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. 2020 Jan 15;17(2):564.
doi: 10.3390/ijerph17020564.

Increased Detection of Viruses in Children with Respiratory Tract Infection Using PCR

Chien-Yu Lin  1   2 , David Hwang  3 , Nan-Chang Chiu  2   3   4 , Li-Chuan Weng  5 , Hsin-Fu Liu  5 , Jung-Jung Mu  6 , Chang-Pan Liu  2   4   5 , Hsin Chi  2   3   4   5
Affiliations

Increased Detection of Viruses in Children with Respiratory Tract Infection Using PCR

Chien-Yu Lin et al. Int J Environ Res Public Health. .

Abstract

Respiratory viruses are a common cause of respiratory tract infection (RTI), particularly in neonates and children. Rapid and accurate diagnosis of viral infections could improve clinical outcomes and reduce the use of antibiotics and treatment sessions. Advances in diagnostic technology contribute to the accurate detection of viruses. We performed a multiplex real-time polymerase chain reaction (PCR) to investigate the viral etiology in pediatric patients and compared the detection rates with those determined using traditional antigen tests and virus cultures. Fifteen respiratory viruses were included in our investigation: respiratory syncytial virus A/B (RSV), influenza virus A (FluA) and influenza virus B (FluB), human metapneumovirus (MPV), enterovirus (EV), human parainfluenza virus (PIV) types 1-4, human rhinovirus (RV), human coronavirus OC43, NL63, and 229E, human adenovirus (ADV), and human bocavirus (Boca). In total, 474 specimens were collected and tested. Respiratory viruses were detected more frequently by PCR (357, 75.3%) than they were by traditional tests (229, 49.3%). The leading pathogens were RSV (113, 23.8%), RV (72, 15.2%), PIV3 (53, 11.2%), FluA (51, 10.8%), and ADV (48, 10.1%). For children younger than 5 years, RSV and RV were most prevalent; for children older than 5 years, FluA and ADV were the most frequently detected. Of the specimens, 25.8% (92/357) were coinfected with two or more viruses. RV, Boca, PIV2, FluB, and PIV4 had higher rates of coinfection; MPV and PIV1 had the lowest rates of coinfection (9.1% and 5.3%). To conclude, the detection power of PCR was better than that of traditional antigen tests and virus cultures when considering the detection of respiratory viruses. RSV and RV were the leading viral pathogens identified in the respiratory specimens. One-quarter of the positive specimens were coinfected with two or more viruses. In the future, further application of PCR may contribute to the rapid and accurate diagnosis of respiratory viruses and could improve patient outcomes.

Keywords: PCR; human metapneumovirus; multiplex quantitative real-time RT-PCR; polymerase chain reaction; respiratory syncytial virus; respiratory virus.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Number of respiratory viruses detected by PCR.
Figure 2
Figure 2
Seasonal distribution of respiratory viruses detected by PCR. (Abbreviations: 229E: coronavirus 229E; ADV: human adenovirus; Boca: human bocavirus; EV: human enterovirus; Flu: influenza virus; MPV: human metapneumovirus; NL63: coronavirus NL63; OC43: coronavirus OC43; PIV: human parainfluenza virus; RSV: respiratory syncytial virus; RV: human rhinovirus).
Figure 3
Figure 3
The distribution of respiratory viruses among different age groups. (Abbreviations: 229E: coronavirus 229E; ADV: human adenovirus; Boca: human bocavirus; EV: human enterovirus; Flu: influenza virus; MPV: human metapneumovirus; NL63: coronavirus NL63; OC43: coronavirus OC43; PIV: human parainfluenza virus; RSV: respiratory syncytial virus; RV: human rhinovirus).
See this image and copyright information in PMC

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