Influenza species and subtypes circulation among hospitalized patients in Laleh hospital during two influenza seasonal (2016-2017 and 2017-2018) using a multiplex Real Time-Polymerase Chain Reaction

Azhar, Iman Rezaee; Mohraz, Minoo; Mardani, Masoud; Tavakoli, Mohammad Ali; Afshar, Amin Ehteshami; Zamani, Mohammad; Sadeghpoor, Simin; Safari, Saeid; Dadashpoor, Roozbeh; Rezaee, Mahsa; Shirvani, Fariba; Azimi, Shohreh; Heydarifard, Zahra; Ranjbar, Hamidreza Hagh; Lotfi, Amir Hossain; Mosadegh, Farhad; Hashemnejad, Farhad; Jazayeri, Seyed Mohammad

This study suffers from some limitations. First, the multiplex panel only allowed to discriminate flu A from flu B, and, among flu A, only flu A (H1N1) subtyped was identified. Identification of flu A subtypes different from H1 was not possible with this panel. Finding of different flu species, subtypes and variants would be useful for epidemiological investigations and for tracking outbreaks and also predict flu vaccine efficiency. Moreover, other flulike illnesses such as respiratory syncytial virus and human metapeumovirus infections were missed from differential diagnosis in patients who were flu-negative. Moreover, coinfections between these viruses were also ignored. These latter issues are due to the absence of more comprehensive diagnostic tools for respiratory viral infection evaluation at least in our center. In conclusion, despite no other respiratory pathogen were investigated, these results showed that almost 40% of patients admitted to Laleh hospital were infected by influenza virus. Influenza diagnosis was not achieved in up to 60% of flu-like respiratory infections, suggesting the potential benefit of adopting the same methodology for assessing the involvement of other viral or/and bacterial pathogens in those patients. This study clearly revealed that the rapid diagnosis due to the application of a multiplex molecular test would result in a shorter period of hospitalization and would benefit patients avoiding unnecessary antibiotic therapy due to the exclusion of bacterial infections.