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Background Human rhinovirus (HRV) is a common cause of respiratory illness in children. The impact of HRV infection on 1- to 90-day-old infants is unclear. We hypothesized that HRV infection would be clinically similar to respiratory syncytial virus (RSV) infection in the hospitalized infants. Methods We conducted a retrospective study of hospitalized infants, who were 1–90 days old, with HRV or RSV within the Southern California Kaiser Permanente network over a 1-year period (August 2010 to October 2011). Results We identified 245 hospitalized infants who underwent respiratory virus testing. HRV was found in 52 infants (21%) compared to 79 infants (32%) with RSV (P = 0.008). Infants with HRV infection experienced longer hospital stays compared to those with RSV (median length of stay 4 days vs. 3 days, P = 0.009) and had fewer short hospital stays ≤3 days (P = 0.029). There was a trend in infants with HRV infection to be younger (P = 0.071) and have more fevers (P = 0.052). Conclusions Recent advances in diagnostics allow for identification of a broad range of viral pathogens in infants. Compared to RSV, HRV was associated with longer hospital stays. Additional studies and improved, more specific testing, methods are needed to further define the effects of HRV infection in infants 1–90 days old.

The advantage direct probe detection offers is a savings of 24 to 48 h in turnaround time (TAT) in detecting group B Streptococcus (GBS). Additionally because the assay is not an amplified molecular assay, there are no template contamination concerns when running the test. Conventional and real-time PCR assays have been developed for the rapid detection of GBS. GBS-PCR tests performed with alternative specimen types including amniotic fluid, neonatal screening swabs, blood, breast milk, urine, and serum have been described in the literature. A rapid and sensitive intrapartum real-time PCR assay offers the advantage of ascertaining the colonization status before delivery. A multiplex PCR-based reverse line-blot hybridization assay and partial sequence of cps gene has been used to compare the distribution of GBS serotypes, serotype III subtypes, and antibiotic resistance-associated genes. Determination of serotype is also epidemiologically important with respect to the proposed development of a preventative conjugate vaccine. Real-time PCR offers a powerful tool for sensitive, specific, and rapid detection of GBS directly from specimens at the time of delivery. It also offers a more sensitive antepartum test with improved TAT over culture.

The focused and unique health care management of the immunocompromised patient has grown significantly over the last several decades. Biomarkers of the immune response, such as procalcitonin (PCT), are evolving in clinical utility for the diagnosis of severe bacterial infections such as sepsis, for prediction of sepsis complications, and for therapeutic follow-up. Microbial and fungal infections are among the most common causes of high morbidity and mortality in critically ill patients in the United States; mortality rates can exceed 80%. Several molecular platforms are slated to play a role in advancing the diagnostic capabilities of clinical laboratories. Only time, cost-benefit studies, and practical evidence-based reviews can reveal the ultimate utility of these methods for diagnosis of infections in the immunocompromised population. Rapid testing for genetic resistance markers is an emerging clinical practice that can not only identify the potential for drug resistance but also help distinguish ambiguous breakpoints associated with susceptibility testing. Biomarkers of the immune response, such as PCT, are useful for the diagnosis of severe bacterial infections such as sepsis, for prediction of sepsis complications, and for therapeutic follow-up. Immunocompromised patients are a unique population, for which extreme measures may be required to make relevant diagnoses, prevent infection, or prevent overuse of health care resources.