1235. Usefulness of the new techniques in the etiological diagnostic of Lower Respiratory Tract Infections in the Pediatric population
Session: Poster Abstract Session: RSV and Other Viral Respiratory Infections in Children
Saturday, October 22, 2011
Room: Poster Hall B1
Background: Lower Respiratory Tract Infections (LRTI) are the most common causes of pediatric hospitalizations in winter season. New techniques developed recently facilitate the etiologic diagnostic improving the managing and care of these patients.

Methods: From October 2008 to September 2009, paediatric inpatients diagnosed of LRTI were offered to participate. Those whose progenitors accepted were surveyed with a questionnaire including demographic, clinical and epidemiological data. Respiratory specimens were obtained from all patients. Immunochromatographic test (IC) for RSV, Real time-PCR (RT-PCR) and Speed-Oligo PCR (SpO-PCR) for RSV and Human Metapneumovirus (hMPV), virus culture for Adenovirus, RSV, hMPV, Influenza and Parainfluenza viruses were performed for all respiratory specimens

Results: During the study period, 246 patients with LTRI were hospitalized and 165 (67%) were eligible. Age was 24.2 months (IC 95% 19.9-29.0) and hospitalization length was 6.2 days (IC 95% 5.5-6.9). More frequent diagnostics were pneumonia (32.7%) and bronchiolitis (30.9%) without differences in severity. Overall, 62 patients (37.5%) had at least one positive specimen for RSV (57 RSV subtype A, 3 RSV subtype B, and 2 unknown subtype). Sensitivity and specificity were 94.9, 99.4 respectively for SpO-RSV, and 92.9 and 96.3 for RT-PCR/RSV. Viral culture showed a sensitivity of 46.4% and a negative predictive value of 78.1%. IC showed a sensitivity of 58.4%, specificity of 98.1%. SpO-RSV and RT-PCR/RSV did not significantly differ in sensitivity or specificity. Both PCR-based methods were significantly more sensitive than IC (p<0.0001) and viral culture (p<0.0001). hMPV was detected in 13 cases (7.7%). Using cell culture, Adenovirus, Influenza B virus, Parainfluenza 2 virus and RSV were isolated in 9(5.3%), 11(6.5%), 10(5.9%) and 35(20.7%) patients respectively. Four patients had mixed viral cultures. Overall, in 98 patients (59%) a viral etiology was found and 10 of these patients (10.2%) had mixed infections

Conclusion: Viral agents are the principal responsible of hospitalizations caused by LTRI. New molecular techniques represent an additional method to improve the accuracy showed by rapid tests used in clinical practice


Subject Category: P. Pediatric and perinatal infections

Francisco Gimenez-Sanchez, MD, PhD1, Miguel Sanchez-Forte2, Waldo Sanchez Yebra2, Antonio Bonillo-Perales2, Yolanda Gonzalez Jimenez2, Joaquin Mendoza3, Teresa Rubi2, Jose Batlles Garrido2 and Cobos Elena2, (1)Pediatrics, Torrecardenas Hospital , Almeria, Spain, (2)Torrecardenas Hospital , Almeria, Spain, (3)Vircell, Granada, Spain

Disclosures:

F. Gimenez-Sanchez, None

M. Sanchez-Forte, None

W. Sanchez Yebra, None

A. Bonillo-Perales, None

Y. Gonzalez Jimenez, None

J. Mendoza, None

T. Rubi, None

J. Batlles Garrido, None

C. Elena, None

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