RT-PCR detection of respiratory pathogens in newborn children admitted to a neonatal medium care unit

Pediatr Res. 2013 Mar;73(3):355-61. doi: 10.1038/pr.2012.176. Epub 2012 Nov 30.


Background: This study aimed to determine the prevalence of respiratory pathogens among newborns admitted to a neonatal medium care unit (NMCU) and to identify clinical predictors.

Methods: A 1-y observational study was performed of neonates admitted to an NMCU in Amsterdam, The Netherlands. Nasopharyngeal samples were collected for the detection of respiratory viruses and bacteria by real-time PCR (RT-PCR). Cycle threshold (Ct) values were provided to estimate viral load. Predictors for the presence of study pathogens were identified.

Results: From October 2010 through September 2011, 334 neonates (median age 1.3 d, 53.6% male) were included. Overall, 37 respiratory pathogens were detected in 34 children (10.2%): parainfluenza-1 (n = 9), human rhinovirus (n = 7), parainfluenza-3 (n = 6), respiratory syncytial virus (RSV, n = 6), Streptococcus pneumoniae (n = 3), adenovirus (n = 2), human coronavirus (n = 2), influenza A (n = 1), and bocavirus (n = 1). Neonates with higher viral loads (Ct <35; n = 11) were more often clinically ill than those with lower viral loads (Ct ≥35; n = 23). Two variables significantly contributed to the detection of study pathogens: age (odds ratio (OR) 1.21 for each day older; 95% confidence interval 1.12-1.30) and rhinorrhea (OR 6.71; 95% confidence interval 1.54-29.21).

Conclusion: Respiratory pathogens seem to play a role in neonates admitted to an NMCU. The influence of respiratory pathogen detection on clinical management remains to be determined.

MeSH terms

  • Age Factors
  • Cross Infection / epidemiology*
  • Female
  • Humans
  • Infant, Newborn
  • Male
  • Nasopharynx / microbiology*
  • Nasopharynx / virology*
  • Netherlands / epidemiology
  • Odds Ratio
  • Postnatal Care
  • Real-Time Polymerase Chain Reaction
  • Respiratory Tract Infections / epidemiology*
  • Viral Load