Introduction: Infants with Bronchopulmonary Dysplasia (BPD) are at higher risk of developing severe RSV Bronchiolitis requiring hospitalisation. Palivizumab Immunoprophylaxis (PIP) was shown to reduce the severity of illness and hence the need for hospitalisation. Currently PIP is recommended for all infants with BPD, but there is little evidence on which infants with BPD would most benefit from PIP. Aim: This study aims to identify the clinical benefit of administering PIP to infants with BPD of different severities and to determine which infants would benefit most from PIP. In order to achieve this, the study also identifies the incidence of BPD, categorised into mild, moderate and severe in infants, in the Greater Manchester Region (GMR).Methods: This is a multi-centre, prospective, observational cohort study, involving 11 hospitals across GMR. Patients were recruited over 2 years, from 1st April 2009 to 31st March 2011. The infants with BPD were recruited and further categorised in various severities, based on Jobe’s BPD classification [Jobe et al 2001]. Patients were followed up for a minimum of one year. Results: The incidence of BPD in the GMR was 5.9 infants per 1000 live births. On categorisation by level of severity, the study found 31% of these to have mild BPD, 39% moderate and 30% severe BPD. Around 60% of infants received PIP in our cohort: one third of mild group, two thirds of moderate and three quarters of severe BPD. The overall proportion of hospitalisation for all the respiratory illnesses in infants with BPD was 44%. The overall incidence of hospitalization secondary to RSV infection was 7.6% of the cohort, and 14.8% due to other respiratory viruses. PIP was most beneficial in infants with moderate BPD (p = 0.016). Infants hospitalised with RSV infection required more admissions to HDU, required a longer duration of supplemental oxygen as well as a longer hospital stay compared to infants hospitalised due to other respiratory viruses and all other respiratory illnesses. Conclusion: This is the first study identifying the incidence of BPD in the GMR, which was lower than expected based on estimates from the JCVI. Both, the distribution of BPD into the various severity categories, as well as the requirement of hospital admission secondary to respiratory illness, were in keeping with published evidence from the USA and UK. PIP practices across North West of England were varied and not compliant with JCVI guidelines. Infants with moderate BPD showed the largest benefit from receiving PIP. This is a novel finding that highlights the need for further research, to determine whether a subgroup of infants might benefit from PIP.

Le système nerveux central est isolé de l’environnement grâce à un ensemble de barrières, incluant la barrière osseuse et la barrière hémato-encéphalique. Il existe cependant des zones où ces barrières sont absentes ou affaiblies, et c’est notamment le cas au niveau des nerfs olfactifs qui ont pour origine les neurones présents dans la cavité nasale. Ces neurones participent à la détection des odeurs et leurs axones contactent directement le système nerveux central au niveau des bulbes olfactifs en traversant la lame criblée de l’éthmoïde. Cette « voie olfactive » représente ainsi un site d’entrée privilégié de certains pathogènes vers le cerveau. La muqueuse olfactive, du fait de son positionnement à l’interface entre l’environnement et le système nerveux central, constitue donc une zone particulièrement sensible sur le plan immunologique. Si cette muqueuse est connue pour produire des composants antimicrobiens, les mécanismes cellulaires et moléculaires mobilisés dans le cadre d’infections par des pathogènes respiratoires restent peu décrits.Au cours de ma thèse, nous nous sommes tout d’abord focalisés sur l’interleukine 17c, connue comme puissant médiateur des réponses immunitaires innées épithéliales respiratoires et dont les récepteurs sont exprimés dans la muqueuse olfactive. Nous avons notamment pu montrer qu’elle était mobilisée in vivo dans un contexte mimant une infection virale et qu’elle favorisait le renouvellement épithélial ainsi que l’infiltration de cellules immunitaires. En voulant caractériser son action dans un contexte viral, nous avons été amenés à étudier les effets de deux virus respiratoires sur la muqueuse olfactive (le virus influenza et le virus respiratoire syncytial). Nous avons observé que les deux virus pouvaient infecter efficacement les neurones sensoriels olfactifs, mais avec une charge virale plus élevée pour influenza. A dose équivalente, le virus de la grippe provoque d'importants dégâts dans la muqueuse olfactive mais ne s’établit pas durablement dans la muqueuse, ce qui suggère que ce virus est éliminé très efficacement et rapidement. En nous focalisant sur les processus d'élimination des neurones sensoriels olfactifs infectés, nous avons identifié un nouveau mécanisme antiviral précoce basé sur l'élastase, une enzyme précédemment décrite comme sécrétée par les neutrophiles, principaux acteurs du système immunitaire inné.Dans l’ensemble, ces travaux de thèse mettent en lumière les défenses immunitaires présentes dans