P V Coyle

Belfast Health and Social Care Trust, Béal Feirste, Northern Ireland, United Kingdom

Are you P V Coyle?

Claim your profile

Publications (115)621.66 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Diagnosis of meningococcal disease relies on recognition of clinical signs and symptoms that are notoriously non-specific, variable, and often absent in the early stages of the disease. Loop-mediated isothermal amplification (LAMP) has previously been shown to be fast and effective for the molecular detection of meningococcal DNA in clinical specimens. We aimed to assess the diagnostic accuracy of meningococcal LAMP as a near-patient test in the emergency department. For this observational cohort study of diagnostic accuracy, children aged 0-13 years presenting to the emergency department of the Royal Belfast Hospital for Sick Children (Belfast, UK) with suspected meningococcal disease were eligible for inclusion. Patients underwent a standard meningococcal pack of investigations testing for meningococcal disease. Respiratory (nasopharyngeal swab) and blood specimens were collected from patients and tested with near-patient meningococcal LAMP and the results were compared with those obtained by reference laboratory tests (culture and PCR of blood and cerebrospinal fluid). Between Nov 1, 2009, and Jan 31, 2012, 161 eligible children presenting at the hospital underwent the meningococcal pack of investigations and were tested for meningococcal disease, of whom 148 consented and were enrolled in the study. Combined testing of respiratory and blood specimens with use of LAMP was accurate (sensitivity 89% [95% CI 72-96], specificity 100% [97-100], positive predictive value 100% [85-100]; negative predictive value 98% [93-99]) and diagnostically useful (positive likelihood ratio 213 [95% CI 13-infinity] and negative likelihood ratio 0·11 [0·04-0·32]). The median time required for near-patient testing from sample to result was 1 h 26 min (IQR 1 h 20 min-1 h 32 min). Meningococcal LAMP is straightforward enough for use in any hospital with basic laboratory facilities, and near-patient testing with this method is both feasible and effective. By contrast with existing UK National Institute of Health and Care Excellence guidelines, we showed that molecular testing of non-invasive respiratory specimens from children is diagnostically accurate and clinically useful. Health and Social Care Research and Development, Public Health Agency, Northern Ireland. Copyright © 2015 Elsevier Ltd. All rights reserved.
    The Lancet Infectious Diseases 02/2015; 15(5). DOI:10.1016/S1473-3099(15)70038-1 · 19.45 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Approximately 5-6% of all infective episodes in NICU are of viral origin. Previous studies suggest that human parechovirus (HPeV) infection presents most commonly in term infants, as a sepsis-like syndrome in which meningoencephalitis is prominent. Our aim was to study the infection rate and associated features of HPeV.
    The Pediatric Infectious Disease Journal 08/2014; 34(2). DOI:10.1097/INF.0000000000000510 · 3.14 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Norovirus (NoV) gastroenteritis occurs in all age groups and is the most common cause of gastroenteritis in the community. However, detection methods and rates vary widely, and few data are available to compare these, particularly in Ireland. Detection of noroviruses through antigen and molecular-based strategies was carried out on 135 suspected NoV-positive samples, collected over the course of three NoV outbreaks, from 2002 to 2006, in the southern region of Ireland. A commercially available ELISA and a panel of six primer sets were evaluated to determine their suitability for NoV detection in Irish clinical samples. The key findings of this study were the detection of both GGI and GGII noroviruses by ELISA, but the detection of only GGII noroviruses by RT-PCR. In addition to this, a variation in the levels of detection from 9.4 % to 17.3 % was observed for conventional PCR assays, while a detection rate of 46.3 % was observed for the real-time PCR assay. A proportion (17.8 %) of samples were found to be negative by all detection strategies, suggesting the possibility of reporting false positives for these samples or low-copy positives that do not often repeat. Sequencing information from selected samples also revealed nucleotide polymorphisms, compromising efficient primer binding in the case of one primer pairing. Phylogenetic analysis of the partial polymerase gene identified NoV GII.4 as the dominant genotype, in accordance with previous NoV studies in Ireland. Investigating the NoV diversity of the circulating strains and the dynamics of strain replacement is important to better assess the efficacy of future NoV vaccines and to facilitate the early detection of changes in circulating NoV strains.
