Association of the CT values of real-time PCR of viral upper respiratory tract infection with clinical severity, Kenya
Quantitative real‐time polymerase chain reaction (qRT‐PCR) assay of the upper respiratory tract is used increasingly to diagnose lower respiratory tract infections. The cycle threshold (CT) values of qRT‐PCR are continuous, semi‐quantitative measurements of viral load, although interpretation of dia...
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| Veröffentlicht in: | Journal of medical virology 2013-05, Vol.85 (5), p.924-932 |
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| creator | Fuller, James A. Njenga, M. Kariuki Bigogo, Godfrey Aura, Barrack Ope, Maurice O. Nderitu, Leonard Wakhule, Lilian Erdman, Dean D. Breiman, Robert F. Feikin, Daniel R. |
| description | Quantitative real‐time polymerase chain reaction (qRT‐PCR) assay of the upper respiratory tract is used increasingly to diagnose lower respiratory tract infections. The cycle threshold (CT) values of qRT‐PCR are continuous, semi‐quantitative measurements of viral load, although interpretation of diagnostic qRT‐PCR results are often categorized as positive, indeterminate, or negative, obscuring potentially useful clinical interpretation of CT values. From 2008 to 2010, naso/oropharyngeal swabs were collected from outpatients with influenza‐like illness, inpatients with severe respiratory illness, and asymptomatic controls in rural Kenya. CT values of positive specimens (i.e., CT values |
| doi_str_mv | 10.1002/jmv.23455 |
| format | Article |
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Kariuki ; Bigogo, Godfrey ; Aura, Barrack ; Ope, Maurice O. ; Nderitu, Leonard ; Wakhule, Lilian ; Erdman, Dean D. ; Breiman, Robert F. ; Feikin, Daniel R.</creator><creatorcontrib>Fuller, James A. ; Njenga, M. Kariuki ; Bigogo, Godfrey ; Aura, Barrack ; Ope, Maurice O. ; Nderitu, Leonard ; Wakhule, Lilian ; Erdman, Dean D. ; Breiman, Robert F. ; Feikin, Daniel R.</creatorcontrib><description>Quantitative real‐time polymerase chain reaction (qRT‐PCR) assay of the upper respiratory tract is used increasingly to diagnose lower respiratory tract infections. The cycle threshold (CT) values of qRT‐PCR are continuous, semi‐quantitative measurements of viral load, although interpretation of diagnostic qRT‐PCR results are often categorized as positive, indeterminate, or negative, obscuring potentially useful clinical interpretation of CT values. From 2008 to 2010, naso/oropharyngeal swabs were collected from outpatients with influenza‐like illness, inpatients with severe respiratory illness, and asymptomatic controls in rural Kenya. CT values of positive specimens (i.e., CT values < 40.0) were compared by clinical severity category for five viruses using Mann–Whitney U‐test and logistic regression. Among children <5 years old we tested with respiratory syncytial virus (RSV), inpatients had lower median CT values (27.2) than controls (35.8, P = 0.008) and outpatients (34.7, P < 0.001). Among children and older patients infected with influenza virus, outpatients had the lowest median CT values (29.8 and 24.1, respectively) compared with controls (P = 0.193 for children, P < 0.001 for older participants) and inpatients (P = 0.009 for children, P < 0.001 for older participants). All differences remained significant in logistic regression when controlling for age, days since onset, and coinfection. CT values were similar for adenovirus, human metapneumovirus, and parainfluenza virus in all severity groups. In conclusion, the CT values from the qRT‐PCR of upper respiratory tract specimens were associated with clinical severity for some respiratory viruses. J. Med. Virol. 85:924–932, 2013. © 2013 Wiley Periodicals, Inc.</description><identifier>ISSN: 0146-6615</identifier><identifier>EISSN: 1096-9071</identifier><identifier>DOI: 10.1002/jmv.23455</identifier><identifier>PMID: 23508918</identifier><identifier>CODEN: JMVIDB</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Child ; Child, Preschool ; Female ; Fundamental and applied biological sciences. Psychology ; Human viral diseases ; Humans ; Infant ; Infant, Newborn ; Infectious diseases ; influenza ; Inpatients ; Kenya ; Male ; Medical sciences ; Microbiology ; Middle Aged ; Miscellaneous ; Nasopharynx - virology ; Oropharynx - virology ; Outpatients ; PCRl ; Polymerase chain reaction ; Real-Time Polymerase Chain Reaction - methods ; Respiratory diseases ; respiratory syncytial virus ; Respiratory Tract Infections - pathology ; Respiratory Tract Infections - virology ; Severity of Illness Index ; Viral diseases ; Viral Load ; viral pneumonial ; Virology ; Virus Diseases - pathology ; Virus Diseases - virology ; Young Adult</subject><ispartof>Journal of medical virology, 2013-05, Vol.85 (5), p.924-932</ispartof><rights>Copyright © 2013 Wiley Periodicals, Inc.