Detection of Respiratory Viruses in Upper and Lower Respiratory Tract Specimens

Clinical Center

Investigators

Abstract

Up to 100 male or female subjects age 12 and above who are already undergoing bronchoscopy for the collection of a BAL specimen and who will have respiratory virus PCR ordered on the BAL specimen as part of their ongoing care at the NIH Clinical Center will be eligible for inclusion in this study. NP swab specimens have been validated for testing using the FilmArray assay. Both the NP swab and the BAL specimens will have the respiratory virus PCR (FilmArray) assay ordered in CRIS and the specimens will be processed and tested by the medical technologists in the Microbiology Service of the Department of Laboratory Medicine. Results from both specimens will be reported in CRIS. Instructions from the Centers for Disease Control on the proper technique for collecting NP swab specimens are presented in Appendix A. To resolve discrepant results, NP and BAL specimens with conflicting results will be tested by a second multiplex PCR (Luminex Fast RVP) in the Laboratory of Infectious Diseases, Viral Pathogenesis and Evolution Branch, NIAID. These results will only be used for research purposes. Demographic and clinical data (including but not limited to laboratory results, microbiologic data, and radiology results) on study participants will be abstracted from CRIS and correlated with results from the FilmArray assay. Excess NP swab or BAL samples will be stored for potential future use by study investigators. To date we have enrolled 35 subjects. The NP results thus far: 22 had negative results for respiratory virus PCR, one cancelled, and 12 had positive results for respiratory PCR. Of the 12 positive NP samples the following was found: 3 Syncytial Virus (RSV); 3 Human Metapneumovirus, 2 influenza A, 1 parainfluenza virus, 1 influenza B, and 2 rhinovirus/enterovirus. Some subjects had more than 1 infection. The BAL results thus far: 21 negative and 14 positive. Of the 14 positive samples 11 BAL and 1 NP matched; 1 BAL (rhinovirus/enterovirus) and NP (Syncytial Virus); 2 BAL (parainfluenza virus) (CMV) and negative NP. Of the 14 positive BAL samples the following was found: 2 for Syncytial Virus (RSV), 3 for Human Metapneumovirus, 1 for CMV; 1 for influenza B, 2 for influenza A, 3 for rhinovirus/enterovirus, and 2 for parainfluenza virus. Some subjects had more than 1 infection.