Yonsei Med J.  2010 Sep;51(5):761-767. 10.3349/ymj.2010.51.5.761.

Identification of Adenovirus, Influenza Virus, Parainfluenza Virus, and Respiratory Syncytial Virus by Two Kinds of Multiplex Polymerase Chain Reaction (PCR) and a Shell Vial Culture in Pediatric Patients with Viral Pneumonia

• Lee JH
• Chun JK
• Kim DS
• Park Y
• Choi JR
• Kim HS

• KMID: 1071430
• DOI: http://doi.org/10.3349/ymj.2010.51.5.761

Abstract

PURPOSE
Early identification of causative agents in lower respiratory infection of pediatric patients can reduce morbidity and prevent an overuse of antimicrobials. Two kinds of multiplex polymerase chain reaction (PCR) and a commercial shell vial viral culture were performed to identify causative agents in pediatric patients.
MATERIALS AND METHODS
Nasopharyngeal aspirates of 220 children diagnosed with viral pneumonia were obtained. Two kinds of multiplex PCR (Seeplextrade mark RV detection kit, and Labopasstrade mark RV detection kit), and a shell vial culture by R-Mix were performed.
RESULTS
Positive samples from 220 total samples by two multiplex PCRs were 52.7% and 46.4%, respectively. We also cultured 103 samples that showed positive results of the adenovirus, influenza virus, parainfluenza virus, and respiratory syncytial virus (RSV) by two multiplex PCR. The RSV was most frequently detected in 53.0% (Seeplex) and 51.7% (Labopass) of patients. The detection rate of adenovirus (AdV) was 10.3% and 12.1%, influenza virus (IFV) A and B was 12.5% and 3.4%, and parainfluenza virus (PIFV) 1, 2, and 3 were 2.9% and 2.6%. Shell vial cultures showed concordant results with each multiplex PCR by 96.1% and 77.7%, respectively. Sequencing results were 90% consistent with multiplex PCR.
CONCLUSION
Multiplex PCR showed more positivity than the shell vial culture and it can be an effective primary test. Other complementary efforts such as viral cultures and sequencing analysis could be considered, according to clinical and laboratory conditions.

Keyword

Multiplex PCR; respiratory virus; virus culture; viral pneumonia

MeSH Terms

Adenoviridae/genetics/*isolation & purification
Child
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Male
Orthomyxoviridae/genetics/*isolation & purification
Pneumonia, Viral/*virology
Polymerase Chain Reaction/*methods
Respiratory Syncytial Viruses/genetics/*isolation & purification
Respirovirus/genetics/*isolation & purification

Figure

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  Fig. 1 Comparison of multiplex PCRs and R-Mix culture for detecting adenovirus (AdV), influenza virus (IFV), parainfluenza virus (PIFV) and respiratory syncytial virus (RSV) in pediatric patients with viral pneumonia.

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