dfa, direct immunofluorescence assay
- ed, emergency department
- hmpv, human metapneumovirus
- hmpvco, hmpv copathogen
- lrti, lower respiratory tract infection
- pcr, polymerase chain reaction
- rsv, respiratory syncytial virus
- rt-pcr, reverse-transcriptase polymerase chain reaction
- wbc, white blood cell
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Affiliation(s)
- Dana G Wolf
- Department of Clinical Microbiology & infectious Diseases, Hadassah University Medical Center, Jerusalem, Israel.
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Evaluation of a new rapid antigen test using immunochromatography for detection of human metapneumovirus in comparison with real-time PCR assay. J Clin Microbiol 2009; 47:2981-4. [PMID: 19571031 DOI: 10.1128/jcm.00321-09] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A new rapid human metapneumovirus (hMPV) detection kit using immunochromatography (SAS hMPV test) was compared to real-time PCR for 224 nasal swab specimens, 96.4% of which were obtained from children of <15 years of age. The overall sensitivity and specificity were 82.3% and 93.8%, respectively, suggesting that this test is useful for pediatricians to diagnose hMPV infection in a clinical setting.
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Barbani MT, Gorgievski-Hrisoho M. Rapid detection of respiratory picornaviruses in nasopharyngeal aspirates by immunofluorescence assay. J Clin Virol 2009; 45:245-8. [PMID: 19502108 PMCID: PMC7172351 DOI: 10.1016/j.jcv.2009.05.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2009] [Revised: 04/03/2009] [Accepted: 05/06/2009] [Indexed: 10/25/2022]
Abstract
BACKGROUND Respiratory picornaviruses (enteroviruses and rhinoviruses) are commonly cited as causes of self-limited upper respiratory tract infection. However, it has recently been suggested that they may cause more severe respiratory disease. Immunofluorescence (IF) assays are rapid and inexpensive and are often used for the detection of respiratory viruses. OBJECTIVES We sought to develop an IF procedure, using commercially available reagents, for the detection of respiratory picornaviruses directly from nasopharyngeal aspirates (NPA). STUDY DESIGN From 1st November 2006 until 31st October 2007 all NPA from patients with respiratory infection were stained with the Light Diagnostic Pan-Enterovirus Reagent - "Blend" by IF (IF-ENVPAN). Those specimens which tested positive with this stain were further tested (subject to the availability of frozen specimen) with the xTAG respiratory viral panel, a multiplex PCR directed against respiratory picornaviruses, adenovirus (ADV), respiratory sincytial virus (RSV), influenza viruses A and B (IFA and IFB), parainfluenza virus (PIV) 1-4, human metapneumovirus (HMPV) and coronaviruses. RESULTS 241/1122 NPA tested positive by IF-ENVPAN. 143 NPA were available for testing by xTAG respiratory viral panel. The multiplex PCR detected respiratory picornaviruses in 139 NPA, in 126 as the sole viral pathogen. CONCLUSIONS Our results indicate the potential of IF-ENVPAN for the laboratory detection of respiratory picornaviruses in clinical specimens. As far as we are aware, this is the first publication of such a method.
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Virtue ER, Marsh GA, Wang LF. Paramyxoviruses infecting humans: the old, the new and the unknown. Future Microbiol 2009; 4:537-54. [DOI: 10.2217/fmb.09.26] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Prior to the emergence of Hendra virus in Australia in 1994, paramyxoviruses were considered to be a taxonomic group of ubiquitous pathogens, consisting primarily of Biosafety Level 2 agents, which possessed narrow host ranges and often caused only mild or preventable diseases in humans and animals. In recent years, a number of Paramyxoviridae members have emerged, including previously unrecognized human pathogens and highly pathogenic zoonoses. The recent emergence of paramyxoviruses in humans suggests that there is an increased incidence of zoonotic transmission between wildlife, livestock and human hosts. This article explores the current body of scientific knowledge, disease burden and knowledge of reservoirs of these emerging paramyxoviruses and provides a comparative review of both older and emerging viruses that have been shown to infect humans.
