Detection of viral respiratory pathogens in mild and severe acute respiratory infections in Singapore

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Sci Rep. 2017 Feb 20;7:42963. doi: 10.1038/srep42963.
Detection of viral respiratory pathogens in mild and severe acute respiratory infections in Singapore.

Jiang L¹, Lee VJ^1,2, Cui L³, Lin R^3,4, Tan CL⁵, Tan LW¹, Lim WY¹, Leo YS⁵, Low L⁶, Hibberd M⁶, Chen MI^1,7.
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Abstract

To investigate the performance of laboratory methods and clinical case definitions in detecting the viral pathogens for acute respiratory infections (ARIs) from a prospective community cohort and hospital inpatients, nasopharyngeal swabs from cohort members reporting ARIs (community-ARI) and inpatients admitted with ARIs (inpatient-ARI) were tested by Singleplex Real Time-Polymerase Chain Reaction (SRT-PCR), multiplex RT-PCR (MRT-PCR) and pathogen-chip system (PathChip) between April 2012 and December 2013. Community-ARI and inpatient-ARI was also combined with mild and severe cases of influenza from a historical prospective study as mild-ARI and severe-ARI respectively to evaluate the performance of clinical case definitions. We analysed 130 community-ARI and 140 inpatient-ARI episodes (5 inpatient-ARI excluded because multiple pathogens were detected), involving 138 and 207 samples respectively. Detection by PCR declined with days post-onset for influenza virus; decrease was faster for community-ARI than for inpatient-ARI. No such patterns were observed for non-influenza respiratory virus infections. PathChip added substantially to viruses detected for community-ARI only. Clinical case definitions discriminated influenza from other mild-ARI but performed poorly for severe-ARI and for older participants. Rational strategies for diagnosis and surveillance of influenza and other respiratory virus must acknowledge the differences between ARIs presenting in community and hospital settings.


PMID: 28218288 DOI: 10.1038/srep42963
[PubMed - in process]