la cavité nasale contre les virus respiratoires et apportent de nouvelles perspectives dans le contrôle des virus infectant le système nerveux central par la voie olfactive. / The central nervous system is sheltered from the environment thanks to cranial bones and the blood brain barrier. Some parts of these barriers are weaker, especially around olfactory nerves originating from olfactory sensory neurons in the nasal cavity. These neurons detect odorants and their axons cross the cribriform plate to project directly into the brain at the level of the olfactory bulbs. The cribriform plate is a thin and perforated area of the cranial bones allowing the crossing of the olfactory nerves. This “olfactory pathway” constitutes a privileged entry site for viruses toward the central nervous system. Hence, the olfactory mucosa represents a particularly sensitive area for the immune system. While the olfactory mucosa is known to produce various anti-microbial compounds, the described molecular and cellular mechanism of immune system defenses against viruses remains sparse.The interleukin 17c (IL-17c) is known as an innate immunity response actor in the respiratory epithelium. While its receptors are expressed in the olfactory mucosa, its role in this tissue was unknown. We found that IL-17c is involved in olfactory mucosa responses to Poly(I:C) mimicking virus presence. We observed that nasal instillation of IL-17c accelerated the olfactory mucosa turn-over and induced its infiltration by immune cells. In attempt to characterize the role of IL-17c in a real viral context, we started to focus on the impact of two viruses of the respiratory tract: influenza and the respiratory syncytial virus. We observed that both viruses could effectively infect olfactory sensory neurons but with a higher virus load for influenza. Indeed, at similar doses, influenza induced important damages in the olfactory mucosa but was not present, indicating that influenza virus is very effectively and rapidly eliminated from the olfactory mucosa. By focusing on the elimination processes of infected olfactory sensory neurons, we identified a novel early anti-viral mechanism based on elastase, an enzyme previously described as secreted by neutrophils, main actors of the innate immunity system.Overall, my PhD results provide new insights on the immune defenses present in the olfactory mucosa against respiratory viruses and could bring new perspectives in the control of virus infecting the central nervous system.

Rhinoviruses (RVs) constitute a substantial public health burden. To evaluate their abundance and genetic diversity in adult patients, RV RNA in respiratory samples was assessed using real-time RT-PCR and the partial nucleic acid sequencing of viral genomes. Additionally, clinical data were retrieved from patient charts to determine the clinical significance of adult RV infections. In total, the respiratory specimens of 284 adult patients (18–90 years), collected from 2013 to 2017, were analyzed. Infections occurred throughout the entire year, with peaks occurring in fall and winter, and showed a remarkably high intra- and interseasonal diversity of RV genotypes. RV species were detected in the following ratios: 60.9% RV-A 173, 12.7% RV-B, and 26.4% RV-C. No correlations between RV species and underlying comorbidities such as asthma (p = 0.167), COPD (p = 0.312) or immunosuppression (p = 0.824) were found. However, 21.1% of the patients had co-infections with other pathogens, which were associated with a longer hospital stay (p = 0.024), LRTI (p < 0.001), and pneumonia (p = 0.01). Taken together, this study shows a pronounced genetic diversity of RV in adults and underlines the important role of co-infections. No correlation of specific RV species with a particular clinical presentation could be deduced.

Rhinoviruses (RVs) constitute a substantial public health burden. To evaluate their abundance and genetic diversity in pediatric patients, RV RNA in respiratory samples was assessed using real-time RT-PCR and partial nucleic acid sequencing of viral genomes. Additionally, clinical data were retrieved from patient charts to determine the clinical significance of pediatric RV infections. In total, the respiratory specimens of 776 patients (<18 years), collected from 2013 to 2017, were analyzed. Infections occurred throughout the entire year, with peaks occurring in fall and winter, and showed remarkably high intra- and interseasonal diversity for RV genotypes. RV species were detected in the following frequencies: 49.1% RV-A, 5.9% RV-B, and 43.6% RV-C. RV-C was found to be more frequently associated with asthma (p = 0.04) and bronchiolitis (p < 0.001), while RV-A was more frequently associated with fever (p = 0.001) and pneumonia (p = 0.002). Additionally, 35.3% of the patients had co-infections with other pathogens, which were associated with a longer hospital stay (p < 0.001), need for ventilation (p < 0.001), and pneumonia (p < 0.001). Taken together, this study shows pronounced RV genetic diversity in pediatric patients and indicates differences in RV-associated pathologies, as well as an important role for co-infections.

