Suvi Mattila (Finland)
Oulu University Hospital Department of Pediatrics and Adolescent MedicineAuthor Of 1 Presentation
IMPACT OF RESPIRATORY PATHOGEN PCR CYCLE THRESHOLD VALUE ON THE CLINICAL SEVERITY OF INFECTION IN ACUTELY ILL CHILDREN
Abstract
Backgrounds:
The polymerase chain reaction (PCR) cycle threshold (Ct) value represents the number of amplification cycles required to yield a positive test result and inversely correlates with pathogen load. Here, we evaluated whether Ct values of respiratory pathogens were associated with the clinical severity of infections in acutely ill children.
Methods
In this cross-sectional study at a pediatric emergency department, we obtained nasopharyngeal swabs from 800 children with fever or respiratory symptoms. Samples were analyzed for 21 respiratory pathogens using point-of-care multiplex-PCR device (Qiastat). We compared Ct values in children who needed hospitalization and those who were discharged from ED using a multivariate logistic regression model adjusted for age and sex. In addition, the association of Ct values with CRP values was analyzed with linear regression.
Results:
Of the 800 participants, 356 (45 %) were girls. The median age was 3.0 years. At least one pathogen was detected in 594 (74 %) participants. The most common pathogen was picornavirus, i.e. rhinovirus or enterovirus (328, 41 %) followed by RSV (133, 17 %). In total, 334 (42 %) patients were hospitalized, ranging from 11 % (3/27) for those with influenza A to 61 % (81/133) for those with RSV infection (Figure). When adjusted for age and sex, no statistically significant associations between Ct-value and need for hospitalization were found for any pathogen. In participants with detection of rhino/enterovirus, high Ct-value, i.e. low viral load, associated with high CRP value (β coefficient 2.51 [95 % CI 0.79 to 4.22]).
Conclusions/Learning Points:
Viral or pathogen load, estimated by PCR cycle threshold values, was not associated with the need for hospitalization due to respiratory viral infection in children. Thus, the clinical utility of Ct-values appears to be limited.
Presenter of 1 Presentation
IMPACT OF RESPIRATORY PATHOGEN PCR CYCLE THRESHOLD VALUE ON THE CLINICAL SEVERITY OF INFECTION IN ACUTELY ILL CHILDREN
Abstract
Backgrounds:
The polymerase chain reaction (PCR) cycle threshold (Ct) value represents the number of amplification cycles required to yield a positive test result and inversely correlates with pathogen load. Here, we evaluated whether Ct values of respiratory pathogens were associated with the clinical severity of infections in acutely ill children.
Methods
In this cross-sectional study at a pediatric emergency department, we obtained nasopharyngeal swabs from 800 children with fever or respiratory symptoms. Samples were analyzed for 21 respiratory pathogens using point-of-care multiplex-PCR device (Qiastat). We compared Ct values in children who needed hospitalization and those who were discharged from ED using a multivariate logistic regression model adjusted for age and sex. In addition, the association of Ct values with CRP values was analyzed with linear regression.
Results:
Of the 800 participants, 356 (45 %) were girls. The median age was 3.0 years. At least one pathogen was detected in 594 (74 %) participants. The most common pathogen was picornavirus, i.e. rhinovirus or enterovirus (328, 41 %) followed by RSV (133, 17 %). In total, 334 (42 %) patients were hospitalized, ranging from 11 % (3/27) for those with influenza A to 61 % (81/133) for those with RSV infection (Figure). When adjusted for age and sex, no statistically significant associations between Ct-value and need for hospitalization were found for any pathogen. In participants with detection of rhino/enterovirus, high Ct-value, i.e. low viral load, associated with high CRP value (β coefficient 2.51 [95 % CI 0.79 to 4.22]).
Conclusions/Learning Points:
Viral or pathogen load, estimated by PCR cycle threshold values, was not associated with the need for hospitalization due to respiratory viral infection in children. Thus, the clinical utility of Ct-values appears to be limited.