POLYMERASE CHAIN-REACTION FOR RAPID DIAGNOSIS OF RESPIRATORY ADENOVIRUS INFECTION

Endemic (type 1, 2, 5 and 6) and epidemic (type 3, 4 and 7) respirator y adenovirus infections are associated with upper respiratory tract sy mptoms, pharyngoconjunctival fever, and pneumonia. Improved methods of diagnosis are needed, particularly in immunocompromized patients. We examined 93 throat swabs or nasophargngeal aspirates from patients wit h acute respiratory disease using virus isolation and an adenovirus-sp ecific polymerase chain reaction (PCR) based on consensus primers H1 a nd H2 derived from the hexon region DNA sequences of serotypes 2 and 5 . Specimens which yielded viruses other than adenovirus in cell cultur e (n=23) or which were negative for infectious viruses (n=25) were neg ative in the PCR. The sensitivity of DNA amplification was 76% (34/45) in comparison with virus culture, being markedly lower with subgenus B (types 3 and 7) strains than with subgenus C (type 1, 2, 5 and 6) is olates (8/16 (50%) vs. 26/28 (93%), P = 0.004) despite the use of a lo w annealing temperature to maximize detection of adenoviruses belongin g to subgenera other than C. Of the 11 samples falsely negative in a s ingle-round PCR but yielding adenovirus type 1 (n=1), type 2 (n=1), ty pe 3 (n=7), type 7 (n=1), or untyped isolates (n=1) in cell culture, n ine (82%) gave positive results after nested DNA amplification. Possib le approaches to further improving the performance of adenovirus PCR w ith respiratory specimens are discussed.