Assessment of Viral and Atypical Bacterial Agents Using Polymerase Chain Reaction in Patients Presenting with Signs of Acute Respiratory Tract Infection

Abstract

Objective: To assess viral and atypical bacterial agents using polymerase chain reaction in patients presenting with signs of acute respiratory tract infection (RTI) to Erzincan Mengucek Gazi Education and Research Hospital, Turkey. Methods: Viral and atypical bacterial agents were explored in patients presenting with RTI between February 1 and June 1, 2017. Genomic isolation was performed using a SolMag®12 fully-automated nucleic acid isolation system and SolMag® Virus Nucleic Acid Isolation Kit. Amplifications were performed using a SmartCycler-II thermocycler (Cepheid) device in accordance with the instructions provided by the manufacturer. Results: Of the 120 patients, 44 (36.6%) were found to have at least one agent. Polymerase chain reaction detected influenza viruses in 28 patients, respiratory syncytial virus in seven, cytomegalovirus (CMV) in six, Herpes simplex virus 1 (HSV1) in two, Chlamydophila pneumonia in two, Human Herpesvirus 6 in one, and Herpes simplex virus 2 in one. Also, coexistent HSV1 and CMV positivity was found in two cases. One patient had positivity in both influenza A and CMV. Among atypical bacterial agents, only two patients were found to have Chlamydophila pneumonia. There was at least one comorbid condition in 48 patients (40%). Of these subjects in whom an agent could be identified, 21 were found to have co-morbidity, while 23 were free of comorbid conditions. Antibiotherapy had been started in 109 (90.8%) of the patients after initial assessment. Sixty-four patients were admitted, and two patients died. Conclusion: Polymerase chain reaction allowed rapid detection of agents responsible for acute RTIs. We believe that this technique may contribute to appropriate use of antibiotics in patients diagnosed with atypical bacterial infection and may prevent unnecessary antibiotherapy in infections caused by viral agents.