The Use of High-throughput Multiplex Detection to Diagnose Respiratory Pathogens
Session III – Jaya, Ungke A.
Title of Contribution: The Use of High-throughput Multiplex Detection to Diagnose Respiratory Pathogens
Author(s): Ungke A Jaya1, Maya Williams1, Herman Kosasih1, Susana Widjaja1,Chairin Ma’roef1, Nurhayati1, Gary Brice1, Ika Susanti1, Timothy Burgess 2and Patrick J Blair3
Affiliation(s): 1Naval Medical Research Unit Two, Jakarta, Indonesia, 2 Naval Medical Research Center, Silver Spring, Maryland, 3Naval Health Research Center, San Diego, California
Abstract:
Influenza-like illness (ILI) surveillance was conducted in Indonesia between September 1999 and April 2008. Influenza infections were confirmed in approximately 25% of these cases leaving the remaining undiagnosed. To determine other etiologies in samples that were negative for influenza, nasal and throat swabs from 175 patients (145 adults and 30 children) were tested using the Multiplex bead array based detection XTAGTM Respiratory Virus Panel (RVP) and 136 patient samples (104 adults and 32 children) were tested using the ResPlex 1 Molecular Differential Diagnostic (MDD) system. Of the 175 cases tested with RVP, the etiologic agent of 31 (17.7%) cases was identified. Entero-Rhinovirus (ERV) was the most predominant (24/13.7%), followed by Parainfluenza virus-3 (PIV-3) (3/1.7%), and Parainfluenza virus-1 (PIV-1) (2/1.1%). Human metapneumovirus (HMPV), Coronavirus COR-229 and COR-HKUI were detected in one case each. Parainfluenza viruses were only found in children, and no cases were positive for more than one pathogen included in this panel. Of the 136 cases tested with ResPlex 1 MDD, 20 (14.7%) cases tested positive for one or more of the targets in the ResPlex 1 MDD system. Haemophillus influenzae (HFLU1) was detected in 9 (6.6%) cases, Streptococcus pneumoniae (SPN) in 3 (2.2%) cases, Mycoplasma pneumoniae (MPN) and Neisseria meningitidis (NMG) each in 1 case (0.7%). Co-infections between HFLU1 and SPN were detected in two (1.4%) cases and co-infections between Adenovirus (ADVE) and SPN were found in two (1.4%) cases. One sample tested positive for HFLU1, SPN, and ADVE (0.7%), and one sample tested positive for HFLU1 , HFLU2, NMG and SPN (0.7%). More than a quarter of the non-influenza cases tested positive for one or more of the pathogens included in the RVP and ResPlex 1 MDD. Clinically, only excess sputum production was more frequent in bacterial cases than in influenza or other viral etiologies. Co-infections were not associated with more severe cases. However, as the specimens tested in this study were from outpatients, further evaluation using specimens from inpatients with severe respiratory illness should be completed.
