title: Diagnosis of human metapneumovirus by immunofluorescence staining with monoclonal antibodies in the North-East of England.
abstract: BACKGROUND
  Since its discovery in 2001 human metapneumovirus (hMPV) has been shown to be a significant cause of human respiratory disease, responsible for 5-8% of respiratory infections in hospitalised children. Diagnosis hitherto has been largely carried out by reverse tanscriptase polymerase chain reaction (RT-PCR) but immunofluorescence staining of cells from nasopharyngeal secretions (IF) offers advantages for some laboratories and may produce a more rapid result in urgent cases. We have recently demonstrated that IF with a rabbit antiserum gave sensitivity equal to that of RT-PCR. However, monoclonal antibodies offer a more plentiful, uniform IF reagent.
  
  
  OBJECTIVE
  Here we have evaluated a pool of anti-hMPV monoclonal antibodies in the routine diagnosis of respiratory infections in hospitalised infants and children.
  
  
  METHODS
  Eight hundred and fifty-seven routine respiratory specimens were tested by IF with rabbit polyclonal antiserum and monoclonal antibody pool in parallel. A further 1003 specimens were tested with the monoclonal antibody pool alone. All specimens were also tested for a panel of other respiratory viruses by IF.
  
  
  RESULTS
  Both rabbit polyclonal antiserum and monoclonal antibody pool gave positive results in 56 and negative results in 797 specimens. The rabbit polyclonal antibody detected virus in a further two specimens which were negative when tested with the monoclonal pool giving a concordance of 96.6% and a specificity of 100% for the monoclonal antibody pool. Overall hMPV was detected in 5% of specimens whilst 18.4% were positive for hRSV.
  
  
  CONCLUSIONS
  The monoclonal antibody pool-based IF is a robust assay suitable for routine use with a sensitivity only slightly less than that of the other major diagnostic methodologies available.
authors.affiliation: The School of Clinical Medical Sciences, The University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4HH, United Kingdom.
authors.forename: F
authors.initials: F
authors.lastname: Fenwick
authors.forename: B
authors.initials: B
authors.lastname: Young
authors.forename: R
authors.initials: R
authors.lastname: McGuckin
authors.forename: M J
authors.initials: MJ
authors.lastname: Robinson
authors.forename: Y
authors.initials: Y
authors.lastname: Taha
authors.forename: C E
authors.initials: CE
authors.lastname: Taylor
authors.forename: G L
authors.initials: GL
authors.lastname: Toms
mesh_terms: D000911:Antibodies, Monoclonal / Q000276:immunology; D000914:Antibodies, Viral / Q000276:immunology; D000956:Antigens, Viral / Q000032:analysis*; D002460:Cell Line; D002648:Child; D002675:Child, Preschool; D005260:Female; D005455:Fluorescent Antibody Technique / Q000379:methods; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D029121:Metapneumovirus / Q000276:immunology / Q000302:isolation & purification*; D018184:Paramyxoviridae Infections / Q000175:diagnosis* / Q000821:virology; D012680:Sensitivity and Specificity; D006113:United Kingdom
chemical_list: D000911:Antibodies, Monoclonal; D000914:Antibodies, Viral; D000956:Antigens, Viral