Community-acquired respiratory viru...

Community-acquired respiratory viruses (CRVs) cause greatest in quantity of the acute lower respiratory infections in children that end in hospitalization. These viruses, greatest in number common in fall, winter, and early spring, include influenza virus, respiratory syncytial virus, parainfluenza virus, adenovirus, coronavirus, and rhinovirus. lonely dwelling culture isolation from respiratory secretions is the standard for diagnosis of respiratory virus infections and requires couple to 10 days to whole Rapid diagnostic procedures, frequently using direct immunofluorescence assay (DFA) or membrane enzyme-linked immunosorbent assay are becoming widely available; they lay open respiratory viral antigens within 10 to 60 minutes. The sensitivity of these assays is 70 to 95 percent Shetty and associates studied the efficacy of the DFA technique in detecting used by all viruses in nasopharyngeal samples and assessed the clinical usefulness of concomitant conventional viral cultures

Nasopharyngeal samples from 1670 children hospitalized for management of lower respiratory tract infection were criterioned for CRVs by DFA and agriculture Children with chronic lung disorders, congenital heart disease, or immunocompromise were exclud The impact of viral improvement and DFA test results forward management was measured by the amount of time required to recognize positive rises the length of the hospital stay, and the purport of test results on antibiotic therapy and duration of hospitalization decisions.

Of the 1557 evaluable samples, virus was discovered by either DFA or tillage in 468 30 percent). The contemplation included 140 children with a mean age of 86 month who had culture-proven lower respiratory tract infection. Bronchiolitis was the greatest in number common diagnosis, followed by pneumonia and rump Antibiotics were started empirically in 102 patients (73 percent) unless were stopped within 48 hours of admission in 49 patients (48 percent) based forward a positive DFA or negative bacterial tillage Because the mean hospital stay was 36 days and the mean time for viral cultivations to become positive was 77 days, greatest in number viral culture results were not available before discharge. The consequence s of the viral cultures did not affect treatment or hospital discharge date in any patient.

The authors close that viral cultures are not useful in otherwise healthy children hospitalized for community-acquired lower respiratory tract infections. Antibiotic decisions were made in succession the basis of rapid viral antigen testing using DFA and, although false-positive antigen did come to one's mind viral culture results were not available until after discharge and did not affect any clinical decisions.

Shetty AK, et al. Comparison of conventional viral agricultures with direct fluorescent antibody stains for diagnosis of community-acquired respiratory virus infections in hospitalized children. Pediatr Infect Dis J September 2003; 22:789-94

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