Comparison of Nasopharyngeal Aspirates and Nasal Swabs for the Detection of Respiratory Viruses by Multiplex RT-PCR / 소아알레르기및호흡기학회지

PURPOSE: Although the nasopharyngeal aspirate (NPA) is more commonly used because of relatively higher accuracy, the nasal swab (NS) is a less painful and easier method than NPA. A few recent reports have shown that NS is more effective than NPA for the detection of respiratory virus using immunofluorescence or viral culture. The objective of the present study was to compare the results of NPA and NS sampling specimens in children for respiratory viruses detection using multiplex RT-PCR. METHODS: From December 2008 to June 2009 Paired NPA and NS specimens were collected from 250 children admitted with symptoms of acute respiratory infections at the Department of Pediatrics, Soonchunhyang University Cheonan Hospital, Cheonan, Korea. The sensitivity and agreement of virus detection between NPA and NS using multiplex RT-PCR were compared and analyzed. RESULTS: The median age of the subjects was 1.3 years (range, 20 days to 16.5 years), and 228 patients (91.2%) were under the age of 5 years. The agreement of virus detection between NPA and NS was excellent (Cohen's kappa >0.8) for parainfluenza virus type 3 or substantial (0.6 to 0.8) for rhinovirus A, RSV A and RSV B, moderate (0.4 to 0.6) for adenovirus and metapneumovirus and poor (<0.4) for influenza A. The overall sensitivity of detection of respiratory viruses was significantly higher in NPA (0.96) than in NS (0.59, P<0.05). CONCLUSION: We recommend NPA may be more accurate specimen for detection of respiratory viruses in hospitalized children. NS might be used in limited cases at a office setting or for larger epidemiological studies. However, results obtained from NS for influenza virus type A, metapneumovirus and adenovirus, should be interpreted carefully.

Comparison of Nasopharyngeal Aspirates and Nasal Swabs for the Detection of Respiratory Viruses by Multiplex RT-PCR / 소아알레르기및호흡기학회지

PURPOSE: Although the nasopharyngeal aspirate (NPA) is more commonly used because of relatively higher accuracy, the nasal swab (NS) is a less painful and easier method than NPA. A few recent reports have shown that NS is more effective than NPA for the detection of respiratory virus using immunofluorescence or viral culture. The objective of the present study was to compare the results of NPA and NS sampling specimens in children for respiratory viruses detection using multiplex RT-PCR. METHODS: From December 2008 to June 2009 Paired NPA and NS specimens were collected from 250 children admitted with symptoms of acute respiratory infections at the Department of Pediatrics, Soonchunhyang University Cheonan Hospital, Cheonan, Korea. The sensitivity and agreement of virus detection between NPA and NS using multiplex RT-PCR were compared and analyzed. RESULTS: The median age of the subjects was 1.3 years (range, 20 days to 16.5 years), and 228 patients (91.2%) were under the age of 5 years. The agreement of virus detection between NPA and NS was excellent (Cohen's kappa >0.8) for parainfluenza virus type 3 or substantial (0.6 to 0.8) for rhinovirus A, RSV A and RSV B, moderate (0.4 to 0.6) for adenovirus and metapneumovirus and poor (<0.4) for influenza A. The overall sensitivity of detection of respiratory viruses was significantly higher in NPA (0.96) than in NS (0.59, P<0.05). CONCLUSION: We recommend NPA may be more accurate specimen for detection of respiratory viruses in hospitalized children. NS might be used in limited cases at a office setting or for larger epidemiological studies. However, results obtained from NS for influenza virus type A, metapneumovirus and adenovirus, should be interpreted carefully.

Viral Etiologic Agents in Acute Viral Lower Respiratory Tract Detected by Multiplex RT-PCR / 소아알레르기및호흡기학회지

PURPOSE:This study was performed to examine seasonal occurrences of respiratory viruses and detect viral etiologic agents, by multiplex RT-PCR in children with acute lower respiratory tract infection (ALRI). METHODS:Nasopharyngeal aspirates (NPA) were collected from 654 hospitalized children with ALRI on admission at Soonchunhyang University Cheonan Hospital and analysed by multiplex RT-PCR between January 2005 and December 2005. RESULTS:Viral agents were detected from 234 subjects (35.8%). The identified viral pathogens were respiratory syncytial virus (RSV) (34.2%), adenovirus (33.8%), parainfluenza virus (21.8%), influenza virus type A (8.1%) and influenza virus type B (2.1%). Viral ALRI occurred most frenquently during the 1st year of life. Clinical diagnoses of viral ALRI included pneumonia (72.2%), bronchiolitis (14.5%), tracheobronchitis (9.8%) and croup (3.5%). The most common cause of bronchiolitis was RSV. Common clinical symptoms and signs of viral ALRI were cough (93.4%), fever (78.2%), rhinorrhea (72.5%), rale (60.2%), and wheezing (26.2%). CONCLUSION:Viral agents were detected by multiplex RT-PCR in 35.8% of NPA obtained from 654 hospitalized patients with acute respiratory tract infections. Multiplex RT-PCR may be useful for detecting virus in children.

Viral Etiologic Agents in Acute Viral Lower Respiratory Tract Detected by Multiplex RT-PCR / 소아알레르기및호흡기학회지

PURPOSE:This study was performed to examine seasonal occurrences of respiratory viruses and detect viral etiologic agents, by multiplex RT-PCR in children with acute lower respiratory tract infection (ALRI). METHODS:Nasopharyngeal aspirates (NPA) were collected from 654 hospitalized children with ALRI on admission at Soonchunhyang University Cheonan Hospital and analysed by multiplex RT-PCR between January 2005 and December 2005. RESULTS:Viral agents were detected from 234 subjects (35.8%). The identified viral pathogens were respiratory syncytial virus (RSV) (34.2%), adenovirus (33.8%), parainfluenza virus (21.8%), influenza virus type A (8.1%) and influenza virus type B (2.1%). Viral ALRI occurred most frenquently during the 1st year of life. Clinical diagnoses of viral ALRI included pneumonia (72.2%), bronchiolitis (14.5%), tracheobronchitis (9.8%) and croup (3.5%). The most common cause of bronchiolitis was RSV. Common clinical symptoms and signs of viral ALRI were cough (93.4%), fever (78.2%), rhinorrhea (72.5%), rale (60.2%), and wheezing (26.2%). CONCLUSION:Viral agents were detected by multiplex RT-PCR in 35.8% of NPA obtained from 654 hospitalized patients with acute respiratory tract infections. Multiplex RT-PCR may be useful for detecting virus in children.