期刊
JOURNAL OF INFECTIOUS DISEASES
卷 215, 期 9, 页码 1407-1415出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jix148
关键词
RNA sequencing (RNA-seq); metagenomics; pan-viral group polymerase chain reaction (PVG PCR); pneumonia
资金
- National Center for Advancing Translational Sciences of the National Institutes of Health [1KL2TR001065, UL1TR001067]
- Primary Children's Hospital Foundation
- ARUP Institute for Clinical and Experimental Pathology
- Centers for Disease Control and Prevention [U181P00030]
Background. Community-acquired pneumonia (CAP) is a leading cause of pediatric hospitalization. Pathogen identification fails in approximately 20% of children but is critical for optimal treatment and prevention of hospital-acquired infections. We used two broad-spectrum detection strategies to identify pathogens in test-negative children with CAP and asymptomatic controls. Methods. Nasopharyngeal/oropharyngeal (NP/OP) swabs from 70 children <5 years with CAP of unknown etiology and 90 asymptomatic controls were tested by next-generation sequencing (RNA-seq) and pan viral group (PVG) PCR for 19 viral families. Association of viruses with CAP was assessed by adjusted odds ratios (aOR) and 95% confidence intervals controlling for season and age group. Results. RNA-seq/PVG PCR detected previously missed, putative pathogens in 34% of patients. Putative viral pathogens included human parainfluenza virus 4 (aOR 9.3, P = .12), human bocavirus (aOR 9.1, P < .01), Coxsackieviruses (aOR 5.1, P = .09), rhinovirus A (aOR 3.5, P = .34), and rhinovirus C (aOR 2.9, P = .57). RNA-seq was more sensitive for RNA viruses whereas PVG PCR detected more DNA viruses. Conclusions. RNA-seq and PVG PCR identified additional viruses, some known to be pathogenic, in NP/OP specimens from one-third of children hospitalized with CAP without a previously identified etiology. Both broad-range methods could be useful tools in future epidemiologic and diagnostic studies.
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