key: cord-1031262-jhimcvqw authors: Tai, Cheng-Chun; Tsai, Cheng-Hsien; Huang, Yu-Han; Lee, Chia-Lin; Chen, Hsin-Pai; Chan, Yu-Jiun title: Detection of Respiratory Viruses in Adults with Respiratory Tract Infection Using a Multiplex PCR Assay at a Tertiary Center date: 2020-08-12 journal: J Microbiol Immunol Infect DOI: 10.1016/j.jmii.2020.07.020 sha: c85f0706ede6a9e09808d2e10ea75e1175848293 doc_id: 1031262 cord_uid: jhimcvqw Abstract Background Respiratory viruses (RVs) are among the most common pathogens for both upper and lower respiratory tract infections (RTIs). However, the viral epidemiology of RV-associated RTIs in adults has long been under-recognized. Through a sensitive molecular assay, it would be possible to have a better understanding of the epidemiology of RV-associated RTIs. Material And Methods Respiratory tract (RT) specimens from adults hospitalized due to RTIs were tested for RVs, using the multiplex PCR-based Luminex xTAG® Respiratory Viral Panel assay. A total of nineteen RVs, including influenza viruses and non-influenza respiratory viruses (NIRVs) were detected. Positive rates were compared using a chi-square test. Results A total of 2292 samples from adult patients hospitalized with RTIs were screened for RVs. The overall positive rate was 22%, with 17.8% samples positive for at least one NIRV. NIRVs had a higher positive rate in non-winter seasons. As many as 12.7% (46/363) of the samples collected through broncho-alveolar lavage and 20.5% (176/859) of the samples collected in ICUs were positive for RVs. Distribution of corona virus (CoV), human metapneumovirus (hMPV) and parainfluenza virus (PIV) demonstrated seasonal variation. Also, temperature was associated with the positive rates of specific viruses, including CoV, respiratory syncytial virus (RSV), hMPV and PIV. Conclusion Respiratory viruses, notably NIRVs, were frequently detected in adults hospitalized with RTIs. Several RVs were detected with distinctive seasonal variations. A substantial number of RVs were identified in lower RT specimens or from patients admitted to ICU, highlighting their important role in causing severe respiratory infection. Worldwide, respiratory tract infections (RTIs) are a major cause of both mortality 25 and morbidity, and can be categorized into upper and lower RTIs according to the 26 anatomical location that is being infected 1 . In 2015, lower RTIs represented the fourth 27 most common cause of death, after ischemic heart disease, cerebrovascular disease, and 28 chronic obstructive pulmonary disease 2 . Pneumonia, being one of the most important 29 lower RTIs, was reported to have an annual incidence of 24.8 per 10,000 adults and the 30 incidence increased with age 3 . Also, pneumonia is the most common nosocomial 31 infection in the intensive care unit (ICU) 4,5 . 32 Respiratory virus (RV) is a common pathogen for RTI, causing significant 33 mortality and morbidity 6 . Though pathogens responsible for RTI could not be 34 determined in the majority of patients, RVs are more frequently detected than bacteria 7 . 35 In the past, RV-related RTIs were commonly seen and studied in the pediatric population 36 8, 9 . Seasonal variation in RVs throughout the year had also been well-established in the 37 pediatric population 10-12 . The viral epidemiology and prevalence of RTIs in the adult 38 population, however, have long been underestimated and inadequately investigated 13 . 39 Recognizing the role of RVs on RTIs, especially lower RTIs, is of clinical 40 importance and should not be neglected. RVs had been reported to compose nearly one-41 third of all hospitalized community-acquired pneumonia, and were actually isolated as 42 frequently as bacterial pathogens in hospital-acquired pneumonia 14 001) (Figure 1b) . The positive rate for samples collected in ICUs was 20.5% 121 (176/859), which was similar to that of general wards (Figure 1c) . 122 The overall positive rates of RVs detected were similar between winter and non-123 winter seasons. However, NIRV had a higher positive rate in non-winter seasons than in 124 winter (18.8% vs 14.8%, P=0.025). As for individual viruses, CoV had a higher positive 125 rate in winter (3.6% vs 0.5% P<0.001), while hMPV and PIV had a significantly higher 126 positive rate in non-winter seasons (0.7% vs 3.3%, P<0.001 for hMPV and 2% vs 5.2%, 127 P=0.001 for PIV, respectively. Figure 1d) . Aetiology of Acute Respiratory Tract Infections in Hospitalised Children in Cyprus Causes of Death C. 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