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Journal of Clinical Microbiology, January 2008, p. 97-102, Vol. 46, No. 1
0095-1137/08/$08.00+0     doi:10.1128/JCM.01117-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Evidence from Multiplex Molecular Assays for Complex Multipathogen Interactions in Acute Respiratory Infections{triangledown}

John D. Brunstein,1,2* Christy L. Cline,2 Steven McKinney,1 and Eva Thomas2

Centre for Translational and Applied Genomics, PHSA Labs,1 Children's and Women's Health Centre of BC, PHSA, Vancouver, British Columbia, Canada2

Received 4 June 2007/ Returned for modification 19 July 2007/ Accepted 24 October 2007

While most diagnostic processes cease with the detection of the first relevant infectious agent, newer multiplexed molecular methods which provide simultaneous analysis of multiple agents may give a more accurate representation of the true pathogen spectrum in these samples. To examine this in the context of respiratory infections, acute-phase respiratory specimens submitted to our clinical diagnostic microbiology/virology laboratory for our routine VIRAP diagnosis protocol during the spring 2006 peak respiratory infection season were processed in parallel by analysis with Genaco (QiaPlex) ResPlex I and ResPlex II molecular diagnostic panels. A total of 1,742 specimens were examined for 21 relevant targets each. The resulting data reveal that multiple infections are frequent and provide evidence for complex interactions between different infectious agents. Statistically relevant association patterns (both positive and negative) were observed between particular pathogens. While some interactions we observed are substantiated by prior reports in the literature, several specific patterns do not appear to have been reported previously. In addition, we report preliminary clinical evidence which supports a hypothesis that these coinfections are medically relevant and that effective treatment for severe respiratory tract infections will increasingly require diagnosis of all involved pathogens, as opposed to single-pathogen reporting.

* Corresponding author. Mailing address: CWHCBC, 2G11—Microbiology, 4480 Oak Street, Vancouver BC V6H 3N1, Canada. Phone: (604) 875-2000, ext. 5283. Fax: (604) 877-3777. E-mail: jbrunstein{at}cw.bc.ca

{triangledown} Published ahead of print on 31 October 2007.

Journal of Clinical Microbiology, January 2008, p. 97-102, Vol. 46, No. 1
0095-1137/08/$08.00+0     doi:10.1128/JCM.01117-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.



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