title: Immunofluorescence versus xTAG multiplex PCR for the detection of respiratory picornavirus infections in children.
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.
  
  
  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.
authors.affiliation: University Children's Hospital, Inselspital, and Institute of Infectious Diseases, University of Bern, Freiburgstrasse 3, 3010 Bern, Switzerland.
authors.forename: Christina
authors.initials: C
authors.lastname: Schindera
authors.forename: Ann Lea
authors.initials: AL
authors.lastname: Kraemer
authors.forename: Nicolas
authors.initials: N
authors.lastname: Regamey
authors.forename: Christoph
authors.initials: C
authors.lastname: Aebi
authors.forename: Meri
authors.initials: M
authors.lastname: Gorgievski-Hrisoho
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Barbani
mesh_terms: 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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