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Identification of respiratory virus in infants with congenital heart disease by comparison of different methods
Tatiana Mitiko Kanashiro1, Lucy Santos Vilas Boas, Ana Maria Thomaz
1Laboratório de Virologia, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, SP, Brazil.
Insights
Diagnosing respiratory viruses in infants with congenital heart disease (CHD) is crucial. Multiplex PCR and PCR showed higher detection rates than direct immunofluorescence assay (DFA), suggesting combination testing improves diagnosis.
Area of Science:
- Pediatric Infectious Diseases
- Molecular Diagnostics
- Cardiology
Background:
- Respiratory virus infections are a primary cause of infant hospitalization.
- These infections pose significant risks for infants with congenital heart disease (CHD).
- Timely diagnosis is essential for effective antiviral treatment and infection control.
Purpose of the Study:
- To compare the diagnostic performance of Multiplex PCR, PCR, and direct immunofluorescence assay (DFA) for respiratory viruses in infants with CHD.
- To evaluate the sensitivity and concordance of these diagnostic methods.
- To determine the optimal diagnostic strategy for respiratory infections in this vulnerable population.
Main Methods:
- Nasopharyngeal aspirate samples were collected from 39 infants with CHD and respiratory symptoms.
- Multiplex PCR (Seeplex® RV 12 ACE Detection) was used to detect 12 respiratory viruses.
- Direct immunofluorescence assay (DFA) and standard PCR were employed to detect seven respiratory viruses.
Main Results:
- Multiplex PCR detected 51.3% of infections, PCR detected 48.7%, and DFA detected 33.3%.
- Both Multiplex PCR (p = 0.001) and PCR (p = 0.002) showed significantly higher detection rates than DFA.
- Moderate concordance was observed between the tested methods (Kappa indices ranging from 0.483 to 0.542).
Conclusions:
- Multiplex PCR and PCR offer superior sensitivity for diagnosing respiratory viruses in infants with CHD compared to DFA.
- Combining diagnostic techniques may enhance sensitivity, aid in co-infection detection, and facilitate prompt treatment.
- Improved diagnostic strategies are vital for reducing morbidity and mortality in CHD infants with respiratory infections.
Abstract:
Respiratory virus infections are the main cause of infant hospitalization and are potentially severe in children with congenital heart disease (CHD). Rapid and sensitive diagnosis is very important to early introduction of antiviral treatment and implementation of precautions to control transmission, reducing the risk of nosocomial infections. In the present study we compare different techniques in the diagnosis of respiratory viruses in CHD infants. Thirty-nine samples of nasopharyngeal aspirate were obtained from CHD infants with symptoms of respiratory infection. The Multiplex PCR (Seeplex® RV 12 ACE Detection) driven to the detection of 12 respiratory viruses was compared with the direct immunofluorescence assay (DFA) and PCR, both targeting seven respiratory viruses. The positivity found by DFA, Multiplex and PCR was 33.3%, 51.3% and 48.7%, respectively. Kappa index comparing DFA and Multiplex, DFA and PCR and PCR and Multiplex PCR was 0.542, 0.483 and 0.539, respectively. The concordance between techniques was considered moderate. Both Multiplex PCR (p = 0.001) and PCR (p = 0.002) detected significantly more respiratory virus than DFA. As the performance of the tests may vary, the combination of two or more techniques may increase diagnostic sensitivity favoring the diagnosis of co-infections, early introduction of antiviral therapy and implementation of appropriate measures.
