Human Metapneumovirus Pediatric Respiratory Infections: Comparing Direct Immunofluorescence versus Polymerase Chain Reaction

Abstract

Human metapneumovirus has been recognized as a common cause of respiratory infections, ranging from URTIs to severe LRTIs, in individuals of all ages, particularly infants and young children. The use of a rapid assay for the diagnosis of hMPV infections is needed in order to properly diagnose such viral respiratory infections, implement appropriate infection control measures to avoid its nosocomial spread and to avoid the unnecessary use of antibiotics.

The present work was designed to determine the frequency of hMPV infections among children less than 2 years of age and to define its clinical features and its seasonal pattern over a single respiratory season. It also attempted to compare the sensitivity and specificity of the DFA assay versus real-time PCR for the detection of hMPV in respiratory specimens and to detect the viral load of hMPV in infected patients.

This cross-sectional study was performed on 50 pediatric patients presenting with acute respiratory tract infection at El-Mounira Pediatric University Hospital, Cairo University, during the period from December 2014 through May 2015. All patients were subjected to history taking, clinical examination and chest X ray. The collected specimens were subjected to direct viral testing by DFA and were tested for the presence of hMPV by real-time PCR.

Fifty patients were enrolled in the study, including 27 males and 23 females with age range from 2–24 months. It was found that hMPV accounted for 4 cases (8%) of the studied patients and the infection rate was higher (20%) among the 12–24 months age group, with no statistically significant difference between males and females.