    Archives of Virology 01/2014; 159(7). DOI:10.1007/s00705-014-1987-5 · 2.28 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Respiratory syncytial virus (RSV) is a major pathogen that primarily infects airway epithelium. Most infants suffer mild upper respiratory tract (URT) symptoms, while approximately one third progress to lower respiratory tract (LRT) involvement. Despite the ubiquity of URT infection, little is known about the relative cytopathogenesis of RSV infection in infant URT and LRT. This study aimed to compare RSV cytopathogenesis in nasal- and bronchial-derived epithelium from the same individuals using novel models derived from well-differentiated primary pediatric nasal (WD-PNECs) and bronchial epithelial cells (WD-PBECs). WD-PNECs and WD-PBECs were generated from nasal and bronchial brushes, respectively, and mock-infected or infected with RSV BT2a. RSV tropism, infectivity, cytopathology, growth kinetics, cell sloughing, apoptosis, and cytokine/chemokine responses were determined. RSV infection in both cultures was restricted to apical ciliated cells and occasional non-ciliated cells but not goblet cells. It did not cause obvious cytopathology. Infection resulted in apical release of progeny virus, increased apical cell sloughing, apoptosis and occasional syncytia. RSV growth kinetics and peak titers were higher in WD-PBECs, coincident with higher ciliated cell contents, cell sloughing and slightly compromised tight junctions. However, pro-inflammatory chemokine responses were similar for both cultures. Also, lambda interferons, especially IL-29, were induced by RSV infection. RSV induced remarkably similar, albeit quantitatively lower, cytopathogenesis and pro-inflammatory responses in WD-PNECs compared to WD-PBECs that reproduce many hallmarks of RSV pathogenesis in infants. WD-PNECs may provide an authentic surrogate model with which to study RSV cytopathogenesis in infant airway epithelium.
    American Journal of Respiratory and Critical Care Medicine 08/2013; 188(7). DOI:10.1164/rccm.201304-0750OC · 11.99 Impact Factor
  • Tanya Curran, Conall McCaughey, Peter V Coyle
    [Show abstract] [Hide abstract]
    ABSTRACT: P jirovecii causes Pneumocystis pneumonia (PCP), a severe opportunistic infection in immunosuppressed patients with both person to person airborne transmission and environmental transmission important routes of infection. An increasing incidence of P. jirovecii in Northern Ireland prompted a detailed epidemiological and molecular review including enhanced surveillance on all lower respiratory specimens. Genotyping of these P. jirovecii positive specimens was undertaken using Multiple Locus Sequence Typing (MLST) targeting known variable regions of the P. jirovecii genome (Hauser et al., 1997). Multiple circulating types were found amongst all patient categories. However a predominance of one MLST type was found in a P. jirovecii outbreak amongst the renal transplant population. Our results demonstrate the diversity of P. jirovecii strains among the local immunosuppressed cohort and highlight the importance of genotyping in the investigation of common sources of P. jirovecii amongst immunosuppressed patients.
    Journal of Medical Microbiology 05/2013; 62. DOI:10.1099/jmm.0.057794-0 · 2.27 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Screening hepatitis B virus (HBV) surface antigen (HBsAg) and HBV core antibody (anti-HBc) is recommended prior to cytotoxic or immunosuppressive therapy. This case describes an anti-HBc negative, DNA positive occult HBV infection in a 71-year-old Caucasian male following rituximab-based treatment for follicular lymphoma. Pre-screening serology indicated negative HBsAg and anti-HBc. However, following sequential treatment cycles the patient developed weak HBsAg with a low HBV DNA load (<1,000 IU/ml), but remained anti-HBc negative. The DNA load peaked 5 months later (>1 × 10(6) IU/ml) and he was subsequently treated with Tenofovir. Currently the patient remains anti-HBc negative, and is anti-HBe negative, anti-HBs negative, HBeAg positive. No clinical or biochemical evidence of hepatitis has occurred. Sequencing and phylogenetic analysis identified the HBV genosubtype as D4, most probably acquired some years ago during a stay in Papua New Guinea, in spite of prior hepatitis B vaccination. Four amino acid substitutions were detected within the HBsAg loop yet none in the core protein. This case questions the dependability of anti-HBc testing and highlights the role of HBV DNA testing prior to and throughout cytotoxic or immunosuppressive regimes. As this case exemplifies, vaccination protects against clinical infection but may not exclude seronegative occult infection with the possibility of reactivation. J. Med. Virol. © 2013 Wiley Periodicals, Inc.
