Detection of Common Respiratory Viruses in Patients with Acute Respiratory Infections Using Multiplex Real-Time RT-PCR

Abstract

Background: Acute respiratory infection (ARI) is caused by human metapneumovirus (HMPV), respiratory syncytial virus type A and B (RSV-A, RSV-B), human parainfluenza viruses 1, 2, and 3 (HPIV-1, HPIV-2, and HPIV-3), influenza viruses A and B (IfV-A, IfV-B), and human coronaviruses (OC43/HKU1, NL63, 229E) worldwide. Objectives: This study was conducted to assess the causative agents of viral ARI among hospitalized adults by real-time PCR. Methods: Clinical nasopharyngeal swabs of 112 patients including 55 (49.1%) males and 57 (50.89%) females with ARI were analyzed using multiplex real-time RT-PCR. Results: Out of 112 specimens, 61 (54.46%) were positive including 10 (8.9%) for influenza H3N2, one (0.89%) for influenza B, 28 (25%) for RSV-A, 18 (16.07%) for HMPV-A, two (1.78%) for HPIV-1, and three (2.67%) for HPIV-3. Two (1.78%) specimens were positive for two agents, RSV-A/HMPV-A and RSV-A/HPIV-3. The distribution of viral infections was 30 among males (26.78%) and 31 (27.67%) among females (P = 0.862). High frequency of RSV-A infection (25%) and the low frequency of influenza B virus infection (0.89%) were detected among patients. The remaining 51 (45.53%) samples were negative for RSV-B, HMPV-B, IfV-A, HPIV2-4A-4B, and HCoVs (OC43/HKU1, NL63, 229E). Conclusions: The role of other viruses such as human adenoviruses rhinovirus/enterovirus (RV/EV), human bocavirus (HBoV), and human parechovirus (HpeV) was not investigated. Multiplex PCR can be used as a rapid test for the diagnosis of viruses causing acute respiratory infection, which results in decreased length of hospitalization.

Coronavirus HKU 1 infection with bronchiolitis, pericardial effusion and acute respiratory failure in obese adult female

“…A recent retrospective analysis of coronavirus detections in respiratory samples across the USA in a three-year period showed that HKU 1 is less common than other coronavirus species; more than 45% of the patients were under 18 years of age; no correlation between different coronavirus species and clinical features was reported (18). An Iranian study among adult patients hospitalized for acute respiratory infection did not find positivity for any of the coronaviruses investigated (HKU 1 included) (19). A Chinese study specifically conducted in Beijing over a period of 4 years on adult (over 14 years) outpatients with respiratory symptoms and normal chest X-rays showed that only 1% had a coronavirus infection (87/ 8396) and only 14 patients (0.2%) were positive for HKU 1.…”