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Journal of Clinical Microbiology, February 2007, p. 548-552, Vol. 45, No. 2
0095-1137/07/$08.00+0     doi:10.1128/JCM.01621-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Diagnosis of Human Metapneumovirus Infection in Immunosuppressed Lung Transplant Recipients and Children Evaluated for Pertussis

Ryan Dare,^1, Sonali Sanghavi,^1,6 Arlene Bullotta,¹ Maria-Cristina Keightley,¹ Kirsten St. George,^1,2 Robert M. Wadowsky,^3,7 David L. Paterson,⁴ Kenneth R. McCurry,⁵ Todd A. Reinhart,⁶ Shahid Husain,⁴ and Charles R. Rinaldo^1,6,7*

Clinical Virology Laboratory, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania,¹ Wadsworth Center, New York State Department of Health, Albany, New York,² Children's Hospital Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania,³ Transplant Infectious Diseases,⁴ Department of Surgery,⁵ Department of Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, Pennsylvania,⁶ Department of Pathology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania⁷

Received 5 August 2006/ Returned for modification 12 September 2006/ Accepted 9 October 2006

Human metapneumovirus (hMPV) is a recently discovered paramyxovirus that is known to cause respiratory tract infections in children and immunocompromised individuals. Given the difficulties of identifying hMPV by conventional culture, molecular techniques could improve the detection of this virus in clinical specimens. In this study, we developed a real-time reverse transcription-PCR (RT-PCR) assay designed to detect the four genetic lineages of hMPV. This assay and a commercial real-time nucleic acid sequence-based amplification (NASBA) assay (bioMérieux, Durham, NC) were used to determine the prevalence of hMPV in 114 immunosuppressed asymptomatic and symptomatic lung transplant recipients and 232 pediatric patients who were being evaluated for pertussis. hMPV was detected in 4.3% of the immunosuppressed lung transplant recipients and in 9.9% of children evaluated for pertussis. Both RT-PCR and NASBA assays were efficient in detection of hMPV infection in respiratory specimens. Even though hMPV was detected in a small number of the lung transplant recipients, it was still the most prevalent etiologic agent detected in patients with respiratory symptoms. In both of these diverse patient populations, hMPV infection was the most frequent viral respiratory tract infection identified. Given our findings, infection with hMPV infection should be determined as part of the differential diagnosis of respiratory illnesses.

Published ahead of print on 25 October 2006.

Present address: Respiratory and Gastroenteritis Viruses Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA.

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