Das severe acute respiratory syndrome Coronavirus (SARS-CoV) ist ein hochpathogenes Virus, dessen zoonotischer Eintrag in die Bevölkerung eine substantielle Gesundheitsgefahr darstellt. Die Identifizierung von Wirtszellfaktoren, die für die SARS-CoV-Ausbreitung und Pathogenese wichtig sind, könnte neue Ansatzpunkte für die Therapie liefern. Das SARS-CoV-Oberflächenprotein Spike (S) bindet an den zellulären Rezeptor angiotensin converting Enzyme 2 (ACE2) und vermittelt den viralen Eintritt in Zielzellen. Die Spaltung und Aktivierung des S Proteins durch Wirtszellproteasen ist für den infektiösen, S Protein-vermittelten Zelleintritt von SARS-CoV essentiell. Die Typ II Transmembranserinproteasen (TTSPs) TMPRSS2 und HAT spalten und aktivieren das S Protein, zumindest nach gerichteter Expression in Zelllinien. Ob diese Enzyme in der menschlichen Lunge, den Zielzellen der SARS-CoV-Infektion, exprimiert werden, war jedoch unklar und sollte im Rahmen der vorliegenden Arbeit untersucht werden. TMPRSS2 und HAT spalten auch den viralen Rezeptor ACE2 und es wurde postuliert, dass die ACE2-Spaltung den viralen Eintritt erhöht. Der zugrundeliegende Mechanismus war jedoch nicht bekannt und sollte innerhalb der vorliegenden Arbeit aufgeklärt werden. Es konnte gezeigt werden, dass TMPRSS2 und HAT zusammen mit ACE2 in Epithelzellen des Respirationstrakts exprimiert werden. Die Proteasen könnten daher die Ausbreitung von SARS-CoV im Lungenepithel fördern. Weiterhin wurde eine Aminosäuresequenz in ACE2 identifiziert, die für die Prozessierung durch TMPRSS2 und HAT essentiell ist. Die funktionelle Analyse von ACE2- Mutanten zeigte, dass die Spaltung in diesem Bereich infektionsverstärkend wirkt. Immunfluoreszenz-Studien erbrachten Hinweise darauf, dass die Verstärkung der Infektion auf eine erhöhte Aufnahme von Virus-Partikeln in die Zelle zurückzuführen ist. Schließlich konnte demonstriert werden, dass TMPRSS2 und eine weitere zelluläre Protease, A Disintegrin And Metalloproteinase 17 (ADAM17), um die ACE2-Spaltung konkurrieren und die ADAM17- Spaltstelle in ACE2 konnte kartiert werden. Die ACE2-Spaltung durch ADAM17 war jedoch für den S Protein-getriebenen Zelleintritt verzichtbar. Zusammenfassend zeigen diese Untersuchungen, dass TMPRSS2 und HAT die SARS-CoV-Infektion durch Spaltung von S Protein und Rezeptor fördern. Die Proteasen stellen daher mögliche Angriffspunkte für die antivirale Intervention dar.

