Rapid Detection of Respiratory Pathogen 33 in Cases of Acute Respiratory Tract Infection

Main Article Content

Sawang Saenghirunvattana
Panpit Suwangool
Paulet Barro Ortiz
Chonticha Noomcharoen
Natsuda Wongkhot

Abstract

OBJECTIVES: To determine the efficacy of respiratory pathogen (RP) 33 test for detecting specific RP that cause acute respiratory infection in a short turnaround time.

MATERIAL AND METHODS: A retrospective study of RP 33 test was performed from June 2018 to June 2019 of twenty symptomatic participants aged > 18 years old, medical evaluation and laboratory test were carried out at OPD Chest Center in Bangkok Hospital and laboratory test should be conducted during the duration of the study. Subjects were immune-competent and manifested signs and symptoms of acute respiratory infections. Seventeen participants were subjected to additional tests such as blood culture and sputum culture, acid fast bacilli (AFB) test, bronchial washing, Influenza AB viruses, and respiratory syncytial virus (RSV) and Quantiferon test for a definitive diagnosis.


RESULT: All 20 participants were included in the study, 10 male and 10 female with a mean age of 64 ± 8.4 years. RP 33 test often takes a shorter turnaround time compared to microbial culture, a mean time of 20 ± 7.767 hours compared to 72 hours from sputum culture or blood culture as demonstrated on our test. Among the twenty participants there were twelve (60%) detected cases, five (25%) of which revealed multiple types of etiologic agent indicating co-infection. For bacterial etiology, nine cases were established: three cases of Staphylococcus Aureus were found, three cases of Klebsiella Pneumonia, one case of Streptococcus Pneumonia. Viral etiology was confirmed in nine cases, the leading pathogen of viral etiology is human Rhinovirus with three cases, two cases of influenza A virus, one case of influenza B virus, one case of Human Corona virus OC43, one case of human Parainfluenza virus 4 and one case of human Metapneumo virus A/B. There were eight (40%) cases of undetected results that needed additional diagnostic tests (sputum culture and sensitivity (Sputum C/S), acid fast bacilli test (AFB test), hemoculture and sensitivity (hemo C/S), bronchial washing, influenza AB&RSV and Quantiferon (TB QFT TB) test) to identify etiologic agent.


CONCLUSION: RP 33 test, a multiplex real time polymerase chain reaction (PCR), provided a commendable implication. RP 33 test provided prompt and optimal diagnostic evaluations in ruling out etiologies of respiratory-related infections, particularly acute respiratory infections, thus delivering definitive and precise clinical care to patients leading to minimal usage of broad spectrum antibiotics.


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1.
Saenghirunvattana S, Suwangool P, Barro Ortiz P, Noomcharoen C, Wongkhot N. Rapid Detection of Respiratory Pathogen 33 in Cases of Acute Respiratory Tract Infection. BKK Med J [Internet]. 2020 Feb. 25 [cited 2024 Nov. 22];16(1):9. Available from: https://he02.tci-thaijo.org/index.php/bkkmedj/article/view/239967
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Original Article

References

Forum of International Respiratory Societies. The Global Impact of Respiratory Disease. Second Edition. Switzerland. 2018

Bruno P. The importance of diagnostic test parameters in the interpretation of clinical test findings: The prone hip extension test as example. J Can Chiropr Assoc 2011;55(2):69-75.

Kay BA. The Role of the Laboratory in Disease Surveillance. EMHJ 1996; 2(1):61-7.

Kha KS, Chien PFW. Evaluation of a clinical test 1: Assessment of reliability. BJOG 2001:108:562-7. https://doi.org/10.1111/j.1471-0528.2001.00150.x

Mauch H. Diagnostic of acute respiratory tract infections: serotology and new method. Clin Microbiol Infect 1996;1(Suppl 2):S16-9. https://doi.org/10.1111/j.1469-0691.1996.tb00186.x

Salez N, Vabret A, Leruez-Ville M, et al. Evaluation of four commercial multiplex molecular tests for the diagnosis of acute respiratory infections. PLoS One 2015;10(6): e0130378. doi: 10.1371/journal.pone.0130378.eCollection.

El Baroudy NRE, Refay ASE, Hamid TAA, et al. Respiratory viruses and atypical bacteria co-infection in children with acute respiratory infection. Open Access Maced J Med Sci 2018;6(9):1588-93

Bauer KA, Perez KK, Forrest GN, et al. Review of rapid diagnostic test used by antimicrobial stewardship programs. Clin Infect Dis 2014:59(Suppl 3):S134-45.

Kim YG, Yun SG, Kim MY, et al. Comparison between Saliva and Nasopharyngeal Swab Specimens for Detection of Respiratory Viruses by Multiplex Reverse Transcription-PCR. J Clin Microbiol 2016;55(1):226-33.

Garcia-Vasquez E, Marcos MA, Mensa J, et al. Assessment of the usefulness of sputum culture for diagnosis of community-acquired pneumonia using the PORT predictive scoring system. Arch Intern Med 2002;164(16).1807-11.

Center for Disease Control and Prevention (CDC). Information on Rapid Molecular Assays, RT-PCR and other Molecular Assays for Diagnosis of Influenza Virus Infection. (Accessed September 10, 2019, at https://www.cdc.gov/flu/professionals/diagnosis/molecular-assays.htm )

Harris AM, Bramley AM, Jain S, et.al. Influence of Antibiotics on the Detection of Bacteria by Culture-Based and Culture- Independent Diagnostic Tests in Patients Hospitalized with Community-Acquired Pneumonia. Open Forum Infect Dis 2017;4(1):ofx014.

Driscoll AJ, Knoll MD, Hamitt LL, et.al. The Effects of Antibiotic Exposure and Specimen Volume on the Detection of Bacterial Pathogens in Children with Pneumonia. Clin Infect Dis 2017:64(3): S368-S377.

Dominguez-Diaz C, Garcia-Orozco A, Riera-Leal A, et al. Microbiota and Its Role on Viral Evasion: Is It with Us or Against Us? Front Cell Infect Microbiol 2019;9:256.

Parker D, Prince A. Immunopathogenesis of Staphylococcus Aureus Pulmonary Infection. Semin Immunopathol 2012; 34(2):281-97.

MorgeneMF,Bohelto-NeversE,GratttardF,etal.Staphy- lococcus Aureus colonization and non-influenza respiratory viruses: Interactions and synergism mechanism. Virulence 2018;9(1): 1354-13.

Paczosa M, Mecsas J. Klebsiella Pneumoniae: Going on the Offense with a strong Defense. American Society of Microbiology. Microbiol Mol Biol Rev 2019;80(3):629-61.

Rhedin S, Lindstrand A, Rotzen-Ostlund M. et al. Clinical Utility of PCR for common viruses in acute respiratory illness. Pediatrics 2014;133(3):e538-45.

Moxon ER, Wilson R, The role of Haemophilus influenza in the pathogenesis of pneumonia. Rev Infect Dis 1991;13(6): S518-27.

Cebey-Lopez M, Herberg J, Pardo-Seco J, Does Viral Co-Infection Influence the Severity of Acute Respiratory Infection in Children? PLoS One 2016;11(4): e012481.