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Affiliation(s)
- Elena R Virtue
- CSIRO Livestock Industries, Australian Animal Health Laboratory (AAHL), Geelong, VIC, Australia and, Australian Biosecurity Cooperative Research Centre for Emerging Infectious Disease and, Department of Microbiology and Immunology, The University of Melbourne, Parkville, VIC, Australia
| | - Glenn A Marsh
- CSIRO Livestock Industries, Australian Animal Health Laboratory (AAHL), Geelong, VIC, Australia
| | - Lin-Fa Wang
- CSIRO Livestock Industries, Australian Animal Health Laboratory, PO Bag 24, Geelong, VIC 3220, Australia, and, Australian Biosecurity Cooperative Research Centre for Emerging Infectious Disease and, Department of Microbiology and Immunology, The University of Melbourne, Parkville, VIC, Australia
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Chun JK, Lee JH, Kim HS, Cheong HM, Kim KS, Kang C, Kim DS. Establishing a surveillance network for severe lower respiratory tract infections in Korean infants and young children. Eur J Clin Microbiol Infect Dis 2009; 28:841-4. [PMID: 19190941 PMCID: PMC7088216 DOI: 10.1007/s10096-009-0701-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2008] [Accepted: 01/05/2009] [Indexed: 11/29/2022]
Abstract
To reduce morbidity and mortality through integrated case management, a pilot study to detect respiratory viruses in patients with acute lower respiratory infections (ALRIs) was designed as part of a nationwide surveillance for this disease in Korea. The study population consisted of hospitalized patients under the age of 5 years with bronchiolitis, pneumonia, croup, or acute respiratory distress syndrome. A prospective 6-month study was performed. Two hundred and ninety-seven nasopharyngeal secretions were collected and multiplex reverse transcriptase polymerase chain reactions (RT-PCR)/polymerase chain reactions (PCR) were performed to detect respiratory viruses. If there were any positive RT-PCR/PCR results, viral cultures were proceeded for confirmation. Respiratory viruses were identified in 49.6% of 296 patients. The detection rates were as follows: respiratory syncytial virus (RSV) was the most commonly detected in 52.7% (87/165), human metapneumovirus (hMPV) in 15.8%, human corona virus (hCoV) in 5.5%, adenovirus in 9.7%, human bocavirus (hBoV) in 5.5%, parainfluenza virus (PIV) in 3.6%, rhinovirus (RV) in 4.2%, and the influenza virus in 3% of the patients with ALRIs. The consistent rate of positive results between RT-PCR and viral culture was 92% (105/114). Using our methods to detect viral causes seemed to be acceptable for the national surveillance of severe acute respiratory infections in infants and children.
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Affiliation(s)
- J-K Chun
- Department of Pediatrics, Yonsei University College of Medicine, Severance Children's Hospital, 250 Seongsanno, Seodaemun-gu, Seoul, 120-752, South Korea
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Kukavica-Ibrulj I, Boivin G. Detection of human metapneumovirus antigens in nasopharyngeal aspirates using an enzyme immunoassay. J Clin Virol 2008; 44:88-90. [PMID: 19010729 PMCID: PMC7108374 DOI: 10.1016/j.jcv.2008.09.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2008] [Revised: 09/29/2008] [Accepted: 09/29/2008] [Indexed: 11/25/2022]
Abstract
BACKGROUND Human metapneumovirus (hMPV) is associated with acute respiratory tract infections (ARTI) in patients from all age groups. OBJECTIVE To evaluate the performance of a rapid antigenic test for all hMPV genotypes. STUDY DESIGN Frozen nasopharyngeal aspirates from 93 individuals with ARTI were analyzed for the presence of hMPV antigens using an enzyme immunoassay (EIA, Biotrin Ltd.). RESULTS The hMPV EIA showed a sensitivity of 81%, a specificity of 100%, a positive predictive value of 100% and a negative predictive value of 77% compared to viral culture and RT-PCR. CONCLUSION The Biotrin hMPV EIA is a convenient alternative to cell culture for detection of hMPV with an excellent specificity.
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Affiliation(s)
- Irena Kukavica-Ibrulj
- Research Center in Infectious Diseases of the Centre Hospitalier Universitaire de Québec and Laval University, Quebec City, Quebec, Canada
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