516. Duration of Parainfluenza Virus Detection in Nasopharyngeal Swabs using a Polymerase Chain Reaction-Based Detection
Session: Poster Abstract Session: Respiratory Infections: Pediatric
Thursday, October 8, 2015
Room: Poster Hall
  • Duration of Parainfluenza Virus Detection in Nasopharyngeal Swabs using PCR.pdf (1.5 MB)
  • Background: Parainfluenza virus (PIV) is an important cause of upper and lower respiratory tract infections in children. Multiplex nucleic acid amplification-based assays for PIV are sensitive and widely used. However, little is known about the duration of detection. The aim of this study was to determine the duration of positive PIV detected on nasopharyngeal secretions.

    Methods: The Department of Infection Control at Cohen Children's Medical Center provided a prospectively prepared list of patients who tested positive for  PIV types 1, 2, 3, and 4 using a polymerase chain reaction (PCR) assay (xTAG Respiratory Viral Panel, Luminex) for the time period March 2010 through October 2012. Patients with more than one test result within a 100 day period were studied. A retrospective medical review abstracted patient age, immunocompromised (IC) state, and illness severity. Days from the first positive test to the first negative test were calculated using Proc ICLifetest in SAS 9.4.  For each factor, survival was compared using a generalized log-rank test.

    Results: For the 77 patients studied, the median time from the first positive (day 0) to the first negative test was 3 days (95% CI, 2-15) and 92% were negative by days 15-23. The median time to first negative for the 35 patients < 3 years and the 42 patients ≥ 3 years was 2 days (95% CI, 2-12) and 4 days (95% CI, 4-15), respectively (difference not significant). Of the 75 patients for which the status was known, 45% (n=34) were IC. The duration of positive PCR in non-immunocompromised patients, 3 days (95% CI, 2-11), did not significantly differ from IC patients, 4 days (95% CI, 4-15). The median duration of positive PCR for the 26 patients with moderate to severe disease, 3 days (95% CI, 2-3) was significantly shorter than for the 34 patients with uncomplicated infection, 10 days (95% CI, 10-15) (p < 0.0192). Illness severity was unknown in 17 patients.

    Conclusion: Fifty percent of patients became PCR negative by 3 days after the positive result and 92% were negative by days 15-23. There was no significant difference in the duration of PIV detection based on patient age or IC status. Patients with uncomplicated infection had a longer duration of positivity compared to those with moderate to severe infection.

    Michelle Sewnarine, MD, Pediatric Infectious Diseases, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, NY, Nina Kohn, MBA, MA, Feinstein Institute for Medical Research, North Shore - LIJ Health System, Manhasset, NY, Stephanie Tong, BS/BA, Hofstra North Shore LIJ School of Medicine, Hempstead, NY and Lorry Rubin, MD, FIDSA, North Shore LIJ, New Hyde Park, NY


    M. Sewnarine, None

    N. Kohn, None

    S. Tong, None

    L. Rubin, None

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