Respiratory Publications

2019 Article - "Epidemiology Of Respiratory Infections Among Adults In Qatar (2012-2017)" (pdf, 1MB)

Objective: This study aimed at providing preliminary estimates of influenza and other respiratory infections circulating among adults in Qatar
Methods: We retrospectively collected data of about 44,000 patients who visited Hamad General Hospital clinics, sentinel sites, and all primary healthcare centers in Qatar between 2012 and 2017. All samples were tested for influenza viruses, whereas about 38,000 samples were tested for influenza and a panel of respiratory viruses using Fast Track Diagnostics (FTD) RT-PCR kit.
Results: Among all ILIs cases, 20,278 (46.5%) tested positive for at least one respiratory pathogen. Influenza virus was predominating (22.6%), followed by human rhinoviruses (HRVs) (9.5%), and human coronaviruses (HCoVs) (5%). A detection rate of 2–3% was recorded for mycoplasma pneumonia, adenoviruses, human parainfluenza viruses (HPIVs), respiratory syncytial virus (RSV), and human metapneumovirus (HMPV). ILIs cases were reported throughout the year, however, influenza, RSV, and HMPV exhibited strong seasonal peaks in the winter, while HRVs circulated more during fall and spring. Elderly (>50 years) had the lowest rates of influenza A (13.9%) and B (4.2%), while presenting the highest rates of RSV (3.4%) and HMPV (3.3%). While males had higher rates of HRVs (11.9%), enteroviruses (1.1%) and MERS CoV (0.2%), females had higher proportions of influenza (26.3%), HPIVs (3.2%) and RSV (3.6%) infections.
Conclusions: This report provides a comprehensive insight about the epidemiology of ILIs among adults in the Qatar, as a representative of Gulf States. These results would help in improvement and optimization of diagnostic procedures, as well as control and prevention of the respiratory infections.

Kit used: FTD Respiratory pathogens 21 and FTD Mers-CoV

2019 Article - "Respiratory Pathogens in Infants Diagnosed with Acute Lower Respiratory Tract Infection in a Tertiary Care Hospital of Western India Using Multiplex Real Time PCR" (limited access)

Objective: To determine the frequency of respiratory pathogens in infants diagnosed with acute lower respiratory tract infections.
Methods: A prospective cross-sectional observational study was conducted in infants hospitalized with a diagnosis of acute lower respiratory tract infection (ALRTI), in a tertiary care hospital in a metropolitan city of Western India. Nasopharyngeal swabs were analyzed by multiplex real time polymerase chain reaction, for 18 viruses and 3 bacteria (H. influenzae type b, C. pneumoniae and M. pneumoniae). The entire data was entered in Microsoft excel sheet and frequencies were determined.
Results: One hundred eligible infants were enrolled. Pathogens were detected in 82 samples, which included Respiratory syncytial viruses (RSV) A / B (35.4%), Human rhinovirus (25.6%), Adenovirus (22%), Human Parainfluenza viruses (11%), Human bocavirus (9.8), Human metapneumovirus A / B (8.5%), Influenza A (H1N1) pdm 09 (6.1%), Parechovirus (3.7%), Human coronaviruses (3.66%), Haemophilus influenzae type b (6.1%), Chlamydia pneumoniae (2.4%) and Mycoplasma pneumoniae (2.4%). Influenza A (other than H1N1), Influenza B, Human Coronavirus 229E and Enterovirus were not detected. The rate of coinfection was 34% and rhinovirus was the most common of the multiple pathogens.
Conclusions: Spectrum of viral etiologies of ALRTI is highlighted. Etiological diagnosis of ALRTI would enable specific antiviral therapy, restrict antibiotic use and help in knowing burden of disease.

Kit used: FTD Respiratory pathogens 21 plus
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2018 Article - "Clinical characteristics of influenza virus-induced lower respiratory infection during the 2015 to 2016 season" (limited access)

Background Influenza A(H1N1)pdm09 virus infections often manifest severe respiratory symptoms, particularly in patients with a past history of allergic disease. Most of these findings were reported during the 2009 pandemic. The purpose of this study was to detail the clinical characteristics of influenza virus-induced lower respiratory infection (LRI) during the A(H1N1)pdm09-predominant 2015–2016 season. Methods We retrospectively reviewed the clinical characteristics of influenza-induced LRI cases in children admitted to a tertiary children's hospital. Molecular diagnostic evaluation was performed on samples obtained from the most severe cases. Results We identified 66 patients with influenza-associated hospitalization and included 21 patients with influenza virus-induced LRI for analyses. Twelve patients (57%) were admitted to the pediatric intensive care unit, seven (33%) required mechanical ventilation, and three (14%) required extracorporeal membrane oxygenation. Plastic bronchitis (PB) was identified in six patients (29%), among whom a past medical history of asthma or food allergy were noted in all six patients. A past history of allergic disease was more common among patients with, than among those without, PB (p = 0.009). A(H1N1)pdm09 was detected from all the PB cases, and phylogenetic analyses of the hemagglutinin and neuraminidase genes demonstrated that this virus belonged to subclades 6B.1 and 6B.2. In the six PB cases, we found one patient with H275Y mutation in neuraminidase. Conclusion Allergic disease was a risk factor for developing PB due to influenza A(H1N1)pdm09 infection during the 2015–16 season.

Kit used: FTD Respiratory pathogens 21
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2018 Article - "Live-Attenuated Respiratory Syncytial Virus Vaccine Candidate With Deletion of RNA Synthesis Regulatory Protein M2-2 is Highly Immunogenic in Children" (limited access)

Background: Live respiratory syncytial virus (RSV) candidate vaccine LIDΔM2-2 is attenuated by deletion of the RSV RNA regulatory protein M2-2, resulting in upregulated viral gene transcription and antigen expression but reduced RNA replication.

Methods: RSV-seronegative children ages 6–24 months received a single intranasal dose of 105 plaque forming units (PFU) of LIDΔM2-2 (n = 20) or placebo (n = 9) (NCT02237209, NCT02040831). RSV serum antibodies, vaccine infectivity, and reactogenicity were assessed. During the following RSV season, participants were monitored for respiratory illness and pre- and post-RSV season serum antibodies.

Results: Vaccine virus was shed by 95% of vaccinees (median peak titers of 3.8 log10 PFU/mL by quantitative culture and 6.3 log10 copies/mL by PCR); 90% had ≥4-fold rise in serum neutralizing antibodies. Respiratory symptoms and fever were common in vaccine (95%) and placebo (78%). One vaccinee had grade 2 rhonchi concurrent with vaccine shedding, rhinovirus, and enterovirus. Eight of 19 vaccinees versus 2 of 9 placebo recipients had substantially increased RSV antibody titers after the RSV season without medically attended RSV disease, indicating anamnestic vaccine responses to wild-type RSV without significant illness.

