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Diagnostic value of respiratory virus detection in symptomatic children using real-time PCR
Elisabeth G Huijskens1, Renée C Biesmans, Anton G Buiting
1Laboratory of Medical Microbiology and Immunology, St Elisabeth Hospital, Tilburg, The Netherlands. i.huijskens@gmail.com
Insights
Molecular testing for common respiratory pathogens in children with respiratory symptoms identified frequent viral infections, particularly respiratory syncytial virus and human rhinovirus. Early detection is linked to younger age and more severe symptoms, but did not alter antibiotic management.
Area of Science:
- Pediatric infectious diseases
- Molecular diagnostics
- Respiratory pathogen detection
Background:
- Acute respiratory tract infections (ARTIs) pose a significant public health challenge.
- Rapid and sensitive diagnostic methods are crucial for clinical practice.
- This study assesses the clinical relevance of detecting 20 common respiratory pathogens using molecular techniques in a pediatric setting.
Purpose of the Study:
- To evaluate the clinical utility of molecular detection of common respiratory pathogens in children presenting with respiratory symptoms.
- To understand the prevalence and clinical characteristics associated with specific respiratory pathogen detection.
Main Methods:
- A retrospective study involving 177 pediatric patients (<18 years) with respiratory symptoms.
- Nasopharyngeal samples were analyzed using real-time polymerase chain reaction (PCR) for 19 viruses and Mycoplasma pneumoniae.
- Clinical data, including symptoms and hospitalization, were collected and analyzed.
Main Results:
- 73% of patients tested positive for at least one respiratory pathogen.
- Respiratory syncytial virus (36.6%) and human rhinovirus (24%) were the most common pathogens detected.
- Patients with detected pathogens were younger, more likely to be hospitalized, and presented with more severe symptoms (e.g., feeding problems, dyspnea, wheezing).
- Antibiotic management was largely unchanged by pathogen detection.
- No significant difference in viral load (mean Ct value) was observed between single and multiple pathogen infections.
Conclusions:
- Routine molecular testing for common respiratory pathogens can enhance understanding of their role in pediatric respiratory illnesses.
- Early identification of specific pathogens may inform clinical management, although current antibiotic prescribing practices were not significantly impacted in this cohort.
Background:
Acute respiratory tract infections are an important public health problem. Sensitive and rapid diagnostic techniques have been developed and are used in daily clinical practice. Here we evaluate the clinical relevance of detecting 20 common respiratory pathogens by molecular methods in a general pediatric clinic.
Methods:
Nasopharynx samples of children < 18 years of age with respiratory symptoms referred to a general pediatric clinic were tested for the presence of 19 viruses and Mycoplasma pneumoniae, using real-time polymerase chain reaction.
Results:
Of 177 patients included in this retrospective study, 73% were positive for at least one virus. Respiratory syncytial virus (36.6%) and human rhinovirus (24%) were most frequently detected. Patients in whom a respiratory virus or Mycoplasma pneumoniae was detected, were younger (6 versus 24 months; p < 0.001) and more often hospitalized (116 versus 34; p = 0.001) than patients in whom no respiratory pathogen was detected. Also they were more likely to present with feeding problems, dyspnea, rhinorrhea and wheezing (all p < 0.05) than patients without a respiratory pathogen.In the majority of cases, clinicians did not change their antibiotic management after detecting a viral respiratory pathogen. No difference in mean Ct value was found between patients with one respiratory pathogen and those with >1 respiratory pathogen (30.5 versus 31.2; p = 0.573).
Conclusion:
Routine testing of common respiratory pathogens could lead to a better understanding of their role in disease in children with respiratory symptoms.
