What is the role of gene amplification in the workup of viral pneumonia?

Updated: Mar 24, 2021
  • Author: Zab Mosenifar, MD, FACP, FCCP; Chief Editor: John J Oppenheimer, MD  more...
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Answer

PCR is a highly sensitive and specific technique for amplifying genes to detect the presence of a virus. For many viruses, this is the diagnostic test of choice, and if possible, it should be used in combination with viral culture and immunocytologic and rapid antigen detection. PCR technology allowed the discovery of such viruses as RSV, hMPV, and coronaviruses in causing pneumonias.

For influenza H1N1 and avian influenza, RT-PCR of either nasopharyngeal swabs or bronchial aspirates/sputa is the diagnostic modality of choice.

PCR has become especially useful for the detection of CMV in various body fluids (eg, blood, urine) in severely immunocompromised patients, particularly hematopoietic stem cell transplant (HSCT) recipients.

A newly developed molecular diagnostic technique, multiplex reverse transcriptase polymerase chain reaction (MRT-PCR), permits rapid detection of influenza virus types A and B, RSV (types A and B), adenoviruses, PIV (types 1, 2, and 3), hMPV, and rhinovirus in appropriate respiratory tract secretions. [66, 67] The single-step MRT-PCR technique has high sensitivity and specificity. Influenza H1N1 is reported as "non-typeable influenza" by the MRT-PCR.


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