Methods: A retrospective cohort study was performed at the Montreal Children’s Hospital from Jan. 2013 to Sept. 2015. Respiratory samples from admitted or immunocompromised patients were routinely inoculated on traditional tube cell culture monolayers if they tested negative by a PCR assay for 12 respiratory viruses. We studied patients <18 years old with a respiratory specimen negative by PCR and positive by cell culture. Duplicates (›1 additional sample during the same illness episode) and samples of sold services (medical records unavailable) were excluded from analyses. Demographics, clinical history, laboratory findings, and impact of a positive cell culture result (i.e., to guide antibiotic stoppage, antiviral treatment or hospital discharge) were collected from patients’ charts. Descriptive statistics were performed.
Results: 4868 PCR-negative samples were inoculated in cell culture during the study period. Of those, 196 (4.0%) were cell culture positive, and 144 met study inclusion criteria. Subjects were mostly male (63.2%) and 81.9% were hospitalized; 43% were previously healthy and 14% were immunocompromised. Mean age was 2.4 ± 3.4 years. The frequency of viruses isolated and result turn-around times are listed in Table 1. Cell culture results prompted a change in management in 5 patients (3.5%), all of who had acyclovir initiated for localized HSV-1 infection. Four of these had skin or mucosal lesions that could be sampled to establish a diagnosis.
|Viruses||N (%)||Mean TAT (days)|
Respiratory viruses: parainfluenza (23), rhinovirus (15), RSV (3), adenovirus (1), influenza B (1)
Conclusion: In children, routine viral culture on specimens that were negative by PCR has low yield and minimal clinical impact.
M. Alghounaim, None
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