    Journal of Medical Virology 04/2013; 85(4). DOI:10.1002/jmv.23513 · 2.22 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: ABSTRACT BACKGROUND: Paper-based diaries and self-report of symptom worsening in COPD studies may lead to under-detection of exacerbations. Epidemiologically, COPD exacerbations exhibit seasonal patterns peaking at year-end. We examined whether use of a BlackBerry-based daily symptom diary would detect 95% or more of exacerbations and enable characterization of seasonal differences between them. METHODS: Fifty participants with GOLD stage l to lV COPD began a community-based study in December 2007. Another 30 began in December 2008. Participants transmitted daily symptom diaries using a BlackBerry. Alerts were triggered when symptom changes, missed diary transmissions or medical care for a respiratory problem occurred. Participant encounters were initiated if COPD exacerbations were suspected. Participants reported returns to normal breathing using their BlackBerry. RESULTS: Participants transmitted 99.9% of 28,514 possible daily diaries. All 191 (2.5/participant-year) COPD exacerbations meeting Anthonisen criteria were detected. During 148/191 exacerbations (78%; 1.97/participant-year) patients were hospitalized and/or ordered prednisone, an antibiotic or both. Respiratory viruses were detected in 78/191 (41%) of exacerbations. Those coinciding with a respiratory viral infection averaged 12.0 days, those without averaged 8.9 days (P <.04), with no difference in Anthonisen score. Respiratory symptom scores before exacerbations and after normal breathing return showed no differences. Exacerbations were more frequent during the Christmas period than the rest of the year but not than the rest of winter alone. CONCLUSIONS: Smartphone-based collection of COPD symptom diaries enables near complete identification of exacerbations at inception. Exacerbation rates in the Christmas season do not reach levels that necessitate changes in disease management.
    Chest 03/2013; 144(2). DOI:10.1378/chest.12-2308 · 7.13 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Rotavirus is a major cause of gastroenteritis in young children worldwide. There have been several recent reports concerning rotavirus isolation from adults, particularly in the elderly, presenting with gastroenteritis. In this study, the authors report on rotavirus outbreaks in five separate elderly care facilities between April, and June 2011 in Ireland. The following genotypes were detected; G1P[8] (n = 5/11), G2P[4] (n = 2/11), and G9P[8] (n = 2/11). Thus, similarities to previous reports were found in that G1P[8] predominated, G9P[8] was still detected but G2P[4] was detected for the first time in a geriatric population in Ireland. Here also described is the detection of Group 2 lineage IIC rotavirus in Ireland for the first time. J. Med. Virol. 84:2008-2017, 2012. © 2012 Wiley Periodicals, Inc.
    Journal of Medical Virology 12/2012; 84(12):2008-17. DOI:10.1002/jmv.23416 · 2.22 Impact Factor
  • Thorax 11/2012; 67(Suppl 2):A74-A74. DOI:10.1136/thoraxjnl-2012-202678.165 · 8.56 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: In Europe fetal loss due to parvovirus B19 (B19V) is under-reported and a poorly addressed occupational risk to pregnant women. This is exemplified internationally, where it was unmentioned in the last 2 ECDC annual surveillance reports or its 2009 special report on infections in pregnancy. To assess this potential for under estimating B19V fetal loss in pregnancy, we undertook a systematic review of practice in Northern Ireland in the management and reporting of B19V infections over a 12 month period of heightened transmission, 1 of 6 observed in a span of 9 years. Pregnant and non-pregnant women presented with symptomatic infection in 24% and 93% of confirmed B19V infections respectively, with no difference in viral loads. There was under investigation of viral causes of fetal loss, with only 143/2739 (5%) tested for B19V, and a failure to follow-up most non-immune women tested following rash contact. Occupational exposure was recorded in 31/60 (51.6%) pregnancies audited following rash exposure, the majority teachers or day care workers. Against a background seroprevalence of 66.5% immunity in women of child-bearing years, two patterns of infection were identified. Firstly, pregnant women investigated for a rash or exposure to slapped cheek syndrome, where an infection incidence of 18% was observed, resulted in 42 confirmed infections, all proceeding to healthy term deliveries. Secondly, pregnant women with unsuspected infection had 6 cases of confirmed B19V fetal loss, including 4 of 22 (18%) diagnosed at autopsy, of which 3 were non-hydropic. While many studies have reported B19V fetal loss in pregnancy, there are no robust public health surveillance figures to draw on. That all 6 confirmed fetal losses came from the small number of miscarriages / stillbirths investigated, 143 out of 2739, suggests inadequate follow-up of those pregnancies where B19V related fetal loss may be most common and supports the need for enhanced surveillance pilots to address this significant gap in public health knowledge.