Conclusion: LIDΔM2-2 had excellent infectivity and immunogenicity, encouraging further study of vaccine candidates attenuated by M2-2 deletion.

Kit used: FTD FTD Respiratory pathogens 21
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2018 Article - "Adenovirus types associated with severe respiratory diseases: A retrospective 4-year study in Kuwait" (limited access)

Summary: Human adenovirus (HAdV) infection can result in a severe respiratory disease. The aim of this study was to identify HAdV types detected in patients hospitalized for severe respiratory illness. The study population consisted of 743 patients with severe respiratory disease admitted to four major hospitals in Kuwait between January 2013 and December 2016. Respiratory specimens were retrospectively screened for 20 respiratory viruses by real-time PCR. The HAdV hexon gene was amplified and directly sequenced, and HAdV types were identified by performing Bayesian phylogenetic analysis. HAdV DNA was detected in 27 (3.6%) patients, with peaks in November and March. Most patients were infants and young children suffering from pneumonia or acute bronchiolitis. The detected HAdV types were C1, C2, C5, B3, and B7. Clusters of HAdV C1, C2, and C5 were observed with high posterior probability. All patients infected with HAdV C5 and 50% of patients infected with HAdV C2 or B7 were admitted to the intensive care unit (ICU). Co-infection with other viruses was detected in 44.4% of patients. The most common co-infecting virus was rhinovirus (HRV). HAdV/HRV co-infection was detected in two children who presumably developed disseminated HAdV infection and died. This is the first report describing the circulation of HAdV types associated with severe outcomes in Kuwait. These findings highlight the need for a national surveillance system to monitor changes in predominant HAdV types and increased numbers of severe respiratory infections.

Kit used: FTD Respiratory pathogens 21
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2018 Article - "Randomised controlled trial of rhinothermy for treatment of the common cold: a feasibility study" (pdf, 858KB)

Objective: To determine the feasibility of a randomised controlled trial (RCT) of rhinothermy for the common cold.
Design: Open label, randomised, controlled feasibility study.
Setting: Single-centre research institute in New Zealand recruiting participants from the community.
Participants: 30 adult participants with symptoms of a common cold, presenting within 48 hours of the onset of symptoms.
Interventions: Participants were randomly assigned 2:1 to receive either 35 L/min of 100% humidified air at 41°C via high flow nasal cannulae, 2 hours per day for up to 5 days (rhinothermy), or vitamin C 250 mg daily for 5 days (control).
Primary and secondary outcome measures: The primary outcome was the proportion of screened candidates who were randomised.
Secondary outcomes included: proportion of randomised participants who completed the study; modified Jackson scores from randomisation to 10 days after initiation of randomised regimen; time until feeling ‘a lot better’ compared with study entry; time until resolution of symptoms or symptom score at 10 days postrandomisation; proportion of organisms identified by PCR analysis of nasal swabs taken at baseline; the patterns of use of the rhinothermy device; estimated adherence of the control group; and rhinothermy device tolerability.
Results: In all 30/79 (38%, 95% CI 27% to 50%) of potential participants screened for eligibility were randomised. Rhinothermy was well tolerated, and all randomised participants completed the study (100%, 95% CI 88% to 100%). The reduction from baseline in the modified Jackson score was greater with rhinothermy compared with control at days 2, 3, 4, 5 and 6, with the maximum difference at day 4 (−6.4, 95% CI −9.4 to −3.3). The substantial clinical benefit threshold for modified Jackson score was a 5-unit change.
Conclusions: This study shows that an RCT of rhinothermy compared with low-dose vitamin C in the treatment of the common cold is feasible.

Kit used: FTD Respiratory pathogens 21

2017 Article - "Does azithromycin given to women in labour decrease ocular bacterial infection in neonates? A double-blind, randomized trial" (pdf, 365KB)

Background: Vertical transmission can result in neonatal infection and disease. Reducing the transmission of bacterial pathogens from mother to infant may be an effective means of preventing neonatal infection, including bacterial conjunctivitis.

Methods: In a double-blind, randomized trial, we assessed the effect of administering a single dose of oral azithromycin to women in labour on bacterial colonization of the neonate. A reduction in purulent neonatal conjunctivitis was a secondary objective of the trial. Ocular samples were collected from the lower fornix of infants presenting with clinical signs of purulent conjunctivitis during the first eight weeks of life. Incidence of purulent conjunctivitis was compared between trial arms. Bacterial infection was assessed using PCR and incidence of purulent conjunctivitis due to bacteria was also compared between arms.

Results: Forty of 843 infants (4.7%) presented clinical signs of purulent conjunctivitis. No significant difference in incidence of purulent conjunctivitis was seen between azithromycin and placebo arms [4.3% (18/419) versus 5.2% (22/424), OR = 0.82,95% CI (0.44,1.54), p=0.628]. S. aureus was the most commonly identified pathogen, detected in 38% of cases. Incidence of purulent-conjunctivitis due to bacterial infection was lower in the azithromycin arm [1.2% (5/419) versus 3.8% (16/424), OR = 0.31, 95% CI (0.12–0.82), p = 0.025)]. The incidence of gram-positive bacteria was also lower in the azithromycin arm [1.0% (4/419) versus 3.3% (14/424), OR = 0.28, 95%CI (0.10–0.82), p = 0.029].

Conclusions: Oral azithromycin given to women during labour may have the potential to reduce the incidence of bacterial neonatal conjunctivitis.

Kit used: FTD SPn/Staph/MC/Hi
FTD Vaginal Swab

2017 Article - "Performance of the Alere i RSV assay for point of care detection of respiratory syncytial virus in children" (pdf, 510KB)

Summary: Respiratory syncytial virus (RSV) is the most important cause of severe acute respiratory tract infection in young children. Alere i RSV is a novel molecular rapid test which identifies respiratory syncytial virus. The group evaluated the clinical performance of the Alere i RSV assay in a pediatric point-of-care setting during winter season 2016 / 2017. Test results from 518 nasopharyngeal swab samples were compared to FTD Respiratory pathogens 21 seen as reference standard. The overall sensitivity and specificity of the Alere i RSV test assay was 93% (CI95 89% – 96%) and 96% (CI95 93% – 98%), respectively. An optimal sensitivity of 98% (CI95 94% - 100%) and specificity of 96% (CI95 90% - 99%) was obtained in children < 6 months. In children ≥ 2 years, sensitivity and specificity remained at 87% (CI95 73% – 96%) and 98% (CI95 92% – 100%), respectively. False negative Alere i RSV test results mostly occurred in samples with low viral load (mean CT value 31.1; CI95 29.6 – 32.6).

