Rapid antigen test for adenovirus in children: Age and onset of symptoms are important / Antígeno de adenovirus en niños: la edad y la aparición de los síntomas son importantes

Introduction: Respiratory infection is the most common human adenovirus (HAdV) disease accounting for 7–8% of viral respiratory diseases in children less than 5 years. Differentiation of bacterial infections and viral infections is a common clinical problem. Material and methods: One hundred oropharyngeal swabs obtained from October 2019 to November 2020 from patients attending the paediatric emergency room with suspicion of upper respiratory tract infection and negative results in influenza and RSV tests were included. Oropharyngeal swabs specimens were rapidly processed with STANDARD™ F Adeno Respi Ag FIA and the results were confirmed by RealStar® Adenovirus PCR Kit 1.0 (Altona diagnostics). Results: STANDARD™ F Adeno Respi Ag FIA had sensitivity and specificity values of 71.93% and 100% respectively. The performance of the test was higher in samples from children younger than 24 months and taken less than 72h since the beginning of symptoms. In this subgroup the test had 88.8% sensitivity and 100% specificity. Conclusion: STANDARD™ F Adeno Respi Ag FIA may improve the management of respiratory diseases in children younger than 24 months and less than 72h since the beginning of symptoms in paediatric emergency rooms.(AU)

Introducción: Las infecciones respiratorias son la enfermedad más común asociada a los adenovirus humanos (AdvH)y causan del 7 al 8% de las enfermedades respiratorias víricas en niños menores de 5 años. La distinción entre las infecciones bacterianas y las víricas constituye un problema clínico frecuente. Materiales y métodos: El estudio incluyó 100 hisopos orofaríngeos obtenidos entre octubre de 2019 y noviembre de 2020 de pacientes que habían acudido a los servicios de urgencias pediátricas con sospecha de infección de las vías respiratorias superiores y resultados negativos en las pruebas de gripe y VRS. Las muestras de los hisopos orofaríngeos se procesaron rápidamente con Standard™ F Adeno Respi Ag FIA y los resultados se confirmaron mediante RealStar® Adenovirus PCR Kit 1.0 (altona Diagnostics). Resultados: Standard™ F Adeno Respi Ag FIA tenía unos valores de sensibilidad y especificidad del 71,93% y el 100%, respectivamente. El rendimiento de la prueba fue superior en muestras de niños menores de 24 meses y tomadas menos de 72 horas después del inicio de los síntomas. En este subgrupo, la prueba tuvo una sensibilidad del 88,8% y una especificidad del 100%. Conclusión: Standard™ F Adeno Respi Ag FIA puede mejorar la gestión de las enfermedades respiratorias en niños menores de 24 meses con menos de 72 desde el inicio de los síntomas en servicios de urgencias pediátricas.(AU)

Considerations on the implementation of the Clinical Microbiology and Parasitology training program in Spanish hospitals: A national survey.

INTRODUCTION: The specialty of Microbiology and Parasitology is a four-year multidisciplinary training with a central role in the diagnosis and epidemiological surveillance of infectious diseases. The aim of this study is to analyze the degree of implementation of the official program and the degree of satisfaction of residents with their training. METHODS: We conducted an online survey distributed in eight sections to which active residents of the Specialty of Clinical Microbiology and Parasitology had access. RESULTS: A total of 69 responses were received, with a predominance of residents from the regions of Madrid (43.5%) and of FIR admission route (55%). The areas in which the residents feel best prepared correspond to systematic bacteriology, antimicrobials and clinical aspects of microbiology. The areas with the worst preparation, on the other hand, are mycology, parasitology and microbiological emergencies. There are significant differences between the clinical rotation time for residents with MIR access pathway with respect to residents with other degrees. Respondents perceive a high degree of responsibility and a medium agreement with the quality of teaching. Attendance at clinical sessions and external rotations is frequent. Research activity is perceived as complicated, both at the level of doctoral studies and with respect to entering research lines and the publication of scientific results. CONCLUSION: Some points of improvement of the training itinerary have been identified that need to be reinforced. Likewise, it would be interesting to seek a better balance between care, teaching and research activities.

Rapid antigen test for adenovirus in children: Age and onset of symptoms are important.

INTRODUCTION: Respiratory infection is the most common human adenovirus (HAdV) disease accounting for 7-8% of viral respiratory diseases in children less than 5 years. Differentiation of bacterial infections and viral infections is a common clinical problem. MATERIAL AND METHODS: One hundred oropharyngeal swabs obtained from October 2019 to November 2020 from patients attending the paediatric emergency room with suspicion of upper respiratory tract infection and negative results in influenza and RSV tests were included. Oropharyngeal swabs specimens were rapidly processed with STANDARD™ F Adeno Respi Ag FIA and the results were confirmed by RealStar® Adenovirus PCR Kit 1.0 (Altona diagnostics). RESULTS: STANDARD™ F Adeno Respi Ag FIA had sensitivity and specificity values of 71.93% and 100% respectively. The performance of the test was higher in samples from children younger than 24 months and taken less than 72h since the beginning of symptoms. In this subgroup the test had 88.8% sensitivity and 100% specificity. CONCLUSION: STANDARD™ F Adeno Respi Ag FIA may improve the management of respiratory diseases in children younger than 24 months and less than 72h since the beginning of symptoms in paediatric emergency rooms.

Accuracy of Xpert Ultra for the diagnosis of paediatric tuberculosis in a low TB burden country: a prospective multicentre study.

INTRODUCTION: Childhood pulmonary tuberculosis (TB) remains a diagnostic challenge. This study aimed to evaluate the performance of Xpert Ultra for the diagnosis of pulmonary TB in children in a low TB prevalence setting. METHODS: Prospective, multicentre, diagnostic accuracy study. Children with clinical or radiological suspicion of pulmonary TB were recruited at 11 paediatric units in Spain. Up to three gastric or sputum specimens were taken on 3 consecutive days, and analysed by Xpert MTB/RIF, Xpert Ultra and culture in parallel. RESULTS: 86 children were included (median age 4.9 years, IQR 2.0-10.0; 51.2% male). The final diagnosis was pulmonary TB in 75 patients (87.2%); 33 (44.0%) were microbiologically confirmed. A total of 219 specimens, comprising gastric aspirates (n=194; 88.6%) and sputum specimens (n=25; 11.4%), were analysed. Using culture as reference standard and comparing individual specimens, the sensitivity was 37.8% (14/37) for Xpert MTB/RIF and 81.1% (30/37) for Xpert Ultra (p<0.001); specificity was 98.4% (179/182) and 93.4% (170/182), respectively (p=0.02). In the per-patient analysis, considering positive results on any specimen, the sensitivity was 42.9% (9/21) for Xpert MTB/RIF and 81.0% for Xpert Ultra (17/21, p=0.01); specificity was 96.9% (63/65) and 87.7% (57/65, p=0.07), respectively. CONCLUSIONS: In children with pulmonary TB in a low burden setting, Xpert Ultra has significantly higher sensitivity than the previous generation of Xpert assay and only marginally lower specificity. Therefore, in children undergoing evaluation for suspected pulmonary TB, Xpert Ultra should be used in preference to Xpert MTB/RIF whenever possible.