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Pediatric Respiratory Syncytial Virus Diagnostic Testing Performance: A Systematic Review and Meta-analysis

BACKGROUND: Adding additional specimen types (eg, serology or sputum) to nasopharyngeal swab (NPS) reverse transcription polymerase chain reaction (RT-PCR) increases respiratory syncytial virus (RSV) detection among adults. We assessed if a similar increase occurs in children and quantified underasc...

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Autores principales: Onwuchekwa, Chukwuemeka, Atwell, Jessica, Moreo, Laura Mora, Menon, Sonia, Machado, Belen, Siapka, Mariana, Agarwal, Neha, Rubbrecht, Michelle, Aponte-Torres, Zuleika, Rozenbaum, Mark, Curcio, Daniel, Nair, Harish, Kalina, Warren V, Vroling, Hilde, Gessner, Bradford, Begier, Elizabeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10681870/
https://www.ncbi.nlm.nih.gov/pubmed/37285396
http://dx.doi.org/10.1093/infdis/jiad185
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author Onwuchekwa, Chukwuemeka
Atwell, Jessica
Moreo, Laura Mora
Menon, Sonia
Machado, Belen
Siapka, Mariana
Agarwal, Neha
Rubbrecht, Michelle
Aponte-Torres, Zuleika
Rozenbaum, Mark
Curcio, Daniel
Nair, Harish
Kalina, Warren V
Vroling, Hilde
Gessner, Bradford
Begier, Elizabeth
author_facet Onwuchekwa, Chukwuemeka
Atwell, Jessica
Moreo, Laura Mora
Menon, Sonia
Machado, Belen
Siapka, Mariana
Agarwal, Neha
Rubbrecht, Michelle
Aponte-Torres, Zuleika
Rozenbaum, Mark
Curcio, Daniel
Nair, Harish
Kalina, Warren V
Vroling, Hilde
Gessner, Bradford
Begier, Elizabeth
author_sort Onwuchekwa, Chukwuemeka
collection PubMed
description BACKGROUND: Adding additional specimen types (eg, serology or sputum) to nasopharyngeal swab (NPS) reverse transcription polymerase chain reaction (RT-PCR) increases respiratory syncytial virus (RSV) detection among adults. We assessed if a similar increase occurs in children and quantified underascertainment associated with diagnostic testing. METHODS: We searched databases for studies involving RSV detection in persons <18 years using ≥2 specimen types or tests. We assessed study quality using a validated checklist. We pooled detection rates by specimen and diagnostic tests and quantified performance. RESULTS: We included 157 studies. Added testing of additional specimens to NP aspirate (NPA), NPS, and/or nasal swab (NS) RT-PCR resulted in statistically nonsignificant increases in RSV detection. Adding paired serology testing increased RSV detection by 10%, NS by 8%, oropharyngeal swabs by 5%, and NPS by 1%. Compared to RT-PCR, direct fluorescence antibody tests, viral culture, and rapid antigen tests were 87%, 76%, and 74% sensitive, respectively (pooled specificities all ≥98%). Pooled sensitivity of multiplex versus singleplex RT-PCR was 96%. CONCLUSIONS: RT-PCR was the most sensitive pediatric RSV diagnostic test. Adding multiple specimens did not substantially increase RSV detection, but even small proportional increases could result in meaningful changes in burden estimates. The synergistic effect of adding multiple specimens should be evaluated.
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spelling pubmed-106818702023-11-30 Pediatric Respiratory Syncytial Virus Diagnostic Testing Performance: A Systematic Review and Meta-analysis Onwuchekwa, Chukwuemeka Atwell, Jessica Moreo, Laura Mora Menon, Sonia Machado, Belen Siapka, Mariana Agarwal, Neha Rubbrecht, Michelle Aponte-Torres, Zuleika Rozenbaum, Mark Curcio, Daniel Nair, Harish Kalina, Warren V Vroling, Hilde Gessner, Bradford Begier, Elizabeth J Infect Dis Major Article BACKGROUND: Adding additional specimen types (eg, serology or sputum) to nasopharyngeal swab (NPS) reverse transcription polymerase chain reaction (RT-PCR) increases respiratory syncytial virus (RSV) detection among adults. We assessed if a similar increase occurs in children and quantified underascertainment associated with diagnostic testing. METHODS: We searched databases for studies involving RSV detection in persons <18 years using ≥2 specimen types or tests. We assessed study quality using a validated checklist. We pooled detection rates by specimen and diagnostic tests and quantified performance. RESULTS: We included 157 studies. Added testing of additional specimens to NP aspirate (NPA), NPS, and/or nasal swab (NS) RT-PCR resulted in statistically nonsignificant increases in RSV detection. Adding paired serology testing increased RSV detection by 10%, NS by 8%, oropharyngeal swabs by 5%, and NPS by 1%. Compared to RT-PCR, direct fluorescence antibody tests, viral culture, and rapid antigen tests were 87%, 76%, and 74% sensitive, respectively (pooled specificities all ≥98%). Pooled sensitivity of multiplex versus singleplex RT-PCR was 96%. CONCLUSIONS: RT-PCR was the most sensitive pediatric RSV diagnostic test. Adding multiple specimens did not substantially increase RSV detection, but even small proportional increases could result in meaningful changes in burden estimates. The synergistic effect of adding multiple specimens should be evaluated. Oxford University Press 2023-06-07 /pmc/articles/PMC10681870/ /pubmed/37285396 http://dx.doi.org/10.1093/infdis/jiad185 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Major Article
Onwuchekwa, Chukwuemeka
Atwell, Jessica
Moreo, Laura Mora
Menon, Sonia
Machado, Belen
Siapka, Mariana
Agarwal, Neha
Rubbrecht, Michelle
Aponte-Torres, Zuleika
Rozenbaum, Mark
Curcio, Daniel
Nair, Harish
Kalina, Warren V
Vroling, Hilde
Gessner, Bradford
Begier, Elizabeth
Pediatric Respiratory Syncytial Virus Diagnostic Testing Performance: A Systematic Review and Meta-analysis
title Pediatric Respiratory Syncytial Virus Diagnostic Testing Performance: A Systematic Review and Meta-analysis
title_full Pediatric Respiratory Syncytial Virus Diagnostic Testing Performance: A Systematic Review and Meta-analysis
title_fullStr Pediatric Respiratory Syncytial Virus Diagnostic Testing Performance: A Systematic Review and Meta-analysis
title_full_unstemmed Pediatric Respiratory Syncytial Virus Diagnostic Testing Performance: A Systematic Review and Meta-analysis
title_short Pediatric Respiratory Syncytial Virus Diagnostic Testing Performance: A Systematic Review and Meta-analysis
title_sort pediatric respiratory syncytial virus diagnostic testing performance: a systematic review and meta-analysis
topic Major Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10681870/
https://www.ncbi.nlm.nih.gov/pubmed/37285396
http://dx.doi.org/10.1093/infdis/jiad185
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