Viral etiology of acute respiratory tract infections in children presenting to hospital: role of polymerase chain reaction and demonstration of multiple infections.
BACKGROUND
Viral lower respiratory tract infections are a leading cause of hospitalization for young children.


METHODS
We used polymerase chain reaction (PCR) and conventional methods of cell culture and antigen detection to establish the viral etiology of acute respiratory tract infections in 75 hospitalized children.


RESULTS
One or more viral pathogens were detected in 65 (87%) children, with respiratory syncytial virus being the most commonly identified virus (36 children). Other viruses identified included influenza virus types A and B, parainfluenzavirus type 3, adenovirus, enterovirus, rhinovirus, coronavirus and human metapneumovirus. PCR increased the diagnostic yield significantly compared with antigen detection and culture, with 39 (21%) diagnoses identified by this method. Multiple infections were identified in 20 (27%) children.


CONCLUSIONS
PCR-based methodologies offer increased sensitivity for the detection of most respiratory viruses in young children. The inclusion of PCR into diagnostic testing strategies is needed to broaden our understanding of the natural ecology of respiratory viruses and the significance of multiple infections.
Jennings
Lance C
LC
Microbiology Unit, Canterbury Health Laboratories, Christchurch School of Medicine and Health Sciences, University of Otago, Christchurch, New Zealand.
Anderson
Trevor P
TP
Werno
Anja M
AM
Beynon
Kirsten A
KA
Murdoch
David R
DR
D000208:Acute Disease; D017677:Age Distribution; D000998:Antiviral Agents / Q000008:administration & dosage; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009975:Orthomyxoviridae / Q000145:classification* / Q000187:drug effects; D016133:Polymerase Chain Reaction; D011336:Probability; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology*; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D017678:Sex Distribution
D000998:Antiviral Agents