Tables: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-017-2855-1

Kit used: FTD Respiratory pathogens 21

2017 Article - "The 2015–2016 influenza epidemic: Late onset, clinical severity and emergence of the B Victoria virus" (pdf, 144KB)

Summary:Flu is a viral infection caused by influenza viruses. There are three types (A, B and C) and only A (A1H1N1 and AH3N2) and B (Victoria line and Yamagata line) are responsible for major seasonal epidemics with a circulation predominance for virus A. However, the 2015-2016 epidemic was different with an unusually high circulation of virus B (Victoria), leading to carry out a descriptive retrospective study at the university hospital (CHU) in Bordeaux.
A total of 110 patients with a positive PCR with a mean age of 53.3 years (16-90 years) were involved in the study. The positive diagnosis was made using a multiplex PCR with the kits available at the CHU de Bordeaux (Anyplex® II RV16, Allplex®Respiratory Panel and Fast Track®Flu Differentiation). Virus B positive sample subtyping was performed by the CNR de Lyon. Type A virus was mostly isolated in 57 patients (52%) with a predominance of subtype A (H1N1) in 50 patients (45% of the total). Type B viruses were isolated from 53 patients (48%) with the Victoria line virus in 47 patients (43% of the workforce). It was late onset epidemic (March-May), 23% of the patient were vaccinated. Same severity for type A (25%) and type B Victoria strain (23%).
Conclusion: The flu epidemic of 2015-2016 was different from the other years of an unusual overrepresentation of B / Victoria in hospital. There was a mismatch between vaccine lineage B / Yamagata and the circulating major strain Victoria with unprotected patients at risk. This study probably provides additional arguments to encourage seasonal influenza vaccination by a quadrivalent vaccine containing both subtypes A and the two B-line viruses (Victoria and Yamagata).

Kit used: FTD Flu differentiation

2017 Article - "Pertussis and Pertussis like Illness: Pediatric Experience in Oman" (pdf, 844KB)

Summary: A resurgence of pertussis or whooping cough has been observed worldwide despite broad vaccination coverage. Pertussis like illness (PLI) refers to a clinical syndrome compatible with pertussis infection but lacking laboratory confirmation or an epidemiological link to a confirmed case. Our study aimed to estimate the contribution of Bordetella pertussis infection and identifying predictors of its diagnosis in a cohort of children with PLI. Demographic and clinical information were retrospectively collected from the medical records of children < 13 years old and hospitalized for PLI in two pediatric units in Oman from 1 January 2012 to 31 December 2013. The laboratory data of all cases were reviewed and confirmed cases of pertussis were identified, analyzed, and compared with non-confirmed cases.A total of 131 patients were enrolled in this study. The majority (95.4% [125/131]) were infants. Only 54.1% (71/131) of admitted children with PLI were tested for pertussis. The incidence of pertussis infection among the tested group was 16.9% (12/71) with a 95% confidence interval 8.2−25.6. Severe illness occurred in 56.4% (74/131) of patients, and six were confirmed to have pertussis. Pediatric intensive care unit admission was required for one confirmed case of pertussis and eight cases from the PLI group (three were negative for pertussis, and five were not tested). Receiver operator characteristic curve analysis revealed that a white blood cell count 3 23.5 × 109/L had 96.6% specificity and lymphocytes 3 17 × 109/L had 98.3% specificity. Taking into consideration that the number tested for pertussis was limited, the incidence of pertussis was 16.9% (12 out of 71 patients). Lymphocytosis can be used as a reliable predictor for the diagnosis of pertussis especially in the absence of specific confirmatory tests or until their results are available.

Kit used: FTD Respiratory pathogens 21

2017 Article - "Evaluation of quantitative FTD Pneumocystis jirovecii kit for Pneumocystis infection diagnosis" (limited access)

Summary: In this study the Fast track Diagnostics (FTD) Pneumocystis PCR kit was evaluated, targeting the mitochondrial large subunit ribosomal RNA gene (mtLSU rRNA) of Pneumocystis jirovecii (P. jirovecii). A hundred and thirty-three patients were prospectively enrolled. Respiratory specimens were examined using both microscopy and the PCR assay. Twenty-six patients led to P. jirovecii detection. Fourteen patients presented with Pneumocystis pneumonia (PCP)whereas 12 patients were considered to be colonized. The median copy numbers in bronchoalveolar lavage fluid were significantly different in the PCP and colonization groups (1.35×10^8/ml vs. 1.45×10^5/ml, P <0.0001). Lower and upper cut-off values of 3.9×10^5 copies/ml and 3.2×10^6 copies/ml allowed differentiating PCP and colonization. The FTD P. jirovecii assay was secondarily compared to an in-house reference PCR assay targeting the mtLSU rRNA gene. A concordance rate of 97.5% was observed (Cohen's kappa coefficient κ=0.935). The FTD Pneumocystis PCR kit showed good performance and represents an alternative method to diagnose P. jirovecii infections.

Kit used: FTD Pneumocystis jirovecii
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2017 Article - "Density of Upper Respiratory Colonization With Streptococcus pneumoniae and Its Role in the Diagnosis of Pneumococcal Pneumonia Among Children Aged <5 Years in the PERCH Study" (pdf, 692KB)

Summary: Previous studies suggested an association between upper airway pneumococcal colonization density and pneumococcal pneumonia, but data in children are limited. Using data from the Pneumonia Etiology Research for Child Health (PERCH) study, we assessed this potential association.
PERCH is a case-control study in 7 countries: Bangladesh, The Gambia, Kenya, Mali, South Africa, Thailand, and Zambia. Cases were children aged 1–59 months hospitalized with World Health Organization–defined severe or very severe pneumonia. Controls were randomly selected from the community. Microbiologically confirmed pneumococcal pneumonia (MCPP) was confirmed by detection of pneumococcus in a relevant normally sterile body fluid. Colonization density was calculated with quantitative polymerase chain reaction analysis of nasopharyngeal/oropharyngeal specimens.
Median colonization density among 56 cases with MCPP (MCPP cases; 17.28 ×106copies/mL) exceeded that of cases without MCPP (non-MCPP cases; 0.75 ×106) and controls (0.60 ×106) (each P < .001). The optimal density for discriminating MCPP cases from controls using the Youden index was >6.9 log10 copies/mL; overall, the sensitivity was 64% and the specificity 92%, with variable performance by site. Pneumococcal colonization density >6.9 log10 copies/mL was strongly associated with MCPP and could be used to improve estimates of pneumococcal pneumonia prevalence in childhood pneumonia studies. Our findings do not support its use for individual diagnosis in a clinical setting.

