Human rhinovirus detection in the lower respiratory tract of hematopoietic cell transplant recipients: association with mortality

Seo, Sachiko; Waghmare, Alpana; Scott, Emily M; Xie, Hu; Kuypers, Jane M; Hackman, Robert C.; Campbell, Angela P.; Choi, Su-Mi; Leisenring, Wendy M.; Jerome, Keith R.; Englund, Janet A.; Boeckh, Michael

To prove a pathogen-disease association for a pathogen that is difficult to cultivate, 18 especially in the molecular era, is difficult, as Koch's postulates or other assessments of direct viral injury cannot be easily applied despite the detection of viral nucleic acid. We employed multiple strategies to examine the plausibility of HRV as a significant pathogen, including: (i) a comparison of mortality in patients with HRV detection in the upper and lower respiratory tract, (ii) a comparison between patients with and without co-pathogens in outcome after HRV LRI, (iii) an evaluation of factors associated with death following HRV detection in BAL samples, (iv) a comparison of mortality with respiratory viruses of well-established pathogenicity, and (v) tissue detection of the virus.