Viruses are etiologic agents of a great number of diseases of human beings and animals. However, there are only a little amount antiviral medicines available that is almost exclusively used in human health. Several studies have demonstrated that propolis has biological activities against virus, bacteria and fungi. Its chemical composition is diverse varying according to season, plants available and collection. The antiviral activity of ethanolic extracts of propolis have already been described for some human viruses. The aim of this study was to evaluate the antiviral activity of propolis ethanolic extracts against two viruses causing respiratory disease in small animals, the feline calicivirus (FCV) and canine adenovirus 2 (CAV-2), and also the bovine diarrheal disease virus (BVDV).Two samples of ethanolic extracts of propolis were used; one obtained in the lab and another obtained commercially. In order to perform the experiments the MTT test ((3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) was used to determine the 50% cytotoxic concentration (CC50), the 50% inhibitory concentration (IC50) and, the terapeuthic index (TI=IC50/CC50). The propolis extracts were added to the cell cultures in different moments of the viral infection. They were included before virus inoculation, after virus inoculation, and before and after virus inoculation. The two propolis samples showed similarities in the qualitative analysis but they had small differences in the quantitative analysis. The CC50 of the extracts varied among 251 and 343μg/ml and the commercial extract showed less toxicity. Both extracts demonstrated better antiviral activity when added before virus inoculation and the ITs varied from 6 to 13. The best results were obtained with the propolis extracted in the lab. The BVD was the virus showing the greater sensitivity to the ethanolic extracts in the conditions applied. Taken all the data together, it can be concluded that the ethanolic extract of propolis has a potential for future use as a medicine in the therapy of respiratory disease caused by CAV-2, and, also, that the action mechanisms on BVDV should be better evaluated in detail regarding the hepatitis C virus (HCV). / Os vírus são os agentes etiológicos de um grande número de enfermidades em seres humanos e animais, no entanto, há um pequeno número de fármacos antivirais disponíveis para o uso que é feito quase exclusivamente na medicina humana. Estudos demonstram que a própolis apresenta variada atividade biológica frente a vírus, bactérias e fungos. Sua composição química é bastante diversa, podendo variar conforme a época, vegetação e área de coleta. A atividade antiviral de extratos aquosos e etanólicos de própolis já foi descrita para alguns vírus humanos. O presente trabalho tem como objetivo avaliar a atividade antiviral do extrato de própolis frente a dois vírus causadores de doença respiratória em pequenos animais, o calicivírus felino (FCV) e o adenovírus canino tipo 2 (CAV-2), e também ao vírus da diarréia viral bovina (BVDV). Foram testadas neste experimento duas amostras de extrato etanólico de própolis, uma delas obtida comercialmente e a outra extraída no laboratório. Para realizar este estudo utilizou-se o método colorimétrico do MTT (3-(4,5 dimetiltiazol-2yl)-2-5-difenil-2H tetrazolato de bromo), através do qual determinou-se a concentração citotóxica a 50% (CC50), concentração inibitória a 50% (IC50) e o índice terapêutico (IT=IC50/CC50). Os extratos de própolis foram adicionados ao cultivo celular em diferentes momentos da infecção viral. Estes foram incluídos antes da inoculação viral, depois da inoculação viral, e antes e depois da inoculação viral. As duas amostras de própolis apresentaram similaridades na análise qualitativa e pequenas diferenças na análise quantitativa. A CC50 destes extratos variou de 251 a 343μg/ml sendo que o extrato comercial apresentou-se ligeiramente menos tóxico. Ambos os extratos demonstraram melhor atividade antiviral quando adicionados anteriormente à inoculação viral apresentando ITs que variaram de 6 a 13. Os melhores resultados foram obtidos com o própolis extraído no laboratório. O BVDV foi o vírus que demonstrou maior sensibilidade ao extrato etanólico de própolis nas condições experimentais aplicadas. Levando-se em consideração os resultados obtidos, pode-se concluir que o extrato etanólico de própolis apresenta potencial para futura utilização como fármaco no tratamento de doenças respiratórias causadas pelo CAV2 e que o mecanismo de ação sobre o BVDV deve ser avaliado com maiores detalhes com vistas ao vírus da hepatite C (HCV).