    Journal of Medical Microbiology 09/2012; 62. DOI:10.1099/jmm.0.046714-0 · 2.27 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Nucleic acid amplification methods such as the PCR have had a major impact on the diagnosis of viral infections, often achieving greater sensitivities and shorter turnaround times than conventional assays and an ability to detect viruses refractory to conventional isolation methods. Their effectiveness is, however, significantly influenced by assay target sequence variability due to natural diversity and rapid sequence changes in viruses that prevent effective binding of primers and probes. This was investigated for a diverse range of enteroviruses (EVs; species A to D), human rhinoviruses (HRVs; species A to C), and human parechovirus (HPeV) in a multicenter assay evaluation using a series of full-length prequantified RNA transcripts. RNA concentrations were quantified by absorption (NanoDrop) and fluorescence methods (RiboGreen) prior to dilution in buffer supplemented with RNase inhibitors and carrier RNA. RNA transcripts were extremely stable, showing minimal degradation after prolonged storage at temperatures between ambient and -20°C and after multiple freeze-thaw cycles. Transcript dilutions distributed to six referral laboratories were screened by real-time reverse transcriptase PCR assays using different primers and probes. All of the laboratories reported high assay sensitivities for EV and HPeV transcripts approaching single copies and similar amplification kinetics for all four EV species. HRV detection sensitivities were more variable, often with substantially impaired detection of HRV species C. This could be accounted for in part by the placement of primers and probes to genetically variable target regions. Transcripts developed in this study provide reagents for the ongoing development of effective diagnostics that accommodate increasing knowledge of genetic heterogeneity of diagnostic targets.
    Journal of clinical microbiology 06/2012; 50(9):2910-7. DOI:10.1128/JCM.01172-12 · 4.23 Impact Factor
  • American Thoracic Society 2012 International Conference, May 18-23, 2012 • San Francisco, California; 05/2012
  • American Thoracic Society 2012 International Conference, May 18-23, 2012 • San Francisco, California; 05/2012
  • [Show abstract] [Hide abstract]
    ABSTRACT: Against a background of point-source outbreaks of Pneumocystis pneumonia (PCP) in renal transplant units in Europe, we undertook a retrospective 3 year observational review of PCP in Northern Ireland. This showed an unexpected increase in incidence, with a mortality rate of 30 %. Fifty-one cases were confirmed compared to 10 cases confirmed in the preceding 7 years. Where undiagnosed HIV infection had previously been the main risk factor for PCP, this was now equally matched by chemotherapy for haematological and non-haematological malignancy and immune suppression for a range of autoimmune conditions. Congenital immunodeficiency and transplantation were less common predisposing factors, but renal grafts also showed a rising incidence. Asymptomatic carriage was uncommon. At presentation both upper and lower respiratory samples were of equal use in establishing the diagnosis, and treatment resulted in rapid clearance. These data suggest the need for considering PCP in at-risk patients, reviewing its mode of acquisition and whether iatrogenic colonization is a treatable pre-condition.
    Journal of Medical Microbiology 04/2012; 61(Pt 7):1009-15. DOI:10.1099/jmm.0.043984-0 · 2.27 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Respiratory syncytial virus (RSV) is the major viral cause of severe pulmonary disease in young infants worldwide. However, the mechanisms by which RSV causes disease in humans remain poorly understood. To help bridge this gap, we developed an ex vivo/in vitro model of RSV infection based on well-differentiated primary pediatric bronchial epithelial cells (WD-PBECs), the primary targets of RSV infection in vivo. Our RSV/WD-PBEC model demonstrated remarkable similarities to hallmarks of RSV infection in infant lungs. These hallmarks included restriction of infection to noncontiguous or small clumps of apical ciliated and occasional nonciliated epithelial cells, apoptosis and sloughing of apical epithelial cells, occasional syncytium formation, goblet cell hyperplasia/metaplasia, and mucus hypersecretion. RSV was shed exclusively from the apical surface at titers consistent with those in airway aspirates from hospitalized infants. Furthermore, secretion of proinflammatory chemokines such as CXCL10, CCL5, IL-6, and CXCL8 reflected those chemokines present in airway aspirates. Interestingly, a recent RSV clinical isolate induced more cytopathogenesis than the prototypic A2 strain. Our findings indicate that this RSV/WD-PBEC model provides an authentic surrogate for RSV infection of airway epithelium in vivo. As such, this model may provide insights into RSV pathogenesis in humans that ultimately lead to successful RSV vaccines or therapeutics.
