Rapid identification of viral respiratory infection is possible

Daily POEMs

Published: 2014-06-16 © 2014 John Wiley & Sons, Inc.

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Clinical question
What is the clinical usefulness of a test for viral respiratory infection in young children?

Bottom line
In this age of CSI and other television shows that show instantaneous identification of the bad guy's DNA, having a test that can indicate "Yes, your child has a virus" is almost expected. Quantitative real-time polymerase chain reaction (PCR) isolated one or more noninfluenza viruses from 72.3% of children with respiratory tract infection symptoms. But we still don’t have a commercially available point-of-care test for rhinovirus, which was isolated by PCR from almost half the children with symptoms. (LOE = 4)

Reference
Rhedin S, Lindstrand A, Rotzen-Ostlund M, et al. Clinical utility of PCR for common viruses in acute respiratory illness. Pediatrics 2014;133(3):e538-545.

Study design: Case-control

Funding source: Foundation

Setting: Outpatient (any)

Synopsis
This study evaluated the clinical utility of viral identification of nasopharyngeal samples using quantitative real-time PCR. The test was performed on aspirates (not swabs) from 151 children younger than 5 years who presented with an acute respiratory infection. The results were compared with results from 74 children without symptoms who were of a similar age at around the same time. Samples were collected during a noninfluenza season. The PCR was capable of identifying 16 viruses. One or more viruses were isolated in 72.3% of children with symptoms; almost half of these findings were rhinovirus (47.9%). In the asymptomatic children, a virus was isolated in 35.4%; rhinovirus was isolated only 21.5% of the time. Enterovirus and coronavirus were present at the same rate in case and control children.

Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA

Copyright © 2014 John Wiley & Sons, Inc.