Leveraging real-time PCR for early diagnosis of respiratory conditions in the Indian pediatric population

Background: Respiratory tract infections (RTIs) caused by various viruses and microbial agents present clinical challenges due to their diverse presentations. This retrospective study aimed to identify epidemiological trends and clinical characteristics of RTIs in pediatric populations using molecular diagnosis. Methods: The study cohort comprised 100 paediatric individuals, predominantly male (70%) compared to female (30%), distributed across different age brackets. Real Time PCR targeting 32 microbial pathogens includes bacteria (15) and viruses (17). Results: The majority of participants were aged 1 to 12 months (38%), followed by 1 to 3 years (29%), and 3 to 10 years (25%), with the smallest group being infants under 1 month (8%).  A total of 134 pathogens were detected in 100 patients, with a higher prevalence in males (80%) compared to females (20%). Human respiratory syncytial viruses A and B were the most common, with 17 cases in males and 5 in females. Klebsiella pneumonia followed, with 19 cases in males and 5 in females. Influenza A and B viruses were also notable, with 7 and 9 cases in males, and 4 and 7 cases in females, respectively. Other significant microbes included human parainfluenza virus 3, human adenovirus, and Streptococcus pneumoniae. Notably, SARS-CoV-2 and Acinetobacter baumannii were not detected in either gender during the study period. Conclusions: Our study shows that nucleic acid-based tests, especially multiplex PCR, effectively detect respiratory viruses in pediatric RTI patients, reducing inappropriate antibacterial use and mortality/morbidity.