Immunofluorescence versus xTAG multiplex PCR for the detection of respiratory picornavirus infections in children.
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.


OBJECTIVE
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.


METHODS
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.
Schindera
Christina
C
University Children's Hospital, Inselspital, and Institute of Infectious Diseases, University of Bern, Freiburgstrasse 3, 3010 Bern, Switzerland.
Kraemer
Ann Lea
AL
Regamey
Nicolas
N
Aebi
Christoph
C
Gorgievski-Hrisoho
Meri
M
Barbani
Maria Teresa
MT
D002648:Child; D002675:Child, Preschool; D005455:Fluorescent Antibody Technique / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009305:Nasopharynx / Q000821:virology; D010849:Picornaviridae / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D010850:Picornaviridae Infections / Q000175:diagnosis* / Q000821:virology; D016133:Polymerase Chain Reaction / Q000379:methods*; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000821:virology; D012680:Sensitivity and Specificity; D014773:Virology / Q000379:methods*
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