Persistence of adenovirus nucleic acids in nasopharyngeal secretions: A diagnostic conundrum

Stella U. Kalu, Michael Loeffelholz, Eric Beck, Janak A. Patel, Krystal Revai, Jiang Fan, Kelly J. Henrickson, Tasnee Chonmaitree

Research output: Contribution to journalArticlepeer-review

66 Scopus citations


Background: Polymerase chain reaction (PCR) assays increase the rate of viral detection in clinical specimens, compared with conventional virologic methods. Studies suggest that PCR may detect virus nucleic acid (NA) that persists in the respiratory tract. Methods: We analyzed virologic data from children having frequent upper respiratory infections (URI), who were followed up in a longitudinal study. Nasopharyngeal secretions were collected at URI onset and when acute otitis media was diagnosed; virus studies were performed using conventional diagnostics and PCR. Repeated presence of adenovirus by PCR was further studied by sequencing and phylogenetic analysis. Results: Of 581 URI episodes in 76 children, 510 viruses were detected. Of the viruses detected by PCR, 15% were those detected previously; repeated positives occurred most frequently with adenovirus. Sequencing results were available in 13 children with repeated adenovirus detection; the following 4 patterns of infection were identified (16 instances): (1) adenovirus of the same serotype and strain detected continuously (n = 8 instances), (2) adenovirus of different serotypes detected during sequential URI episodes (n = 3), (3) adenovirus of the same serotype but different strains detected during sequential URI episodes (n = 3), and (4) adenovirus of the same serotype and strain detected intermittently (n = 2). Conclusions: Among children with frequent URIs, repeated positive PCR results for adenovirus NA may represent a new serotype/strain, or persistence of viral NA. Results must be interpreted with caution; clinical correlation and presence of other viruses are important. Further longitudinal studies of children during and after infection are required for better understanding of the clinical significance of positive PCR tests for adenovirus NA in the respiratory tract.

Original languageEnglish (US)
Pages (from-to)746-750
Number of pages5
JournalPediatric Infectious Disease Journal
Issue number8
StatePublished - Aug 2010


  • PCR
  • adenovirus
  • nasopharyngeal secretion
  • upper respiratory tract infection
  • virus detection

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases


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