    Proceedings of the National Academy of Sciences 03/2012; 109(13):5040-5. DOI:10.1073/pnas.1110203109 · 9.81 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Mycoplasma pneumoniae (M. pneumoniae) is a common pathogen in cases of atypical pneumonia. Most individuals with Mycoplasma pneumonia run a benign course, with non-specific symptoms of malaise, fever and non-productive cough that usually resolve with no long-term sequelae. Acute lung injury is not commonly seen in Mycoplasma pneumonia. We report a case of acute respiratory distress syndrome cause by M. pneumoniae diagnosed by quantitative real-time polymerase chain reaction (RT-PCR).
    The Ulster medical journal 01/2012; 81(1):28-29.
  • [Show abstract] [Hide abstract]
    ABSTRACT: False-positive PCR results usually occur as a consequence of specimen-to-specimen or amplicon-to-specimen contamination within the laboratory. Evidence of contamination at time of specimen collection linked to influenza vaccine administration in the same location as influenza sampling is described. Clinical, circumstantial and laboratory evidence was gathered for each of five cases of influenza-like illness (ILI) with unusual patterns of PCR reactivity for seasonal H1N1, H3N2, H1N1 (2009) and influenza B viruses. Two 2010 trivalent influenza vaccines and environmental swabs of a hospital influenza vaccination room were also tested for influenza RNA. Sequencing of influenza A matrix (M) gene amplicons from the five cases and vaccines was undertaken. Four 2009 general practitioner (GP) specimens were seasonal H1N1, H3N2 and influenza B PCR positive. One 2010 GP specimen was H1N1 (2009), H3N2 and influenza B positive. PCR of 2010 trivalent vaccines showed high loads of detectable influenza A and B RNA. Sequencing of the five specimens and vaccines showed greatest homology with the M gene sequence of Influenza A/Puerto Rico/8/1934 H1N1 virus (used in generation of influenza vaccine strains). Environmental swabs had detectable influenza A and B RNA. RNA detection studies demonstrated vaccine RNA still detectable for at least 66 days. Administration of influenza vaccines and clinical sampling in the same room resulted in the contamination with vaccine strains of surveillance swabs collected from patients with ILI. Vaccine contamination should therefore be considered, particularly where multiple influenza virus RNA PCR positive signals (e.g. H1N1, H3N2 and influenza B) are detected in the same specimen.
    Journal of Medical Microbiology 11/2011; 61(Pt 3):332-8. DOI:10.1099/jmm.0.036178-0 · 2.27 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: There is a need to provide rapid, sensitive, and often high throughput detection of pathogens in diagnostic virology. Viral gastroenteritis is a serious health issue often leading to hospitalization in the young, the immunocompromised and the elderly. The common causes of viral gastroenteritis include rotavirus, norovirus (genogroups I and II), astrovirus, and group F adenoviruses (serotypes 40 and 41). This article describes the work-up of two internally controlled multiplex, probe-based PCR assays and reports on the clinical validation over a 3-year period, March 2007 to February 2010. Multiplex assays were developed using a combination of TaqMan™ and minor groove binder (MGB™) hydrolysis probes. The assays were validated using a panel of 137 specimens, previously positive via a nested gel-based assay. The assays had improved sensitivity for adenovirus, rotavirus, and norovirus (97.3% vs. 86.1%, 100% vs. 87.8%, and 95.1% vs. 79.5%, respectively) and also more specific for targets adenovirus, rotavirus, and norovirus (99% vs. 95.2%, 100% vs. 93.6%, and 97.9% vs. 92.3%, respectively). For the specimens tested, both assays had equal sensitivity and specificity for astrovirus (100%). Overall the probe-based assays detected 16 more positive specimens than the nested gel-based assay. Post-introduction to the routine diagnostic service, a total of 9,846 specimens were processed with multiplex 1 and 2 (7,053 pediatric, 2,793 adult) over the 3-year study period. This clinically validated, probe-based multiplex testing algorithm allows highly sensitive and timely diagnosis of the four most prominent causes of viral gastroenteritis.
