The value of polymerase chain reaction for the diagnosis of viral respiratory tract infections in lung transplant recipients.
BACKGROUND
Respiratory viruses cause severe infections in lung transplant recipients, which require rapid and accurate diagnosis for appropriate management.


OBJECTIVE
To evaluate the added benefit of a multiplex PCR for respiratory viruses (influenza [FLU] A and B, respiratory syncytial virus [RSV] A and B and parainfluenza virus [PIV] 1, 2, and 3) complementing rapid respiratory viral culture (RRV) and FLU-A antigen detection (EIA) in this transplant population.


RESULTS
Over 6 months, 116 nasal washes and bronchoalveolar lavages, obtained from 72 lung transplant recipients with symptoms of upper or lower respiratory tract infections, were tested in real time by RRV and FLU-A EIA, and batched frozen by PCR. One or more methods recognized a respiratory virus in 31 (27%) specimens, including 15 FLU-A, nine RSV and seven PIV. PCR identified 26 of 31 positive samples demonstrating a sensitivity of 84%, higher than RRV (67%) or EIA (54%). PCR, RRV and EIA detected 60, 80 and 54%, respectively, FLU-A samples. PCR and RRV were equivalent for RSV-A, PIV-2 and 3, but PCR found a significantly higher number of RSV-B and PIV-1.


CONCLUSIONS
These data indicate that routine use of PCR will enhance the number and speed with which viral respiratory tract infections are diagnosed in lung transplant recipients.
D000328:Adult; D002460:Cell Line; D006801:Humans; D007124:Immunoenzyme Techniques; D009980:Influenza A virus / Q000302:isolation & purification; D009981:Influenza B virus / Q000302:isolation & purification; D016040:Lung Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods*; D018113:Respiratory Syncytial Virus, Human / Q000302:isolation & purification; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000821:virology; D018108:Respirovirus / Q000302:isolation & purification; D012680:Sensitivity and Specificity; D014776:Virus Cultivation; D014777:Virus Diseases / Q000175:diagnosis*