Par le passé les virus influenza A ont montré leur capacité d’émergence dans la population humaine. En 2009, l’apparition d’un nouveau variant réassortant a provoqué une pandémie. Ces travaux avaient pour objectifs d’étudier la propagation de la pandémie en France et Bolivie. Premièrement en Franve avec l’étude sérologique d’une population hospitalière et la surveillance hebdomadaire mise en place grâce au programme SéroGrippeHebdo. La séroprévalence prépandémique était de plus de 20% (au1/80) chez les plus de 60ans et de moins de 10% dans les autres groupes. Il a été possible de calculer un taux d’attaque d’environ 12% au sein de la population française métropolitaine. Mais aussi d’observer la perte d’anticorps rapide après le pic d’infection. Les taux de séroconversions les plus importants étaient chez les 0-24 ans (23.4%). La deuxième partie de ce travail s’est déroulée à Santa Cruz de la Sierra, en Bolivie. Le programme CoPanFlu international en association avec le CENETROP a permis l’étude de la sérologie sur une cohorte de foyers en 2010. Par ailleurs, nous avons caractérisé les pathogènes respiratoires de 2010 à 2012 à Santa Cruz. La grippe représente entre 40 et 58% des cas chaque années, suivie des rhinovirus, des coronavirus et des VRS. L’épidémiologie moléculaire des virus influenza a mis au jour un cluster de circulation sud américain pour les virus H1N1(2009).Les sérologies pré-pandémiques montrent une séroprévalence de 23% pour les ≥60ans. Après la pandémie la distribution par tranche d’âge est différente entre les villes de haute altitude et les autres.Enfin une estimation de la séroconversion montre que les jeunes adultes entre 20-39 sont les plus touchés. / Influenza viruses A have shown their ability to emerge in the human population and in 2009, the appearance of a new variant has caused a pandemia. The objective of this work was to study the pandemia’s spread in France and in Bolivia.In France, first, with the serological study of a hospital population and the weekly supervision established with SeroGrippeHebdo. The prepandemic seroprevalence was more than 20%(au1/80) for the >sixty years, and less than 10% in the others groups. It was possible to reckon an attack rate for about 12% in the metropolitan French population, and to observe a quick loss of antibody after the infection rate. Most important seroconversion rates concerned the 0-24 years(23.4%).The second part of this work took place in Santa Cruz de la Sierra, in Bolivia, developing country in the tropical zone of South America. The international CoPanFlu in partnership with the CENETROP, has enabled to study serology among a cohort of families in 2010. Moreover, we have characterized etiologies of respiratory pathogenesis from 2010 to 2012, in Santa Cruz. Flu represented about 40 to 58% of the cases each year, followed by rhinoviruses, coronaviruses and SRV. The molecular epidemiology of influenza viruses has shown a South American circulation cluster for the H1N1 viruses(2009). The prepandemic serologies in Santa Cruz show a seroprevalence of 23% for the ≥60. After the pandemia, the distribution by age is different for the towns at high altitude and others. Finally, an estimation of the sero-conversion showed that young adults between 20 and 39 were more affected in Bolivia.

As doenças respiratórias agudas (DRAs) são as causas mais comuns de morbidez e mortalidade infantil mundial, podendo ser causadas por uma grande variedade de microorganismos. A fim de se detectar os vírus respiratórios mais comumente associados às infecções agudas do trato respiratório e traçar seu perfil epidemiológico, utilizamos um protocolo de GS RT-PCR (GeneScan Transcrição Reversa-Reação em Cadeia da Polimerase) para a rápida detecção simultânea do, vírus influenza A e B, parainfluenzavirus tipo 1, 2 e 3, picornavirus, metapneumovirus e o adenovírus. As amostras clínicas foram colhidas de crianças menores de cinco anos de idade, apresentando sintomas respiratórios, no Hospital Universitário (HU) da Universidade de São Paulo (USP), durante o ano de 2003. O GS RT-PCR se mostrou uma metodologia sensível e específica, capaz de detectar uma diversidade maior de agentes infecciosos do trato respiratório em relação à Imunofluorescência Indireta (IFI), reduzindo neste estudo a porcentagem de amostras negativas de 69,9% (235 amostras) para 22% (74 amostras). / A reverse transcription polymerase chain reaction (RT-PCR) assay based on automated fluorescent capillary electrophoresis and GeneScan software analysis was used to detect nine common respiratory viruses in clinical specimens from young children. Assays for human respiratory syncytial virus (HRSV), human parainfluenza viruses 1, 2, and 3, influenza A and B viruses, human metapneumovirus, adenovirus and picornavirus were incorporated into a screening PCR standard assay format. The optimized assay panel was used to test 336 respiratory specimens obtained from children hospitalized with acute respiratory illness (ARI) that had been previously tested by viral culture and indirect immunofluorescence staining (IIF). GS RT-PCR showed be a sensitive and specific methodology, able to detect a larger diversity of respiratory viruses regarding IFI, reducing in this study the percentage of negative samples of 69,9% (235 samples) to 22% (74 samples).

