Seasonality and prevalence of respiratory pathogens detected by multiplex PCR at a tertiary care medical center
- 841 Downloads
Respiratory tract infections (RTIs) are a leading cause of mortality and morbidity. Seasonality has been reported for many viruses, including influenza virus, respiratory syncytial virus (RSV), and the recently described human metapneumovirus (hMPV). We hypothesize that the availability of rapid, multiplex PCR diagnostics will provide better clinical care and new insights into the etiology and clinical spectrum of RTIs. We conducted a retrospective analysis of the incidence of respiratory pathogens at a 500-bed adult and 154-bed pediatric hospital tertiary care center. A total of 939 specimens from patients with an age range of 5 days to 91 years (median, 2 years) were tested by a multiplex respiratory pathogen PCR from November 14, 2011 to November 13, 2012. Sixty-five percent of specimens were positive for at least one pathogen. As the age of the patient increased, the positivity rate for the PCR decreased proportionately. Rhinoviruses/enteroviruses (Rhino/Entero) were the most prevalent (34.3 %) followed by RSV (19.2 %) and hMPV (6.2 %). Twelve percent of the positive samples were positive for multiple analytes, with Rhino/Entero and RSV being the most common combination. The peak months were September and May for Rhino/Entero infections, January for RSV and February for coronavirus. hMPV peaked 2 months after RSV, as has been observed recently in other studies. Multiplex PCR provides rapid diagnostic information that can be used to make knowledgeable clinical decisions and potentially reduce the use of antibiotics. Active respiratory PCR surveillance could also predict seasonal respiratory epidemics to allow for adequate planning of additional infection control measures.
KeywordsRespiratory Syncytial Virus Bronchiolitis Respiratory Pathogen Chlamydophila Pneumoniae Tertiary Care Medical Center
This study was supported by the Department of Pathology, Medical College of Georgia, Georgia Regents University, Augusta, Georgia.
Conflict of interest
We declare that we have no conflicts of interest with respect to this study.
- 1.(2012) Review of the 2011-2012 winter influenza season, northern hemisphere. Wkly Epidemiol Rec 87:233-240Google Scholar
- 6.Altman DG (1991) Practical statistics for medical research 1st edn. Chapman and Hall, LondonGoogle Scholar
- 9.Bierbaum S, Konigsfeld N, Besazza N, Blessing K, Rucker G, Kontny U, Berner R, Schumacher M, Forster J, Falcone V, van de Sand C, Essig A, Huzly D, Rohde G, Neumann-Haefelin D, Panning M (2012) Performance of a novel microarray multiplex PCR for the detection of 23 respiratory pathogens (SYMP-ARI study). Eur J Clin Microbiol Infect Dis 31:2851–2861PubMedCrossRefGoogle Scholar
- 13.CDC (2012) 2012 Provisional Pertussis Surveillance Report. http://www.cdc.gov/pertussis/downloads/Provisional-Pertussis-Surveillance-Report.pdf
- 18.Liao RS, Tomalty LL, Majury A, Zoutman DE (2009) Comparison of viral isolation and multiplex real-time reverse transcription-PCR for confirmation of respiratory syncytial virus and influenza virus detection by antigen immunoassays. J Clin Microbiol 47:527–532PubMedCentralPubMedCrossRefGoogle Scholar
- 20.Madhi SA, Ludewick H, Kuwanda L, van Niekerk N, Cutland C, Klugman KP (2007) Seasonality, incidence, and repeat human metapneumovirus lower respiratory tract infections in an area with a high prevalence of human immunodeficiency virus type-1 infection. Pediatr Infect Dis J 26:693–699PubMedCrossRefGoogle Scholar
- 30.Poritz MA, Blaschke AJ, Byington CL, Meyers L, Nilsson K, Jones DE, Thatcher SA, Robbins T, Lingenfelter B, Amiott E, Herbener A, Daly J, Dobrowolski SF, Teng DH, Ririe KM (2011) FilmArray, an automated nested multiplex PCR system for multi-pathogen detection: development and application to respiratory tract infection. PLoS One 6:e26047PubMedCentralPubMedCrossRefGoogle Scholar
- 33.Richard N, Komurian-Pradel F, Javouhey E, Perret M, Rajoharison A, Bagnaud A, Billaud G, Vernet G, Lina B, Floret D, Paranhos-Baccala G (2008) The impact of dual viral infection in infants admitted to a pediatric intensive care unit associated with severe bronchiolitis. Pediatr Infect Dis J 27:213–217PubMedCrossRefGoogle Scholar