Human Metapneumovirus Pediatric Respiratory Infections: Comparing Direct Immunofluorescence versus Polymerase Chain Reaction

Background: estimated as the second or third most prevalent respiratory pathogen in the pediatric population, routine testing for human metapneumovirus (hmpv) can have a pivotal impact on children’s clinical outcome. objectives: this cross-sectional analytical study aimed to determine the efficiency of direct fluorescent antibody (dfa) assay as a rapid tool for the diagnosis of hmpv infection as compared to real time reverse transcriptase polymerase chain reaction (rrt-pcr). in the meantime, we endeavored to analyze the clinical features in hmpv patients. methods: a total of 50 children aged ≤ 24 months presenting with manifestations of acute respiratory tract infection (arti) at el-mounira pediatric university hospital, cairo university were enrolled in the study. nasopharyngeal aspirates (or endotracheal aspirates in intubated children) were examined with the dfa assay as well as rrt-pcr as a gold standard for the detection and quantification of hmpv. results and conclusion: human mpv was detected in two cases by dfa and in four cases by rrt-pcr among hospitalized children with artis. the dfa assay proved to be a highly specific test, yet with low sensitivity when compared to rrt-pcr. most of hmpv-infected cases presented during the winter season, with january and february exhibiting the highest hmpv activity. pneumonia was the most common presentation of artis in hmpv-infected patients. direct evaluation of respiratory specimens by dfa provides rapid results with low cost and a subsequent early medical management. however, its use should be restricted as a first-line approach, and a confirmatory test would be needed for a definite diagnosis.