Detection of respiratory coinfections in pediatric patients using a small volume polymerase chain reaction array respiratory panel: More evidence for combined droplet and contact isolation

Eric J. McGrath, Ronald Thomas, Basim Asmar, Marilyn R. Fairfax, Paul Lephart, Jamal Ameli, Nahed Abdel-Haq, Hossein Salimnia

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background: In fall 2009, Children's Hospital of Michigan (CHM) instituted combined isolation precautions (contact and droplet isolation) for pediatric inpatients with upper respiratory infection (URI) symptoms to prevent health care-associated infection. Methods: Pediatric patients with symptoms of URI had nasopharyngeal (NP) swab samples obtained prospectively between January and April and September and December 2010 for small volume polymerase chain reaction (SVPCR) array respiratory panel (RP) multiplex nucleic acid testing. NP swabs or nasal washes were obtained for viral culture and rapid antigen testing (RAT). Results: Of 499 evaluable SVPCR array RP samples, 344 (69%) tested positive for at least 1 of the 21 tested organisms. The most commonly identified pathogen was rhinovirus/enterovirus (181/344 [53%]) for which no RAT exists at CHM. Of 344 positive specimens, 57 (17%) had at least 2 identified pathogens; 8 (2%) of these had 3. In 11% of patients, molecular testing detected pathogens or pathogen combinations requiring both contact and droplet precautions. Conclusion: SVPCR array RP testing detected respiratory pathogens in pediatric patients with URI at rates higher than that of RAT and viral culture. Because of the pathogens and pathogen combinations detected, the study findings suggest that combined contact and droplet isolation precautions may be warranted to prevent health care-associated infection in pediatric inpatients with URI. Further studies will be needed to confirm these results.

Original languageEnglish
Pages (from-to)868-873
Number of pages6
JournalAmerican Journal of Infection Control
Volume41
Issue number10
DOIs
StatePublished - Oct 2013

Keywords

  • Children
  • Co-infection
  • Isolation precautions
  • Molecular diagnostics
  • Respiratory virus

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