14 Recently, new flocked swabs (Copan, Brescia, Italy) were developed, and presented better performance during data collection. Recent studies using this

type of swab presented a sensitivity comparable to that of NPA when the detection is performed by PCR, suggesting that this swab can be used in epidemiological research and surveillance studies, due to its greater technical simplicity.15 and 16 There are few data to support the use of combined oral-nasal swabs for BMS-387032 in vivo virus detection, and its sensitivity is lower than that of the nasopharyngeal swab or aspirate, which can be explained by the lower viral load in the oropharynx than in the nasopharynx. The collection can also be performed on material from the lower airways, such as induced

sputum and bronchial lavage.17 The methods for detection of respiratory E7080 viruses are varied and include rapid tests for antigen detection, culture, direct and indirect immunofluorescence, and nucleic acid amplification reactions, such as RT-PCR, which can detect a single agent (monoplex) or perform multiple detections (multiplex). The sensitivity of the latter is higher, and it was used in most recent studies.18 and 19 immunofluorescence reactions have lower cost, are faster to perform, and are also able to detect multiple viruses. A panel of seven viruses (IFlu A and B, PFlu 1 to 3, hAdV, and RSV) is generally used. Some viruses, such as HRV and Bocavirus, can only be detected through nucleic acid amplification reactions. 17 Several authors have performed studies aiming to detect viruses in respiratory secretions of exacerbated asthma patients, showing a prevalence of viral identification that varies with several factors, such as patient age, time of the year,

method of sample collection, and method of viral detection. Table 2 presents the original articles that demonstrate results of viral testing in children with exacerbated asthma. Most studies found prevalence rates between 36.0%20 and 92.2%;5 in these cases, the most frequently identified virus was HRV. An investigation of respiratory Dolichyl-phosphate-mannose-protein mannosyltransferase viruses in 209 children aged between three and 16 years hospitalized for asthma exacerbation was performed over a period of 12 months in Buenos Aires, Argentina. Due to the possibility of other diagnoses for wheezing episodes in infants, the definition of asthma was based on the criteria of Castro-Rodriguez for children younger than 3 years, and on the Global Initiative for Asthma (GINA) criteria for those older than 3. Immunofluorescence and PCR were performed in nasopharyngeal secretions of the children and showed a positive rate of 78.0% for viruses in general; hRV and hRSV were the most frequently identified types. There was also 20.