Les techniques de biologie moléculaire ont pris au cours des 20 dernières années une place importante dans le diagnostic direct des pathogènes viraux. Notre travail a porté sur la mise en place et le développement d’une plate-forme de biologie moléculaire, au sein du laboratoire de virologie de l’hôpital de la Timone, pour répondre aux demandes et contraintes du diagnostic en milieu hospitalier. L’organisation de cette plate-forme a nécessité plusieurs étapes : la prévention des risques de contamination, l’aliquotage et le stockage des réactifs, l’automatisation des techniques d’extraction des acides nucléiques, la mise au point de témoins positifs synthétiques et de témoins internes et l’optimisation des protocoles de PCR. Cette approche optimisée du diagnostic moléculaire des infections virales a été appliqué notamment à la détection de la grippe pandémique A/H1N1v dans les laboratoires de routine hospitalière et d’urgence « Point Of Care ». La mise en place de cette plate-forme a fait progresser de manière considérable le diagnostic moléculaire du laboratoire. Elle nous permet actuellement de détecter un grand nombre de pathogènes (>80) et de réaliser des tests dans un format à haut débit (≈40 000 tests/an). Au total, cette plateforme est au coeur de la capacité du laboratoire pour réagir de manière rapide aux évènements d'émergence en mettant en place rapidement des procédures diagnostiques standardisées. Ces techniques ont été transférées à de nombreux autres laboratoires de virologie partenaires nationaux et internationaux. Nous envisageons maintenant son utilisation dans une approche syndromique avec notamment, le développement du diagnostic des virus respiratoires. / Molecular biology techniques have taken an important role in the direct diagnosis of viral pathogens over the last 20 years. Our work focused on establishing and developing a platform for molecular diagnosis in the laboratory of Virology (Timone Hospital) to meet the demands and constraints of diagnosis in hospitals. The organization of this platform required several steps: prevention of contamination risks, aliquoting and storage of reagents, automation techniques of nucleic acid extraction, development of synthetic positive controls and internal controls and optimization of PCR protocols. This optimized approach of the molecular diagnosis of viral infections has particularly been applied to the detection of pandemic influenza A/H1N1v in hospital laboratories for routine and emergency "Point Of Care." The implementation of this platform has significantly improved molecular diagnosis in our laboratory. It currently allows us to detect a large number of pathogens (> 80) and perform tests in a high-throughput (≈ 40,000 tests per year). In total, this platform is at the heart of the laboratory capacity to react quickly to emerging events by rapidly implementing standardized procedures. These techniques have been transferred to many other partners’ laboratories nationally and internationally. We are now considering its use in a syndromic approach including the development of the diagnosis of respiratory viruses.

As doenças respiratórias agudas (DRAs) são as causas mais comuns de morbidez e mortalidade infantil mundial, podendo ser causadas por uma grande variedade de microorganismos. A fim de se detectar os vírus respiratórios mais comumente associados às infecções agudas do trato respiratório e traçar seu perfil epidemiológico, utilizamos um protocolo de GS RT-PCR (GeneScan Transcrição Reversa-Reação em Cadeia da Polimerase) para a rápida detecção simultânea do, vírus influenza A e B, parainfluenzavirus tipo 1, 2 e 3, picornavirus, metapneumovirus e o adenovírus. As amostras clínicas foram colhidas de crianças menores de cinco anos de idade, apresentando sintomas respiratórios, no Hospital Universitário (HU) da Universidade de São Paulo (USP), durante o ano de 2003. O GS RT-PCR se mostrou uma metodologia sensível e específica, capaz de detectar uma diversidade maior de agentes infecciosos do trato respiratório em relação à Imunofluorescência Indireta (IFI), reduzindo neste estudo a porcentagem de amostras negativas de 69,9% (235 amostras) para 22% (74 amostras). / A reverse transcription polymerase chain reaction (RT-PCR) assay based on automated fluorescent capillary electrophoresis and GeneScan software analysis was used to detect nine common respiratory viruses in clinical specimens from young children. Assays for human respiratory syncytial virus (HRSV), human parainfluenza viruses 1, 2, and 3, influenza A and B viruses, human metapneumovirus, adenovirus and picornavirus were incorporated into a screening PCR standard assay format. The optimized assay panel was used to test 336 respiratory specimens obtained from children hospitalized with acute respiratory illness (ARI) that had been previously tested by viral culture and indirect immunofluorescence staining (IIF). GS RT-PCR showed be a sensitive and specific methodology, able to detect a larger diversity of respiratory viruses regarding IFI, reducing in this study the percentage of negative samples of 69,9% (235 samples) to 22% (74 samples).