Nucleic acid tests identified respiratory viruses in 83% of symptomatic children compared to 49% by conventional methods (P<0.001), and in 41.7% vs 4.4% of asymptomatic children (P<0.001).
Cohort (n=306)
No
Do nucleic acid tests improve the detection of respiratory viruses compared to conventional methods in hospitalized children with and without symptoms of respiratory viral illness?
Molecular assays (NATs) have higher sensitivity for detecting respiratory viruses than conventional methods, but their high positivity rate in asymptomatic children requires cautious interpretation.
Absolute Event Rate: 83% vs 49%
p-value: p=<0.001
BACKGROUND: Viral respiratory infections are among the most common reasons for hospitalization of children in the United States. Our objective was to compare molecular and conventional methods in a cohort of hospitalized children with and without symptoms of respiratory viral illness (RVI). METHODS: We conducted a retrospective cohort study of infants and toddlers hospitalized between December 2007 and March 2008 at Johns Hopkins Hospital. Five hundred sixty-nine of 641 patient visits (89%) were tested on admission. Conventional tests (immunochromatography, direct fluorescent antibody, shell vial and tube culture) were performed on all patients and nucleic acid tests (NATs) were performed on available samples (n = 306). Viruses were grouped into those routinely (group 1) and those not routinely (group 2) detected by conventional methods. RESULTS: In children with RVI symptoms (n = 148), NATs identified a virus in 83% of specimens compared with 49% by conventional methods (P < 0.001), but detected a similar percentage of specimens with group 1 viruses (48.6% and 55.4%; P = 0.13) compared with conventional tests. In children without RVI symptoms (n = 158), NATs identified a virus in 41.7% of specimens compared with 4.4% by conventional tests (P < 0.001) and identified more group 1 viruses (9.5% and 4.4%; P = 0.03) compared with conventional tests. Group 2 viruses were identified by NATs in a similar percentage of symptomatic and asymptomatic patients (25% and 32.3%; P = 0.20). CONCLUSIONS: Molecular assays may have several advantages over conventional methods for detecting respiratory viruses, including improved sensitivity and rapid detection, but given the high prevalence of positive results in children without RVI symptoms, results should be interpreted cautiously.
Advani et al. (Wed,) conducted a cohort in Respiratory viral illness (n=306). Nucleic acid tests (NATs) vs. Conventional tests (immunochromatography, direct fluorescent antibody, shell vial and tube culture) was evaluated on Detection of a respiratory virus in children with RVI symptoms (p=<0.001). Nucleic acid tests identified respiratory viruses in 83% of symptomatic children compared to 49% by conventional methods (P<0.001), and in 41.7% vs 4.4% of asymptomatic children (P<0.001).