    Journal of Medical Virology 09/2011; 83(9):1650-6. DOI:10.1002/jmv.22162 · 2.22 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We have developed a winter forecasting service to predict when patients with COPD are at higher risk of an exacerbation and alert them via an automated telephone call. To assess the effect of the service and its ability to predict periods of increased risk. A 4-month prospective randomised controlled trial using clinical criteria and the EXACT PRO questionnaire to identify exacerbations. Patients were randomly allocated to receive alert calls. All patients completed a diary including the EXACT PRO questionnaire on a BlackBerry Smartphone each day. They were contacted and assessed if they appeared to be exacerbating. 79 patients participated, 40 received alert calls. The exacerbation frequency per patient per week was significantly greater during periods of predicted high risk (0.086 ± 0.010 v 0.055 ± 0.010). The exacerbation frequency (± standard error of the mean, SEM) in patients receiving alert calls was lower (0.95 ± 0.27 v 1.17 ± 0.29) but this was not statistically significant. Fewer patients receiving alert calls had one or more EXACT event compared to the controls (34% v 53%, p=0.11), their duration was shorter (8.2 ± 2.0 v10.1 ± 1.9 days, p=0.481) and they were less severe (AUC 65 ± 21 v 115 ± 22, p=0.118). There were no significant differences in the mean change (± SEM) in SGRQ scores between the groups. The ability of the forecast to predict high risk periods was confirmed unequivocally. Alert calls appeared to reduce the frequency and severity of exacerbations but these effects did not reach statistical significance, perhaps because of the number of participants, lower than expected exacerbation rates, and the fact that there was contact with patients in both groups whenever they appeared to be exacerbating.
    Primary care respiratory journal: journal of the General Practice Airways Group 06/2011; 20(3):324-31, 2 p following 331. DOI:10.4104/pcrj.2011.00057
  • [Show abstract] [Hide abstract]
    ABSTRACT: Early meningococcal disease (MD) diagnosis is difficult. We assessed rapid molecular testing of respiratory specimens. We performed genotyping of respiratory swabs, blood, and cerebrospinal fluid from children with suspected disease and nasal swabs (NSs) from matched controls. Thirty-nine of 104 suspected cases had confirmed disease. Four controls were carriers. Throat swab ctrA and porA testing for detection of disease gave a sensitivity of 81% (17/21), specificity of 100% (44/44), positive predictive value (PPV) of 100% (17/17), negative predictive value (NPV) of 92% (44/48), and relative risk of 12. NS ctrA and porA testing gave a sensitivity of 51% (20/39), specificity of 95% (62/65), PPV of 87% (20/23), NPV of 77% (62/81), and relative risk of 4. Including only the 86 NSs taken within 48 h of presentation, the results were sensitivity of 60% (18/30), specificity of 96% (54/56), PPV of 90% (18/20), NPV of 82% (54/66), and relative risk of 5. Swab type agreement was excellent (kappa 0.80, P < 0.001). There was exact phylogenetic agreement from different specimen sites for individuals. Carried genosubtypes were P1.7 and P1.21-7. Prehospital rapid molecular testing of easily obtained respiratory specimens could accelerate diagnosis of MD.
    Diagnostic microbiology and infectious disease 06/2011; 70(4):427-34. DOI:10.1016/j.diagmicrobio.2011.03.018 · 2.57 Impact Factor

Publication Stats

1k Citations
621.66 Total Impact Points

Institutions

  • 2008–2015
    • Belfast Health and Social Care Trust
      • Regional Virus Laboratory
      Béal Feirste, Northern Ireland, United Kingdom
    • Antrim Area Hospital
      Aontroim, Northern Ireland, United Kingdom
  • 1994–2014
    • Royal Victoria Eye and Ear Hospital
      Dublin, Leinster, Ireland
  • 2007–2010
    • The Royal Society of Medicine
      Londinium, England, United Kingdom
  • 2004–2010
    • Queen's University Belfast
      • Centre for Infection and Immunity
      Béal Feirste, N Ireland, United Kingdom
  • 2005
    • Royal Berkshire NHS Foundation Trust
      Reading, England, United Kingdom
  • 1992
    • Oxford University Hospitals NHS Trust
      Oxford, England, United Kingdom
  • 1991–1992
    • Royal Victoria Regional Health Centre
      Barrie, Ontario, Canada