</rights><rights>2014 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjmv.23455$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjmv.23455$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27179494$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23508918$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fuller, James A.</creatorcontrib><creatorcontrib>Njenga, M. Kariuki</creatorcontrib><creatorcontrib>Bigogo, Godfrey</creatorcontrib><creatorcontrib>Aura, Barrack</creatorcontrib><creatorcontrib>Ope, Maurice O.</creatorcontrib><creatorcontrib>Nderitu, Leonard</creatorcontrib><creatorcontrib>Wakhule, Lilian</creatorcontrib><creatorcontrib>Erdman, Dean D.</creatorcontrib><creatorcontrib>Breiman, Robert F.</creatorcontrib><creatorcontrib>Feikin, Daniel R.</creatorcontrib><title>Association of the CT values of real-time PCR of viral upper respiratory tract infection with clinical severity, Kenya</title><title>Journal of medical virology</title><addtitle>J. Med. Virol</addtitle><description>Quantitative real‐time polymerase chain reaction (qRT‐PCR) assay of the upper respiratory tract is used increasingly to diagnose lower respiratory tract infections. The cycle threshold (CT) values of qRT‐PCR are continuous, semi‐quantitative measurements of viral load, although interpretation of diagnostic qRT‐PCR results are often categorized as positive, indeterminate, or negative, obscuring potentially useful clinical interpretation of CT values. From 2008 to 2010, naso/oropharyngeal swabs were collected from outpatients with influenza‐like illness, inpatients with severe respiratory illness, and asymptomatic controls in rural Kenya. CT values of positive specimens (i.e., CT values < 40.0) were compared by clinical severity category for five viruses using Mann–Whitney U‐test and logistic regression. Among children <5 years old we tested with respiratory syncytial virus (RSV), inpatients had lower median CT values (27.2) than controls (35.8, P = 0.008) and outpatients (34.7, P < 0.001). Among children and older patients infected with influenza virus, outpatients had the lowest median CT values (29.8 and 24.1, respectively) compared with controls (P = 0.193 for children, P < 0.001 for older participants) and inpatients (P = 0.009 for children, P < 0.001 for older participants). All differences remained significant in logistic regression when controlling for age, days since onset, and coinfection. CT values were similar for adenovirus, human metapneumovirus, and parainfluenza virus in all severity groups. In conclusion, the CT values from the qRT‐PCR of upper respiratory tract specimens were associated with clinical severity for some respiratory viruses. J. Med. Virol. 85:924–932, 2013. © 2013 Wiley Periodicals, Inc.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infectious diseases</subject><subject>influenza</subject><subject>Inpatients</subject><subject>Kenya</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Microbiology</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Nasopharynx - virology</subject><subject>Oropharynx - virology</subject><subject>Outpatients</subject><subject>PCRl</subject><subject>Polymerase chain reaction</subject><subject>Real-Time Polymerase Chain Reaction - methods</subject><subject>Respiratory diseases</subject><subject>respiratory syncytial virus</subject><subject>Respiratory Tract Infections - pathology</subject><subject>Respiratory Tract Infections - virology</subject><subject>Severity of Illness Index</subject><subject>Viral diseases</subject><subject>Viral Load</subject><subject>viral pneumonial</subject><subject>Virology</subject><subject>Virus Diseases - pathology</subject><subject>Virus Diseases - virology</subject><subject>Young Adult</subject><issn>0146-6615</issn><issn>1096-9071</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkctu1DAUhi0EokNhwQsgSwiJBWmPb3GyrEZQWjqA0FCWlpM4qofcajspeft6Li1SV-f2_Uc-_hF6S-CEANDTTTudUMaFeIYWBPI0yUGS52gBhKdJmhJxhF55vwGALKf0JTqiTMSUZAs0nXnfl1YH23e4r3G4MXi5xpNuRuO3DWd0kwTbGvxz-WvbmKzTDR6Hwbg49EMsQ-9mHJwuA7ZdbcrdsjsbbnDZ2M6WkfdmMs6G-RP-ZrpZv0Yvat148-YQj9HvL5_Xy6_J1Y_zi-XZVWIZlyJhBRUVK5nQmZZZVTAtAERWGBDSpHmR8YoDLWRRVilUpAJai0LKguvcMODAjtHH_d7B9bfxoqBa60vTNLoz_egVYSQjwMgOff8E3fSj6-LrFOEsIzLljETq3YEai9ZUanC21W5WDz8agQ8HQPt4eO10V1r_n5NE5jznkTvdc3e2MfPjnIDaWqqipWpnqbpcXe-SqEj2CuuD-feo0O6vSiWTQv35fh7F69WKXl6rFbsHzcGhVQ</recordid><startdate>201305</startdate><enddate>201305</enddate><creator>Fuller, James A.</creator><creator>Njenga, M. Kariuki</creator><creator>Bigogo, Godfrey</creator><creator>Aura, Barrack</creator><creator>Ope, Maurice O.</creator><creator>Nderitu, Leonard</creator><creator>Wakhule, Lilian</creator><creator>Erdman, Dean D.</creator><creator>Breiman, Robert F.</creator><creator>Feikin, Daniel R.