Tracheal aspirate as a substrate for polymerase chain reaction detection of viral genome in childhood pneumonia and myocarditis

Noorullah Akhtar, Jiyuan Ni, Daniel Stromberg, Geoffrey L. Rosenthal, Neil E. Bowles, Jeffrey Towbin

Research output: Contribution to journalArticle

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Abstract

Background - Infectious respiratory disorders are important causes of childhood morbidity and mortality. Viral causes are common and may lead to rapid deterioration, requiring mechanical ventilation; myocardial dysfunction may accompany respiratory decompensation. The etiologic viral diagnosis may be difficult with classic methods. The purpose of this study was to evaluate polymerase chain reaction (PCR) as a diagnostic method for identification of causative agents. Methods and Results - PCR was used to amplify sequences of viruses known to cause childhood viral pneumonia and myocarditis. Oligonucleotide primers were designed to amplify specific sequences of DNA virus (adenovirus, cytomegalovirus, herpes simplex virus, and Epstein-Barr virus) and RNA virus (enterovirus, respiratory syncytial virus, influenza A, and influenza B) genomes. Tracheal aspirate samples were obtained from 32 intubated patients and nucleic acid extracted before PCR. PCR results were compared with results of culture, serology, and antigen detection methods when available. In cases of myocarditis (n=7), endomyocardial biopsy samples were analyzed by PCR and compared with tracheal aspirate studies. PCR amplification of viral genome occurred in 18 of 32 samples (56%), with 3 samples PCR positive for 2 viral genomes. Amplified viral sequences included RSV (n=3), enterovirus (n=5), cytomegalovirus (n=4), adenovirus (n=3), herpes simplex virus (n=2), Epstein-Barr virus (n=1), influenza A (n=2), and influenza B (n=l). All 7 cases of myocarditis amplified the same viral genome from heart as found by tracheal aspirate. Conclusions - PCR is a rapid and sensitive diagnostic tool in cases of viral pneumonia with or without myocarditis, and tracheal aspirate appears to be excellent for analysis.

Original languageEnglish (US)
Pages (from-to)2011-2018
Number of pages8
JournalCirculation
Volume99
Issue number15
DOIs
StatePublished - Apr 20 1999
Externally publishedYes

Fingerprint

Viral Genome
Myocarditis
Pneumonia
Polymerase Chain Reaction
Human Influenza
Viral Pneumonia
Enterovirus
Cytomegalovirus
Human Herpesvirus 4
Adenoviridae
DNA Primers
DNA Viruses
Human Herpesvirus 2
Respiratory Syncytial Viruses
RNA Viruses
Simplexvirus
Serology
Artificial Respiration
Nucleic Acids
Genome

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Tracheal aspirate as a substrate for polymerase chain reaction detection of viral genome in childhood pneumonia and myocarditis. / Akhtar, Noorullah; Ni, Jiyuan; Stromberg, Daniel; Rosenthal, Geoffrey L.; Bowles, Neil E.; Towbin, Jeffrey.

In: Circulation, Vol. 99, No. 15, 20.04.1999, p. 2011-2018.

Research output: Contribution to journalArticle

Akhtar, Noorullah ; Ni, Jiyuan ; Stromberg, Daniel ; Rosenthal, Geoffrey L. ; Bowles, Neil E. ; Towbin, Jeffrey. / Tracheal aspirate as a substrate for polymerase chain reaction detection of viral genome in childhood pneumonia and myocarditis. In: Circulation. 1999 ; Vol. 99, No. 15. pp. 2011-2018.
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