title: Identification of adenovirus, influenza virus, parainfluenza virus, and respiratory syncytial virus by two kinds of multiplex polymerase chain reaction (PCR) and a shell vial culture in pediatric patients with viral pneumonia.
abstract: OBJECTIVE
  Early identification of causative agents in lower respiratory infection of pediatric patients can reduce morbidity and prevent an overuse of antimicrobials. Two kinds of multiplex polymerase chain reaction (PCR) and a commercial shell vial viral culture were performed to identify causative agents in pediatric patients.
  
  
  METHODS
  Nasopharyngeal aspirates of 220 children diagnosed with viral pneumonia were obtained. Two kinds of multiplex PCR (Seeplex(TM) RV detection kit, and Labopass(TM) RV detection kit), and a shell vial culture by R-Mix were performed.
  
  
  RESULTS
  Positive samples from 220 total samples by two multiplex PCRs were 52.7% and 46.4%, respectively. We also cultured 103 samples that showed positive results of the adenovirus, influenza virus, parainfluenza virus, and respiratory syncytial virus (RSV) by two multiplex PCR. The RSV was most frequently detected in 53.0% (Seeplex) and 51.7% (Labopass) of patients. The detection rate of adenovirus (AdV) was 10.3% and 12.1%, influenza virus (IFV) A and B was 12.5% and 3.4%, and parainfluenza virus (PIFV) 1, 2, and 3 were 2.9% and 2.6%. Shell vial cultures showed concordant results with each multiplex PCR by 96.1% and 77.7%, respectively. Sequencing results were 90% consistent with multiplex PCR.
  
  
  CONCLUSIONS
  Multiplex PCR showed more positivity than the shell vial culture and it can be an effective primary test. Other complementary efforts such as viral cultures and sequencing analysis could be considered, according to clinical and laboratory conditions.
authors.affiliation: Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jong-Han
authors.initials: JH
authors.lastname: Lee
authors.forename: Jin-Kyong
authors.initials: JK
authors.lastname: Chun
authors.forename: Dong Soo
authors.initials: DS
authors.lastname: Kim
authors.forename: Yongjung
authors.initials: Y
authors.lastname: Park
authors.forename: Jong Rak
authors.initials: JR
authors.lastname: Choi
authors.forename: Hyon-Suk
authors.initials: HS
authors.lastname: Kim
mesh_terms: D000256:Adenoviridae / Q000235:genetics / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009975:Orthomyxoviridae / Q000235:genetics / Q000302:isolation & purification*; D011024:Pneumonia, Viral / Q000821:virology*; D016133:Polymerase Chain Reaction / Q000379:methods*; D012136:Respiratory Syncytial Viruses / Q000235:genetics / Q000302:isolation & purification*; D018108:Respirovirus / Q000235:genetics / Q000302:isolation & purification*