الفهرس 
ADENOVIRUSES
Respiratory infection in childrenOnly 14 pages are availabe for public view
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Abstract
The current study was conducted to evaluate the prevalence of HAdV infection in children presented with different clinical manifestations and the usefulness of DIF and EIA as a rapid diagnostic tool for diagnosis of adenovirus infection in comparison with conventional culture technique. The present study was conducted over period of 20 months, from September 2008 until April 2010 and involved 126 children, 153 samples were collected from them. They were distributed as follow: twenty four patients with acute conjunctivitis, sixty four patients with upper respiratory tract infection and sixty five patients with acute diarrhea. Human adenovirus was detected by cell culture in 8/24 (33.3%), 8/64 (12.5%) and 3/65 (4.6%) from conjunctival swabs, throat swabs and stool specimens respectively. By direct immunofluorescence, adenovirus was detected in 7/24 (29.2%) and 7/64 (10.9%) from conjunctival swabs and throat swabs. Regarding EIA, adenovirus was identified in 3/65 (4.6%) from patients with acute diarrhea . In the present study virus culture was considered as the gold standard test and the rapid diagnostic tests (EIA and DIF) were compared to it relying on previous studies due to its higher sensitivity and specificity. The overall sensitivity, specificity, positive predictive value and negative predictive value and accuracy of DIF compared to virus isolation by culture in patients with conjunctivitis were 75%, 94%, 88%, 86% and 88%, and in patients with URTI were 50%, 95%, 93%, 57% and 89%, respectively. On comparing EIA with culture in patient with acute diarrhea, sensitivity, specificity, positive predictive value and negative predictive value and accuracy were 100%,100%,100%,100% and 100% .As regard clinical manifestations follicular conjunctivitis and preauricular lymphadenopathy were significantly associated with adenovirus infection in patients with acute conjunctivitis, while in patients presented with URTI and patients presented with acute diarrhea there was no statistical significant difference between adenovirus positive and adenovirus negative patients. Adenovirus isolation showed significant variability in patients presented with triad of acute conjunctivitis, upper respiratory tract infection and acute diarrhea. CONCLUSION 1. Virus isolation by cell culture requires viable organism and experienced laboratory staff. It is costly and time consuming but remains the “gold standard” for diagnosis.. 2. Adenovirus was significantly isolated from patients with URTI admitted to inpatients wards. 3. DIF procedure using monoclonal antibodies was practical and efficient for the rapid identification of adenovirus in conjunctival and throat samples. 4. EIA showed excellent sensitivity and specificity for the detection of HAdV in stool specimens and will make an important contribution to the accurate diagnosis of adenovirus gastroenteritis.