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QL</scope><scope>7TK</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>201305</creationdate><title>Association of the CT values of real-time PCR of viral upper respiratory tract infection with clinical severity, Kenya</title><author>Fuller, James A. ; Njenga, M. 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Psychology</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infectious diseases</topic><topic>influenza</topic><topic>Inpatients</topic><topic>Kenya</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Microbiology</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Nasopharynx - virology</topic><topic>Oropharynx - virology</topic><topic>Outpatients</topic><topic>PCRl</topic><topic>Polymerase chain reaction</topic><topic>Real-Time Polymerase Chain Reaction - methods</topic><topic>Respiratory diseases</topic><topic>respiratory syncytial virus</topic><topic>Respiratory Tract Infections - pathology</topic><topic>Respiratory Tract Infections - virology</topic><topic>Severity of Illness Index</topic><topic>Viral diseases</topic><topic>Viral Load</topic><topic>viral pneumonial</topic><topic>Virology</topic><topic>Virus Diseases - pathology</topic><topic>Virus Diseases - virology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fuller, James A.</creatorcontrib><creatorcontrib>Njenga, M. 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Kariuki</au><au>Bigogo, Godfrey</au><au>Aura, Barrack</au><au>Ope, Maurice O.</au><au>Nderitu, Leonard</au><au>Wakhule, Lilian</au><au>Erdman, Dean D.</au><au>Breiman, Robert F.</au><au>Feikin, Daniel R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of the CT values of real-time PCR of viral upper respiratory tract infection with clinical severity, Kenya</atitle><jtitle>Journal of medical virology</jtitle><addtitle>J. Med. Virol</addtitle><date>2013-05</date><risdate>2013</risdate><volume>85</volume><issue>5</issue><spage>924</spage><epage>932</epage><pages>924-932</pages><issn>0146-6615</issn><eissn>1096-9071</eissn><coden>JMVIDB</coden><abstract>Quantitative real‐time polymerase chain reaction (qRT‐PCR) assay of the upper respiratory tract is used increasingly to diagnose lower respiratory tract infections. The cycle threshold (CT) values of qRT‐PCR are continuous, semi‐quantitative measurements of viral load, although interpretation of diagnostic qRT‐PCR results are often categorized as positive, indeterminate, or negative, obscuring potentially useful clinical interpretation of CT values. From 2008 to 2010, naso/oropharyngeal swabs were collected from outpatients with influenza‐like illness, inpatients with severe respiratory illness, and asymptomatic controls in rural Kenya. CT values of positive specimens (i.e., CT values < 40.0) were compared by clinical severity category for five viruses using Mann–Whitney U‐test and logistic regression. Among children <5 years old we tested with respiratory syncytial virus (RSV), inpatients had lower median CT values (27.2) than controls (35.8, P = 0.008) and outpatients (34.7, P < 0.001). Among children and older patients infected with influenza virus, outpatients had the lowest median CT values (29.8 and 24.1, respectively) compared with controls (P = 0.193 for children, P < 0.001 for older participants) and inpatients (P = 0.009 for children, P < 0.001 for older participants). All differences remained significant in logistic regression when controlling for age, days since onset, and coinfection. CT values were similar for adenovirus, human metapneumovirus, and parainfluenza virus in all severity groups. In conclusion, the CT values from the qRT‐PCR of upper respiratory tract specimens were associated with clinical severity for some respiratory viruses. J. Med. Virol. 85:924–932, 2013. © 2013 Wiley Periodicals, Inc.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>23508918</pmid><doi>10.1002/jmv.23455</doi><tpages>9</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Biological and medical sciences Child Child, Preschool Female Fundamental and applied biological sciences. Psychology Human viral diseases Humans Infant Infant, Newborn Infectious diseases influenza Inpatients Kenya Male Medical sciences Microbiology Middle Aged Miscellaneous Nasopharynx - virology Oropharynx - virology Outpatients PCRl Polymerase chain reaction Real-Time Polymerase Chain Reaction - methods Respiratory diseases respiratory syncytial virus Respiratory Tract Infections - pathology Respiratory Tract Infections - virology Severity of Illness Index Viral diseases Viral Load viral pneumonial Virology Virus Diseases - pathology Virus Diseases - virology Young Adult |
| title | Association of the CT values of real-time PCR of viral upper respiratory tract infection with clinical severity, Kenya |
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