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Clinical Trial
. 2017 Aug:61:97-102.
doi: 10.1016/j.ijid.2017.06.011. Epub 2017 Jun 15.

Surveillance of upper respiratory infections using a new multiplex PCR assay compared to conventional methods during the influenza season in Taiwan

Shu-Chun Chiu  1 , Yung-Cheng Lin  2 , Hsiao-Chi Wang  3 , Jen-Jen Hsu  1 , Ting-Kai Yeh  1 , Hsin-Fu Liu  4 , Jih-Hui Lin  5
Affiliations
Clinical Trial

Surveillance of upper respiratory infections using a new multiplex PCR assay compared to conventional methods during the influenza season in Taiwan

Shu-Chun Chiu et al. Int J Infect Dis. 2017 Aug.

Abstract

Objectives: To improve diagnosis as part of laboratory surveillance in Taiwan, influenza-like illness (ILI) surveillance was conducted using a new multiplex PCR assay (FilmArray) and the results compared to those of conventional methods The study was performed during the winter months.

Methods: Throat swabs from patients with an ILI presenting to physicians in sentinel practices were collected during the 2016-2017 influenza season.

Results: A total of 52 samples tested positive by FilmArray Respiratory Panel. Forty percent were influenza A virus, and subtype H3N2 virus was the major epidemic strain. However, nearly 60% of ILI cases seen at sentinel sites were caused by non-influenza pathogens. The results of the FilmArray assay and cell culture were identical, and this assay was more sensitive than a rapid influenza diagnostic test. Genetic analyses revealed new influenza A H3N2 variants belonging to a novel subclade 3C.2a2.

Conclusions: The FilmArray assay facilitates urgent testing and laboratory surveillance for common viral and bacterial respiratory pathogens. This study demonstrated the use of a highly sensitive assay using clinical samples that is feasible for application worldwide. This may lead to an increased rate of diagnosis of viral infections and to improved patient outcomes, and in particular to a reduction in the overuse of antibiotics and antivirals.

Keywords: Influenza virus; Multiplex PCR; Taiwan; URI.

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Figures

Figure 1
Figure 1
Molecular phylogenetic analysis by maximum likelihood method. The evolutionary history was inferred using the maximum likelihood method based on the Tamura–Nei model. Numbers to the left of the nodes are bootstrap percentages (1000 replications). Bootstrap values of less than 70 are not shown. Initial tree(s) for the heuristic search were obtained automatically by applying the Neighbor-Join and BioNJ algorithms to a matrix of pairwise distances estimated using the maximum composite likelihood (MCL) approach, and then selecting the topology with superior log likelihood value. The tree is drawn to scale, with branch lengths measured in the number of substitutions per site. Evolutionary analyses were conducted in MEGA 6.
Figure 2
Figure 2
Schematic illustration of the workflow for the detection of common upper respiratory infection pathogens. Sample processing steps include virus isolation from the clinical sample, followed by immunofluorescence assay (IFA) identification when a cytopathic effect (CPE) is observed. The IFA untypeable viruses or pathogens are then detected by RT-PCR and sequencing.
See this image and copyright information in PMC

References

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