title: RT-PCR detection of respiratory pathogens in newborn children admitted to a neonatal medium care unit.
abstract: BACKGROUND
  This study aimed to determine the prevalence of respiratory pathogens among newborns admitted to a neonatal medium care unit (NMCU) and to identify clinical predictors.
  
  
  METHODS
  A 1-y observational study was performed of neonates admitted to an NMCU in Amsterdam, The Netherlands. Nasopharyngeal samples were collected for the detection of respiratory viruses and bacteria by real-time PCR (RT-PCR). Cycle threshold (Ct) values were provided to estimate viral load. Predictors for the presence of study pathogens were identified.
  
  
  RESULTS
  From October 2010 through September 2011, 334 neonates (median age 1.3 d, 53.6% male) were included. Overall, 37 respiratory pathogens were detected in 34 children (10.2%): parainfluenza-1 (n = 9), human rhinovirus (n = 7), parainfluenza-3 (n = 6), respiratory syncytial virus (RSV, n = 6), Streptococcus pneumoniae (n = 3), adenovirus (n = 2), human coronavirus (n = 2), influenza A (n = 1), and bocavirus (n = 1). Neonates with higher viral loads (Ct <35; n = 11) were more often clinically ill than those with lower viral loads (Ct ≥35; n = 23). Two variables significantly contributed to the detection of study pathogens: age (odds ratio (OR) 1.21 for each day older; 95% confidence interval 1.12-1.30) and rhinorrhea (OR 6.71; 95% confidence interval 1.54-29.21).
  
  
  CONCLUSIONS
  Respiratory pathogens seem to play a role in neonates admitted to an NMCU. The influence of respiratory pathogen detection on clinical management remains to be determined.
authors.affiliation: Department of Internal Medicine, Slotervaart Hospital, Amsterdam, The Netherlands. patrickmsmit@gmail.com
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Smit
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Pronk
authors.forename: Jos C
authors.initials: JC
authors.lastname: Kaandorp
authors.forename: Olivier
authors.initials: O
authors.lastname: Weijer
authors.forename: Fanny N
authors.initials: FN
authors.lastname: Lauw
authors.forename: Paul H M
authors.initials: PH
authors.lastname: Smits
authors.forename: Eric C J
authors.initials: EC
authors.lastname: Claas
authors.forename: Jan W
authors.initials: JW
authors.lastname: Mulder
authors.forename: Jos H
authors.initials: JH
authors.lastname: Beijnen
authors.forename: Dees P M
authors.initials: DP
authors.lastname: Brandjes
mesh_terms: D000367:Age Factors; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009305:Nasopharynx / Q000382:microbiology* / Q000821:virology*; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D011181:Postnatal Care; D060888:Real-Time Polymerase Chain Reaction; D012141:Respiratory Tract Infections / Q000453:epidemiology*; D019562:Viral Load