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Frequent Detection of Viral Coinfection in Children Hospitalized With Acute Respiratory Tract Infection Using a Real-Time Polymerase Chain Reaction

Bonzel, Linda MD*; Tenenbaum, Tobias MD; Schroten, Horst MD; Schildgen, Oliver PhD; Schweitzer-Krantz, Susanne MD§; Adams, Ortwin MD*

The Pediatric Infectious Disease Journal: July 2008 - Volume 27 - Issue 7 - p 589-594
doi: 10.1097/INF.0b013e3181694fb9
Original Studies

Background: Respiratory viruses are the main cause of acute respiratory tract infection (ARI) in children. Real-time polymerase chain reaction (PCR) technology is highly practicable for the rapid detection of viral pathogens. The simultaneous detection of a broad spectrum of viruses enables the diagnosis and evaluation of viral coinfection in ARI.

Methods: A 1-step real-time PCR was developed for the detection of 12 respiratory viruses (10 RNA and 2 DNA viruses) in clinical samples. Clinical samples from 254 children admitted to the Departments of Pediatrics with ARI during a 10-month period were tested.

Results: Respiratory syncytial virus (RSV) was the most frequently detected pathogen in 112 samples (44.1%), followed by human bocavirus (hBoV) in 49 (19.3%), and rhinovirus in 17 samples (6.7%). Viral coinfection was detected in 41 (16.1%) samples with RSV and hBoV being the most dominating combination (27 cases, 10.6%). Viral coinfection was found in 10 cases (17%) of children with bronchitis (n = 58) and in 7 cases (23%) of bronchiolitis (n = 30). In patients with pneumonia (n = 51), 17 cases (33%) were positive for 2 or more viral pathogens.

Conclusions: Simultaneous testing of respiratory viruses by real-time PCR is a suitable tool for the detection of viral coinfections. In children hospitalized because of respiratory infection viral coinfection is frequently detected with RSV and hBoV being a common combination.

Supplemental Digital Content is Available in the Text.

From the *Institute for Virology, University of Duesseldorf; †Pediatric Infectious Diseases, Department of General Pediatrics, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany; ‡Department of Virology, Institute for Medical Microbiology, Immunology, and Parasitology, University of Bonn, Bonn, Germany; and §Children's Hospital, Evangelisches Krankenhaus Duesseldorf, Duesseldorf, Germany.

Accepted for publication January 17, 2008.

Parts of this work were reported as an oral presentation on the ESCV Symposium on Respiratory Viruses, May 24-25, 2007, Lyon, France.

Address for correspondence: Ortwin Adams, MD, Institut für Virologie, Geb. 22.21, Universitaetsstr. 1, D-40225, Düsseldorf, Germany. E-mail:

© 2008 Lippincott Williams & Wilkins, Inc.