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Use of a molecular panel in acute viral respiratory infections

Abstract number: P1598

Minosse C., Selleri M., Zaniratti M.S., Pisciotta M., Chiappini R., Carletti F., Gualano G., Bevilacqua N., Buscaioni M., Passariello F., Giannetti R., Boschi A., Giustiniani M., Pietrini S., Sciarra F., Capobianchi M.R., Lauria F.N.

Objectives: The aetiology of acute influenza-like illness (ILI) and of other respiratory diseases generally is not established, as the diagnosis is mostly clinical, while laboratory tests for viruses are not diffused in routine laboratories. We used a molecular panel to detect common and emerging respiratory viruses in the upper respiratory tract from patients with ILI referred to our laboratory by general practitioners during the influenza season, or attending the respiratory disease clinic at the National Institute for Infectious Diseases in Rome. The predictive power and applicability of rapid influenza tests in the context of ILI was studied as well.

Methods: During February-April 2006 and 2007, 33 and 42 nasopharyngeal swabs were collected from patients with influenza-like illness. Moreover, 25 samples (4 nasopharyngeal swabs, 21 sputum samples) were obtained from individuals hospitalised for acute respiratory diseases during the period 30/11/06–11/4/07.

All the samples were analysed by PCR or RT-PCR for the presence of twelve different viruses (Influenza A and B, Metapneumovirus, Adenoviruses, Parainfluenza 1, 2 and 3, RSV, Coronaviruses OC43, 229E, NL63 and Rhinovirus). Moreover, nasopharyngeal swabs from ILI patients were analysed with rapid test for influenza A and B.

Results: The frequency of positive samples by PCR for at least one virus was 72.7% in 2006 and 59.5% in 2007; the rate of coinfections, generally including Rhinovirus, were 21.2% and 9.5%, respectively. By PCR, 11 influenza infections (33.3%, 9 A and 2 B) in 2006, and 13 in 2007 (30.9%, 9 A and 4 B) were identified. In 2007, 5 samples (11.9%) were positive to coronaviruses (3 OC43, 2 NL63), none in 2006. With rapid tests, only 6/24 (25%) influenza infections, all type A, were detected.

Concerning the hospitalised patients, all were positive for at least one virus, 4 (14.8%) presenting coinfection (3 with rhinovirus); 6 influenza infections were identified in 2007 (5 A and 1 B).

On the whole, the most commonly detected viruses were rhinovirus (44/100 samples, 44.0%), followed by influenza A (23.0%), generally H3N2.

Conclusions: Many viruses are frequently detected in respiratory samples from patients with acute respiratory illness. It is necessary to evaluate in a larger amount of samples and in distinct clinical contexts the clinical utility of the extended molecular panels for aetiologic diagnosis of acute respiratory illness, in order to confirm and/or exclude their viral aetiology.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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