Kit used: FTD Respiratory pathogens 33

2017 Article - "Standardization of Laboratory Methods for the PERCH study" (pdf, 395KB)

Summary: The Pneumonia Etiology Research for Child Health study was conducted across 7 diverse research sites and relied on standardized clinical and laboratory methods for the accurate and meaningful interpretation of pneumonia etiology data. Blood, respiratory specimens, and urine were collected from children aged 1–59 months hospitalized with severe or very severe pneumonia and community controls of the same age without severe pneumonia and were tested with an extensive array of laboratory diagnostic tests. As molecular diagnostic tool FTD Respiratory pathogens 33 was used. A standardized testing algorithm and standard operating procedures were applied across all study sites. Site laboratories received uniform training, equipment, and reagents for core testing methods. Standardization was further assured by routine teleconferences, in-person meetings, site monitoring visits, and internal and external quality assurance testing. Targeted confirmatory testing and testing by specialized assays were done at a central reference laboratory.

Kit used: FTD respiratory pathogens 33

2017 Article - "Association of C-Reactive Protein With Bacterial and Respiratory Syncytial Virus–Associated Pneumonia Among Children Aged <5 Years in the PERCH Study" (pdf, 430KB)

Summary: Lack of a gold standard for identifying bacterial and viral etiologies of pneumonia has limited evaluation of C-reactive protein (CRP) for identifying bacterial pneumonia. We evaluated the sensitivity and specificity of CRP for identifying bacterial vs respiratory syncytial virus (RSV) pneumonia in the Pneumonia Etiology Research for Child Health (PERCH) multicenter case-control study. We measured serum CRP levels in cases with World Health Organization–defined severe or very severe pneumonia and a subset of community controls. We evaluated the sensitivity and specificity of elevated CRP for “confirmed” bacterial pneumonia (positive blood culture or positive lung aspirate or pleural fluid culture or polymerase chain reaction [PCR]/FTD Respiratory pathogens 33) compared to “RSV pneumonia” (nasopharyngeal/oropharyngeal or induced sputum PCR-positive without confirmed/suspected bacterial pneumonia). Receiver operating characteristic (ROC) curves were constructed to assess the performance of elevated CRP in distinguishing these cases. Among 601 human immunodeficiency virus (HIV)–negative tested controls, 3% had CRP ≥40 mg/L. Among 119 HIV-negative cases with confirmed bacterial pneumonia, 77% had CRP ≥40 mg/L compared with 17% of 556 RSV pneumonia cases. The ROC analysis produced an area under the curve of 0.87, indicating very good discrimination; a cut-point of 37.1 mg/L best discriminated confirmed bacterial pneumonia (sensitivity 77%) from RSV pneumonia (specificity 82%). CRP ≥100 mg/L substantially improved specificity over CRP ≥40 mg/L, though at a loss to sensitivity. Elevated CRP was positively associated with confirmed bacterial pneumonia and negatively associated with RSV pneumonia in PERCH. CRP may be useful for distinguishing bacterial from RSV-associated pneumonia, although its role in discriminating against other respiratory viral-associated pneumonia needs further study.

Kit used: FTD respiratory pathogens 33

2017 Article - "The potential influence of human parainfluenza viruses detected during hospitalization among critically ill patients in Kuwait, 2013–2015" (pdf, 485KB)

Summary: The aim of this study is to describe the spectrum, incidence and clinical features of of human parainfluenza viruses (PIV)-associated infections diagnosed during the hospital stay of patients admitted to pediatric intensive care unit (PICU) and intensive care unit (ICU) of 5 medical centers across Kuwait.This was a population-based, retrospective study from 2013 to 2015. Specimens were analyzed by FTD Respiratory pathogens 21. This analysis was performed using the database of Virology Unit, Mubarak Al-Kabeer Hospital. Data from 1510 admitted patients with suspected respiratory viral infections was extracted.The database contained a total of 39 (2.6%) patients infected with PIV (53.8% male and 46.2% females) and 20 (51.3%) were under 1 year of age. The most frequently isolated type was type 3 (28, 71.8%) followed by type 1 (9, 23.1%). At admission the most common clinical diagnosis was pneumonia in 12 patients (30.8%, p < 0.05) followed by bronchiolitis in 10 patients (25.6%).PIV plays an important yet unrecognized role in the outcomes of PIUC and ICU patients. These results contribute to the limited epidemiologic data of PIV in PIUC and ICU in this region.

Kit used: FTD Respiratory pathogens 21

2017 Article - "Viral aetiology of bronchiolitis in hospitalised children in Qatar" (pdf, 836KB)

Summary: Bronchiolitis is considered one of the earliest and most common causes of hospitalisation in young children. Development of molecular technologies allowed a better understanding of bronchiolitis aetiology. Results from cohort studies evaluating the association between single, multiple viral infections and clinical outcomes are conflicting. Data on viral bronchiolitis in children were found to be limited in Qatar. This study aimed to determine frequency and seasonal trends of viral pathogens causing acute bronchiolitis, and to explore association between viral pathogens, disease severity and length of stay (LOS). Multiplex, real-time, polymerase chain reaction (RT-PCR) using FTDResp21 kit (Fast Track Diagnostics, Silema, Malta) was used for the detection of respiratory pathogens.

Kit used: FTD Respiratory pathogens 21

2017 Article - "Genotyping of human rhinovirus in adult patients with acute respiratory infections identified predominant infections of genotype A21" (pdf, 1MB)

Summary: The aim of this study was the assessment of the prevalence of HRV and its specific genotypes in patients suffering from acute respiratory tract infections (ARTIs). Samples from 147 adult inpatients with community-acquired pneumonia (CAP) and 291 adult outpatients with upper ARTIs (URTIs) were collected. The presence of HRVs and other common respiratory pathogens were screened using the FTD Respiratory pathogens 21 plus kit. HRV was detected in 42 patients, with 35 species A, five B and two C. Seventeen genotypes were identified, and HRV-A21 ranked the highest (9/42, 21.4%). The HRV-A21 genome sequenced in this study contained 12 novel coding polymorphisms in viral proteins. The infections of HRV-A21 virus obtained in this study could not be neutralized by antiserum of HRVA21 prototype strain (VR-1131), indicating remarkable antigenic variation. The results highlight an unexpected infection of genotype HRV-A21 in the clinic, indicating the necessity of precise genotyping and surveillance of HRVs to improve the clinical management of ARTIs.

