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Updated: Mar 15, 2026
Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses
Published on: November 10, 2023
A GeXP-Based Assay for Simultaneous Detection of Multiple Viruses in Hospitalized Children with Community Acquired
Le Wang1, Mengchuan Zhao2, Zhongren Shi1
1Institute of Pediatric Research, Children's Hospital of Hebei Province, Shijiazhuang 050031, China.
Insights
The GeXP assay effectively detects 20 viruses in children with community-acquired pneumonia (CAP). This rapid diagnostic tool shows high accuracy, identifying viral infections in about 65% of pediatric CAP cases.
Area of Science:
- Virology
- Molecular Diagnostics
- Pediatric Infectious Diseases
Background:
- Community-acquired pneumonia (CAP) is a major global child mortality cause, often viral.
- Accurate and rapid viral diagnosis is crucial for effective CAP management in children.
- The GeXP assay offers potential for simultaneous multi-pathogen detection.
Purpose of the Study:
- To evaluate the GeXP assay for simultaneous detection of 20 virus types/subtypes in hospitalized children with CAP.
- To assess the diagnostic performance and clinical utility of the GeXP assay in a large pediatric cohort.
Main Methods:
- Prospective collection of 1699 nasopharyngeal swabs from children with CAP.
- Viral nucleic acid extraction followed by simultaneous detection using the GeXP assay.
- Validation of GeXP assay results against mono-RT-PCR for a subset of samples.
Main Results:
- The GeXP assay successfully identified all 20 target viruses at a concentration of 10^4 copies/μl, with no amplification of 15 control microorganisms.
- Approximately 65% of pediatric CAP cases tested positive for viral infection, with higher rates in children under 3 years (70%).
- Respiratory Syncytial Virus (RSV) was the most common, followed by Parainfluenza virus type 3 (PIV3), Human Rhinovirus (HRV), Adenovirus (ADV), and Human Bocavirus (HBoV).
- High agreement (97.5%) was observed between the GeXP assay and mono-RT-PCR.
Conclusions:
- The GeXP assay is a reliable tool for simultaneous detection of multiple viruses in pediatric CAP.
- Its application in a large clinical sample set demonstrates its potential for routine diagnostics.
- The assay facilitates rapid identification of causative viral agents, aiding clinical management of pediatric CAP.
Abstract:
The GeXP-based assay has recently been developed for simultaneous detection of multiple pathogens. So far, the application of the GeXP assay to test larger clinical samples has hardly been reported. Community-acquired pneumonia (CAP) is the leading cause of death in children worldwide and a substantial proportion of childhood CAP is caused by viruses. Rapid and accurate diagnosis of virus infection is important for the clinical management of CAP. In this study, we explored the GeXP assay for simultaneous detection of 20 types/subtypes of viruses in hospitalized children with CAP. A total of 1699 nasopharyngeal swabs were prospectively collected and viral nucleic acid was extracted and assayed. Using viral genomic DNA or RNA as template, we showed that at the concentration of 104 copies of DNA or RNA of each virus/μl, all 20 target viruses were simultaneously identified by the GeXP assay. Fifteen control microorganisms, in contrast, failed to be amplified by the assay. About 65% of cases tested in this study had viral infection, with patients aged <3 years having a 70% positive rate, significantly higher than that in patients aged > 3 years (40%). The most frequently detected virus was RSV followed by PIV3, HRV, ADV and HBoV. Seasonal distribution analysis revealed that RSV was the most predominant in autumn and winter, while in spring and summer PIV3 and RSV were the most frequently identified with similar positive percentages. One hundred twenty randomly-chosen samples tested by the GeXP assay were re-evaluated by mono-RT-PCR, the results showed 97.5% diagnosis agreement between these 2 methods. Our findings suggest that the GeXP assay could be a valuable diagnostic tool for virus infection in pediatric patients with CAP.
