OBJECTIVE: This study evaluated the diagnostic performance of two methods for the detection of influenza virus in immunocompromised transplant patients. METHODS: A total of 475 respiratory samples, 236 from patients in a hematopoietic stem cell transplantation program and 239 from kidney transplant patients, were analyzed by a direct fluorescence assay and the Centers for Disease Control real-time polymerase chain reaction protocol for influenza A and B detection. RESULTS: Influenza detection using either method was 7.6% in the hematopoietic stem cell transplant group and 30.5% in the kidney transplant patient group. Influenza detection by real-time polymerase chain reaction yielded a higher positive rate compared with fluorescence than that reported by other studies, and this difference was more pronounced for influenza A. The fluorescence assay sensitivity, specificity, positive and negative predictive values, and kappa coefficient were 17.6%, 100%, 1, 0.83, and 0.256, respectively, and lower detection rates occurred in the kidney transplant patients. CONCLUSIONS: The real-time polymerase chain reaction performance and the associated turnaround time for a large number of samples support the choice of this method for use in different routine diagnostic settings and influenza surveillance in high-risk patients.

INTRODUCTION: Human adenoviruses (HAdV) play an important role in the etiology of severe acute lower respiratory infection, especially in immunocompromised individuals. The aim of the present study was detect the HAdV through different methods: direct fluorescence assay (DFA) and nested-polymerase chain reaction (PCR-nested) from patients with acute respiratory infection (ARI) up to 7 days of symptoms onset.METHODS:Samples (n=643) were collected from different risk groups during from 2001 to 2010: 139 adults attended in an Emergency Room Patients (ERP); 205 health care workers (HCW); 69 from Renal Transplant Outpatients (RTO); 230 patients in hematopoietic stem cell transplantation (HSCT) program.RESULTS:Among all patients (n=643) adenovirus was detected on 13.2% by DFA and/or PCR: 6/139 (4.3%) adults from ERP, 7/205 (3.4%) from HCW samples, 4/69 (5.8%) from RTO and 68/230 (29.5%) from HSCT patients. Nested PCR showed higher detection (10%) compared to DFA test (3.8%) (p < 0.001). HSCT patients presented significantly higher prevalence of HAdV infection.CONCLUSIONS:Adenovirus detection through nested-PCR assay was higher. However the inclusion of molecular method in laboratorial routine diagnostic should be evaluated considering the reality of each specific health service.

INTRODUÇÃO E OBJETIVOS: O bocavírus humano (HBoV) tem sido descrito desde 2005 como agente etiológico de infecções respiratórias virais. O presente estudo tem como objetivo investigar a etiologia da infecção respiratória pelo HBoV em pacientes adultos e crianças de diferentes grupos de risco para complicação de infecções respiratórias agudas desde 2001 até 2008 em um hospital terciário no Brasil. PACIENTES E MÉTODOS: O HBoV foi investigado, através de reação em cadeia da polimerase, em 598 amostras respiratórias coletadas de pacientes hospitalizados e não hospitalizados. RESULTADOS: Das 598 amostras testadas o HBoV foi detectado em 2,44% (8/328) das crianças, incluindo cinco crianças portadoras de cardiopatia congênita, e 0,4% (1/270) dos adultos em programa de transplante de células tronco hematopoiéticas. CONCLUSÃO: Os dados do presente estudo sugerem baixa freqüência de detecção do HBoV entre pacientes de risco, e destaca a necessidade de novos estudos para um melhor entendimento do verdadeiro papel desse agente em infecções respiratórias agudas em pacientes sintomáticos.

BACKGROUND AND OBJECTIVES: Human Bocavirus (HBoV) has been described since 2005 as an etiological agent of respiratory virus infections. From 2001 to 2008 we investigated the etiology of HBoV among adults and children in different groups at risk of presenting complications arising from acute respiratory infection, the investigation was carried out in a tertiary hospital health care system in Brazil. METHODS: HBoV DNA was assayed in 598 respiratory samples from community and hospitalized patients by PCR. RESULTS: Of the 598 tested samples, 2.44% (8/328) of children, including five children with heart disease, and 0.4% (1/270) of adult bone-marrow-transplant were HBoV positive. CONCLUSIONS: These data suggested lower HBoV frequency among different at-risk patients and highlights the need to better understand the real role of HBoV among acute respiratory symptomatic patients.

INTRODUÇÃO: Influenza A H1N1 2009 está associado com uma alta taxa de morbidade entre crianças ao redor do mundo, incluindo o Brasil. Esta pesquisa foi realizada em amostras de crianças sintomáticas (< 12 anos) em uma creche escola para filhos de funcionários do hospital durante a primeira e segunda onda pandêmica (2009-2010) em São Paulo, Brasil. MÉTODOS: Infecções pelo vírus influenza foram determinadas por PCR em tempo real em 34% (47/137) em crianças com idade mediana de 5 anos (8 meses -12 anos), entre junho e outubro de 2009 e em 16% (14/85) daquelas com mediana de idade de 6 anos (1-12 anos), de março a novembro de 2010. RESULTADOS: Em geral, a maioria dos casos positivos (64%) ocorreu em crianças com idade entre 5-12 anos, esta faixa etária foi significativamente a mais afetada (39,8%, p = 0,001, OR = 8,3, CI 95%: 1,9-36,9). Chiado foi relatado em 31% (19/61) e dispnéia em 23% (14/61) dos pacientes estudados. Um surto de gripe H1N1 com uma taxa de ataque de 35,7% entre as crianças (mediana de idade de 6 anos) foi documentado em abril de 2010, antes da extensão da campanha de vacinação contra o vírus pandêmico para crianças até 5 anos no Brasil. CONCLUSÕES: Portanto, neste estudo reforça a recomendação para imunizar crianças em idade escolar para reduzir a incidência da doença.

INTRODUCTION: Influenza A H1N1 2009 is associated with a high morbidity rate among children around the world, including Brazil. This survey was conducted on samples of symptomatic children (< 12 years) to investigate the influenza virus as the etiological agent of respiratory infections in a day care school in a health facility during the first and second pandemic wave of H1N1 (2009-2010) in São Paulo, Brazil. METHODS: Influenza infections were determined by real-time PCR in 34% (47/137) of children with a median age of 5 years (8 months - 12 years), from June to October 2009 and in 16% (14/85) of those with median age of 6 years (1-12 years), from March to November 2010. RESULTS: In general, most positive cases (64%) occurred in children aged 5-12 years, this age group was significantly the most affected (39.8%, p = 0.001, OR = 8.3, CI 95% 1.9-36.9). Wheezing was reported by 31% (19/61) and dyspnea by 23% (14/61) of the studied patients. An outbreak of influenza H1N1 with an attack rate of 35.7% among children (median age 6 years) was documented in April 2010, before the vaccination campaign against the pandemic virus was extended for children up to 5 years in Brazil. CONCLUSIONS: Therefore, the study reinforces the recommendation to immunize school children to reduce the incidence of the disease.