Kit used: FTD Respiratory pathogens 21 plus

2017 Article - "Assessment of the Usefulness of Multiplex Real-Time PCR Tests in the Diagnostic and Therapeutic Process of Pneumonia in Hospitalized Children: A Single-Center Experience" (1) (pdf, 1MB)

Summary: The aim of the study was assessment of the usefulness of multiplex real-time PCR tests in the diagnostic and therapeutic process in children hospitalized due to pneumonia and burdened with comorbidities. The study group included 97 children hospitalized due to pneumonia at the Karol Jonscher Teaching Hospital in Poznań, in whom multiplex real-time PCR tests (FTD Respiratory pathogens 33) were used. Positive test results of the test were achieved in 74 patients (76.3%). The average age in the group was 56 months. Viruses were detected in 61 samples (82% of all positive results); bacterial factors were found in 29 samples (39% of all positive results). The presence of comorbidities was established in 90 children (92.78%). The analysis demonstrated that the participation of viruses in causing severe lung infections is significant in children with comorbidities. Multiplex real-time PCR tests proved to be more useful in establishing the etiology of pneumonia in hospitalized children than the traditional microbiological examinations.

Kits used: FTD Respiratory pathogens 33

2017 Article - "Performance evaluation of Direct Fluorescent Antibody, Focus Diagnostics SimplexaTM Flu A/B and RSV and Multi-parameter Customized Respiratory Taqman® Array Card in Immunocompromised Patients" (limited access)

Summary: Molecular assays for diagnosis of Flu A, Flu B, and RSV with short turnaround time (TAT) are of considerable clinical importance. In addition, rapid and accurate diagnosis of a large panel of viral and atypical pathogens can be crucial in immunocompromised patients. The objective of the study was to evaluate the performance of the Simplexa™ Direct assay system in comparison with direct fluorescent antibody (DFA) and customized Taqman® Array Card (TAC) testing for RSV, Flu A, and Flu B in immunocompromised patients. FTD Flu/HRSV was used as golden standard reference method for verification testing. Secondly, they evaluate different algorithms for the detection of respiratory pathogens in terms of cost, turn-around-time (TAT) and diagnostic yield. They collected 125 nasopharyngeal swabs (NTS) and 25 BAL samples from symptomatic immunocompromised patients. The overall sensitivity was significantly lower for DFA testing than for the two molecular methods (p<0.05). Performance characteristics of Simplexa™ testing were not significantly different compared to TAC testing (p>0.1). For BAL samples only, the sensitivity and specificity of the Simplexa™ assay was 100%. In total, 6.7%, 16% and 18% of samples were positive for Flu A, Flu B or RSV by DFA, Simplexa™ and TAC testing respectively. When considering not only these pathogens but all results for TAC, the method identified 93 samples with one or more respiratory pathogens (62%). A co-infection rate of 15.3% was found by TAC. The estimated costs and TAT were 8.2€ and 2 hours for DFA, 31.8€ and 1.5 hours for Simplexa™ and 55€ and 3 hours for TAC testing. Taken all this together diagnostic using FTD kits, especially in lyophilized formulation, is extremely time and cost saving!

Kit used: FTD FLU/HRSV
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2017 Article - "Respiratory multiplex polymerase chain reaction: An important diagnostic tool in immunocompromised patients" (pdf, 530KB)

Summary: Viruses and atypical pathogens can cause significant respiratory illness in immunocompromised patients. Multiplex polymerase chain reaction (MPCR) has improved the diagnostic yield of pathogens, and it is easier to identify the co-infections also. The present study was done to evaluate the performance of MPCR on bronchoalveolar lavage (BAL) samples in immunocompromised patients. MPCR identified the causative pathogen in 59.3% of patients while culture could identify only in 37.8% of patients. Most frequent etiological agent was Klebsiella pneumoniae (32%), followed by cytomegalovirus (21%), and Pneumocystis jirovecii (10%). Mortality was significantly higher in patients having mixed infections. MPCR is highly sensitive and rapid tool which can be considered in the routine diagnostic algorithm of respiratory illness in immunocompromised patients.

Kit used: FTD Respiratory pathogens 33

2017 Article - "Etiology of Acute Respiratory Infections in Infants" (pdf, 389KB)

Summary: There is paucity of studies on etiology of acute respiratory infections (ARI) in infants. The objective of this study is to document incidence and etiology of ARI in infants, their seasonal variability and association of clinical profile with etiology. In this study, a birth cohort was followed for the first year of life; for each episode of ARI, nasopharyngeal aspirates were collected to identify the causative respiratory virus(es) using multiplex real-time polymerase chain reaction assay. For lower respiratory tract infections blood culture, serum procalcitonin, serum antibodies to Mycoplasma and Chlamydia and urinary Streptococcus pneumoniae antigen were also assayed. In this cohort of infants, ARI incidence was 1.8 episodes per year per infant; 95% were upper respiratory tract infections. One or more viruses were detected in 63.3% of episodes and viral coinfections in 18.2% of episodes. Rhinovirus was the most common virus (42%) followed by respiratory syncytial virus (20%), parainfluenza virus (16.8%) and coronavirus (17.6%). In lower respiratory tract infections, viral infections were detected in 66.7% of episodes, bacterial infections in 94.4% of episodes and mixed bacterial–viral infections in 44.4% of episodes. Peak incidence of viruses was observed during February–March and September–November. There was no significant difference in symptom duration with virus types.

Kit used: FTD respiratory pathogens 21

2016 Article - "Pertussis-Associated Pneumonia in Infants and Children From Low- and Middle-Income Countries Participating in the PERCH Study" (1) (pdf, 255KB)

Summary: Few data exist describing pertussis epidemiology among infants and children in low- and middle-income countries to guide preventive strategies.
Children 1–59 months of age hospitalized with World Health Organization–defined severe or very severe pneumonia in 7 African and Asian countries and similarly aged community controls were enrolled in the Pneumonia Etiology Research for Child Health study. They underwent a standardized clinical evaluation and provided nasopharyngeal and oropharyngeal swabs and induced sputum (cases only) for Bordetella pertussis polymerase chain reaction. Risk factors and pertussis-associated clinical findings were identified.
Bordetella pertussis was detected in 53 of 4200 (1.3%) cases and 11 of 5196 (0.2%) controls. In the age stratum 1–5 months, 40 (2.3% of 1721) cases were positive, all from African sites, as were 8 (0.5% of 1617) controls. The case fatality ratio of pertussis-infected pneumonia cases 1–5 months of age was 12.5% (95% confidence interval, 4.2%–26.8%; 5/40); pertussis was identified in 3.7% of 137 in-hospital deaths among African cases in this age group.
In the postneonatal period, pertussis causes a small fraction of hospitalized pneumonia cases and deaths; however, case fatality is substantial. The propensity to infect unvaccinated infants and those at risk for insufficient immunity (too young to be vaccinated, premature, HIV-infected/exposed) suggests that the role for maternal vaccination should be considered along with efforts to reduce exposure to risk factors and to optimize childhood pertussis vaccination coverage.

Kit used: FTD respiratory pathogens 33

2016 Article - "Underdiagnosing of Mycoplasma pneumoniae infections as revealed by use of a respiratory multiplex PCR panel" (limited access)

Summary: We compared a multiplex PCR diagnostic approach against specific PCR diagnosis for detection of Mycoplasmapneumoniae infection. Seventy-five percent of all M. pneumoniae infections were only detected “unintentionally”by the use of the multiplex PCR indicating underdiagnosing of M. pneumoniae due to absenceof clinical suspicion.

Kit used: FTD Respiratory pathogens 21
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2016 Article - "Detection of enterovirus D68 in patients hospitalised in three tertiary university hospitals in Germany, 2013 to 2014" (pdf, 2MB)

Summary: Enterovirus D68 (EV-D68) has been recognised as a worldwide emerging pathogen associated with severe respiratory symptoms since 2009. We here report EV-D68 detection in hospitalised patients with acute respiratory infection admitted to three tertiary hospitals in Germany between January 2013 and December 2014. From a total of 14,838 respiratory samples obtained during the study period, 246 (1.7%) tested enterovirus-positive and, among these, 39 (15.9%) were identified as EV-D68.

Kits used: FTD Respiratory pathogens 21

2016 Article - "A new real-time RT-qPCR assay for the detection, subtyping and quantification of human respiratory syncytial viruses positive- andnegative-sense RNAs" (limited access)

Summary: Human respiratory syncytial virus (RSV) is a major health problem and the main cause of hospitalization due to bronchiolitis. RSV is divided into two antigenic subgroups, RSV-A and -B that co-circulate worldwide. Rapid and sensitive detection is desirable for proper patient handling while assessment of viral load may help to evaluate disease severity and progression. Finally RSV subtyping is needed to determine the prevalence and pathogenicity of each RSV subgroup, as well as their sensitivity to treatment. In this study, we took into account the most recent circulating RSV variants and designed two quantitative TaqMan one-step RT-PCR assays to detect and quantify both RSV subgroups separately. Standard dilutions of transcripts of positive and negative polarities were included in the assay validation to assess potential differences in sensitivity on negative-sense genomes and positive-sense RNAs. In addition, RSV detection in respiratory specimens of different types and sampled in different populations was compared to commercially available RSV diagnostic tools. Altogether, the RSV-A and -B assays revealed sensitive and quantitative over a wide range of viral loads, with a slight improved sensitivity of the RSV-B assay on positive sense transcripts, and allowed accurate RSV subtyping. We thus provide a useful tool for both RSV diagnostics and research.

Kit used: FTD Respiratory pathogens 21
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2016 Article - "Aetiology of childhood pneumonia in a well vaccinated South African birth cohort: a nested case-control study of the Drakenstein Child Health Study" (pdf, 814KB)

Summary: Pneumonia is a leading cause of mortality and morbidity in children globally. The cause of pneumonia after introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) has not been well studied in low-income and middle-income countries, and most data are from cross-sectional studies of children admitted to hospital. We aimed to longitudinally investigate the incidence and causes of childhood pneumonia in a South African birth cohort.

Kit used: FTD Respiratory pathogens 33

2016 Article - "The Relevance of a Novel Quantitative Assay to Detect up to 40 Major Streptococcus pneumoniae Serotypes Directly in Clinical Nasopharyngeal and Blood Specimens" (pdf, 595KB)

Summary: For epidemiological and surveillance purposes, it is relevant to monitor the distribution and dynamics of Streptococcus pneumoniae serotypes. Conventional serotyping methods do not provide rapid or quantitative information on serotype loads. Quantitative serotyping may enable prediction of the invasiveness of a specific serotype compared to other serotypes carried. Here, we describe a novel, rapid multiplex real-time PCR assay for identification and quantification of the 40 most prevalent pneumococcal serotypes and the assay impacts in pneumonia specimens from emerging and developing countries. Eleven multiplex PCR to detect 40 serotypes or serogroups were optimized. Quantification was enabled by reference to standard dilutions of known bacterial load. Performance of the assay was evaluated to specifically type and quantify S. pneumoniae in nasopharyngeal and blood samples from adult and pediatric patients hospitalized with pneumonia (n = 664) from five different countries. Serogroup 6 was widely represented in nasopharyngeal specimens from all five cohorts. The most frequent serotypes in the French, South African, and Brazilian cohorts were 1 and 7A/F, 3 and 19F, and 14, respectively. When both samples were available, the serotype in blood was always present as carriage with other serotypes in the nasopharynx. Moreover, the ability of a serotype to invade the bloodstream may be linked to its nasopharyngeal load. The mean nasopharyngeal concentration of the serotypes that moved to the blood was 3 log-fold higher than the ones only found in the nasopharynx. This novel, rapid, quantitative assay may potentially predict some of the S. pneumoniae serotypes invasiveness and assessment of pneumococcal serotype distribution.

Kit used: FTD Respiratory pathogens 21 plus

2016 Article - "Missed opportunities for antimicrobial stewardship in pre-school children admitted to hospital with lower respiratory tract infection" (limited access)

Summary: To describe the usage of multiplex polymerase chain reaction on nasopharyngeal swab (NPS) samples in pre-school children presenting with lower respiratory tract infection (LRTI) at Christchurch Hospital, and its impact on the use of antibiotics empirically and at discharge. This retrospective cohort study included 237 children, ages 3 months to 5 years, admitted to hospital during the winter months of 2012–2015 with a diagnosis of community-acquired LRTI. Children were identified by discharge coding and their notes reviewed. A significantly larger proportion of children who had a NPS sample taken (42/146, 36%) received no empiric antibiotics compared with children who did not have a sample taken (7/91, 7.7%, P < 0.001). Of those who did have a NPS sample taken 17 of 146 (11.6%) had their antibiotics discontinued prior to or at the time of discharge compared with only 3 of 91 (3.3%) of those who did not have a NPS sample (P < 0.025). Children with influenza detected were more likely to receive no antibiotics or have their antibiotics discontinued prior to or at discharge. Only a small proportion of children with other viruses identified had their antibiotics discontinued. It appears that clinicians were generally reluctant to stop antibiotics prior to discharge in young children with LRTI in whom influenza or other viruses were identified. In our view, it makes sense to stop antibiotics when the clinical presentation and NPS testing is consistent with a viral aetiology. Not stopping antibiotics at or before discharge in these children represents a missed opportunity for antimicrobial stewardship.

Kit used: FTD Respiratory pathogens 21
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2016 Article - "Pertussis-Associated Pneumonia in Infants and Children from Low- and Middle-Income Countries Participating in the PERCH Study" (pdf, 280KB)

Summary: Most deaths from pertussis occur in developing countries and among children during the first weeks or months of life. The World Health Organization (WHO) estimated that in 2013, Bordetella pertussis caused approximately 60 257 deaths in children <5 years of age. Protecting young infants from pertussis is considered a priority. To achieve this goal, robust data on pertussis case-fatality and risk factors are needed to guide prioritization of control strategies and public health interventions. The Pneumonia Etiology Research for Child Health (PERCH) Study, described in detail elsewhere, provided an opportunity to examine the clinical and epidemiologic characteristics of pertussis among infants and young children hospitalized with WHO-defined severe and very severe pneumonia in 7 developing countries. Here the paper reports the pertussis findings among all PERCH-enrolled children, with more detailed analyses of those most at risk for pertussis, infants <6 months of age.

The PERCH (Pneumonia Etiology Research for Child Health) project is a rigorous multi-country, case-control study of hospitalized pediatric patients with severe lower respiratory tract illnesses to determine the etiology and risk factors associated with the syndrome.
Fast-Track Diagnostics is part of the PERCH project since 2011 by providing FTD Respiratory kits.

Kit used: FTD Respiratory pathogens 33

2015 Article - "Evaluation of epidemiological and clinical features of influenza and other respiratory viruses" (pdf, 232KB)

Summary: The aim of the study is to clinically and epidemiologically evaluate respiratory tract infections the viral agents of which were detected by molecular methods and to compare influenza and other respiratory tract viruses in this context. It was concluded that influenza and other respiratory viruses cannot be differentiated definitely by clinical and radiological findings, though there are some differences.

Kit used: FTD Respiratory Pathogens 21

2015 Article - "Elevated transmission of upper respiratory illness among new recruits in military barracks in Thailand" (pdf, 339KB)

Summary: Recruits in four successive Royal Thai Army basic training classes living in military barracks were monitored for the symptoms of influenza-like illness (ILI) or upper respiratory illness (URI). Classes 1 and 2 were also monitored after basic training. Nasal/throat swabs from acute illnesses were collected and tested by influenza RT-PCR (all four classes). In addition, class 1 had multiplex PCR performed along with the analysis of bed locations within the barracks. The study concluded that basic training recruits in military barracks in the tropics had high rates of acute respiratory illnesses with illness patterns consistent with external seeding followed by substantial internal transmission.

Kit used: FTD Respiratory Pathogens 33

2015 Poster - "Evaluation of 3 Commercial Real-time RT-PCR Assays for Middle East Respiratory Syndrome Coronavirus" (pdf, 493KB)

Summary: The 3 commercial RT-PCR kits in the study provided all necessary reagents and easy-to-follow instructions for MERS-CoV diagnostic testing. The Fast-track diagnostics and RS assays performed comparably to the CDC reference assay, whereas the GS assay lacked sensitivity in both LOD determinations and with authentic MERS-CoV positive specimens.

Kit used: FTD hCoV-EMC

2015 Article - "Identification of viral and bacterial pathogens from hospitalized children with severe acute respiratory illness in Lusaka, Zambia, 2011–2012: a cross-sectional study" (pdf, 1MB)

Summary: The study examined non-influenza respiratory pathogens in children with severe acute respiratory illness (SARI) in Zambia, to estimate the scope of disease burden and determine commonly-identified respiratory pathogens. Singleplex and multiplex RT-PCR assays were used.

Kit used: FTD Respiratory pathogens 33

2014 Article - "Detection of Respiratory Viruses in Nasopharyngeal Swab and Adenoid Tissue from Children Submitted to Adenoidectomy: Pre- and Postoperative Analysis" (pdf, 133KB)

Summary: A prospective observational study was conducted in 36 patients under 12 years of age with upper airway lymphoid hypertrophy who were undergoing adenoidectomy, in which various respiratory viruses were investigated using real-time polymerase chain reaction in adenoid tissue and nasopharyngeal secretions collected preoperatively and 30 days postoperatively. The virus found more frequently in all samples was rhinovirus. After removal of adenoid tissue, there was a decrease in the prevalence of the virus contained in nasopharyngeal secretion 30 days after surgery.

Kits used: FTD Respiratory Pathogens 21

2014 Article - "Detection of respiratory viruses by real-time polymerase chain reaction in outpatients with acute respiratory infection" (pdf, 312KB)

Summary: The aim of this study was to determine the frequencies for a large range of respiratory viruses using a sensitive molecular detection technique in specimens from outpatients of all ages with ARIs. Nasopharyngeal aspirates were obtained from 162 individuals. Twenty-three pathogenic respiratory agents, 18 respiratory viruses and five bacteria were investigated using multiplex real-time reverse transcriptase polymerase chain reaction (RT-PCR) and indirect immunofluorescence assay (IIF). Through IIF, 33 (20.4%) specimens with respiratory virus were recognised, with influenza virus representing over half of the positive samples. Through a multiplex real-time RT-PCR assay, 88 (54.3%) positive samples were detected; the most prevalent respiratory viral pathogens were influenza, human rhinovirus and respiratory syncytial virus (RSV). Six cases of viral co-detection were observed, mainly involving RSV. The use of multiplex real-time RT-PCR increased the viral detection by 33.9% and revealed a larger number of respiratory viruses implicated in ARI cases, including the most recently described respiratory viruses [human bocavirus, human metapneumovirus, influenza A (H1N1) pdm09 virus, human coronavirus (HCoV) NL63 and HCoV HKU1].

Kit used: Respiratory pathogens 21 plus

2014 Article - "Acute respiratory viral infections in pediatric cancer patients undergoing chemotherapy" (pdf, 403KB)

Summary: The aim of the study is to estimate the prevalence of infection by respiratory viruses in pediatric patients with cancer and acute respiratory infection (ARI) and/or fever. A cross-sectional study, from January 2011 to December 2012 was carried out. The secretions of nasopharyngeal aspirates were analyzed in children younger than 21 years with acute respiratory infections. The rapid test was used for detection of influenza virus, and real-time multiplex polymerase chain reaction (FTD, Respiratory pathogens, multiplex Fast Trade Kit, Malta) for detection of influenza virus (H1N1, B), rhinovirus, parainfluenza virus, adenovirus, respiratory syncytial virus, human parechovirus, bocavirus, metapneumovirus, and human coronavirus. The study concluded that the prevalence of respiratory viruses was relevant in the infectious episode, with no increase in morbidity and mortality. Viral co-detection was frequent in patients with cancer and ARIs.

Kit used: Respiratory pathogens 21

2014 Article - "The Role of Multiplex PCR in Respiratory tract infections in children" (pdf, 503KB)

Summary: Especially children are of high risk of suffering of respiratory infections. From the clinical picture it is often impossible to distinguish between a viral and a bacterial infection. Multiplex PCR is a highly sensitive, highly specific test for the detection of viral nucleic acids in respiratory secretions, being used as aid in diagnosis of respiratory infections. These highly sensitive diagnostic tests can be used to distinguish viral from bacterial infections and thus reducing unnecessary prescription of antibiotics.

2013 Article - "Epidemiology of respiratory viruses in bronchoalveolar lavage samples in a tertiary hospital" (limited access)

Summary: The prevalence of respiratory viruses in adults is largely underexplored, as most studies focus on children. Additionally, in severely ill or immunocompromised adults, where respiratory infections are mostly attributed to bacteria and fungi; respiratory viruses can lead to severe complications. Objectives: To evaluate the epidemiology of respiratory viruses in bronchoalveolar lavage fluid (BAL) specimens from patients with lower respiratory tract disease. A total of 134BALfluid specimens collected during 2009–2011 were retrospectively assessed with the new commercial multiplex real-time PCR FTD Respiratory 21 Plus, targeting 18 different viruses and 2 atypical bacterial pathogens. Viral or atypical bacterial pathogens were detected in 29.1% of BAL fluid specimens. Coronaviruses were most prevalent, followed by rhinoviruses, RSV and bocaviruses. In conclusion, the study highlights the high prevalence of respiratory viruses in BAL fluid specimens from adult patients with lower respiratory tract disease. The methods to be used should be sensitive and cover a wide range of potential pathogens. The specific patient population can also influence the detection rates of respiratory viruses. Kit used: Respiratory pathogens 21 plus

Kit used: FTD Respiratory pathogens 21 plus
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2013 Article - "Detection of respiratory viruses using a multiplex real-time PCR assay in Germany, 2009/10" (limited access)

Summary: The aim of this study was to determine the prevalence of respiratory viruses and to prospectively evaluate the performance of the FTD respiratory pathogens multiplex PCR assay shortly after the 2009/10 influenza pandemic. The most prevalent viruses were respiratory syncytial virus and human metapneumovirus. Only pandemic influenza virus A/H1N1 (2009), and not seasonal influenza virus, was detected. Viruses other than influenza virus accounted for the majority of acute respiratory infections. The FTD assay can be easily implemented in general diagnostic laboratories and facilitate the optimization of patient-management schemes.

Kit used: FTD Respiratory pathogens 21
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2013 Article - "Comparison of four multiplex PCR assays for the detection of viral pathogens in respiratory specimens" (limited access)

Summary: Multiplex PCR has become the test of choice for the detection of multiple respiratory viruses in clinical specimens. However, there are few direct comparisons of different PCR assays. This study compares 4 different multiplex PCR assays for the recovery of common respiratory viruses. We tested 213 respiratory specimens using four different multiplex PCR assays: the xTAG respiratory viral panel fast (Abbott Molecular Laboratories), Fast-track Respiratory Pathogen assay (Fast-track Diagnostics), Easyplex respiratory pathogen 12 kit(Ausdiagnostics), and an in-house multiplex real-time PCR assay. The performance of the four assays was very similar, with 93–100% agreement for all comparisons. Other issues, such as through-put, technical requirements and cost, are likely to be as important for making a decision about which of these assays to use given their comparative performance.

Kit used: FTD Respiratory pathogens 21
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2012 Article - "Comparison of fast-track diagnostics respiratory pathogens multiplex real-time RT-PCR assay with in-house singleplex assays for comprehensive detection of human respiratory viruses" (pdf, 293KB)

Summary: Fast-track diagnostics respiratory pathogens (FTDRP) multiplex real-time RT-PCR assay was compared with in-house singleplex real-time RT-PCR assays for detection of 16 common respiratory viruses. The FTDRP assay correctly identified 26 diverse respiratory virus strains, 35 of 41 (85%) external quality assessment samples spiked with cultured virus and 232 of 263 (88%) archived respiratory specimens that tested positive for respiratory viruses by in-house assays. Of 308 prospectively tested respiratory specimens selected from children hospitalized with acute respiratory illness, 270 (87.7%) and 265 (86%) were positive by FTDRP and in-house assays for one or more viruses, respectively, with combined test results showing good concordance (K = 0.812, 95% CI = 0.786–0.838). Individual FTDRP assays for adenovirus, respiratory syncytial virus and rhinovirus showed the lowest comparative sensitivities with in-house assays, with most discrepancies occurring with specimens containing low virus loads and failed to detect some rhinovirus strains, even when abundant. The FTDRP enterovirus and human bocavirus assays appeared to be more sensitive than the in-house assays with some specimens. With the exceptions noted above, most FTDRP assays performed comparably with in-house assays for most viruses while offering enhanced throughput and easy integration by laboratories using conventional real-time PCR instrumentation.

Kits used: FTD Respiratory Pathogens 21

2012 Poster - "Respiratory virus detection by multiplex PCR in nasal lavage from exacerbation prone asthmatic subjects with symptoms of the common cold" (pdf, 271KB)

Summary: The aim was to identify respiratory viruses in nasal lavage collected from asthmatic subjects when they experienced symptoms of the common cold. This study formed part of a Phase II clinical trial of inhaled interferon beta for the treatment of virus induced asthma exacerbations conducted between March 2010 and December 2011 in the UK and Australia. It was found that rhinovirus, the most frequent cause of the common cold, accounted for the majority of the viruses detected. Virus detection rates were comparable to those reported in other studies. The failure to detect a virus in all subjects could reflect issues with sample quality, a limitation of the assay or the presence of undiscovered pathogens. Samples in which a virus was not detected are currently undergoing sequencing with the aim of identifying potential novel viruses.

Kit used: Respiratory Pathogens 21

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