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Castejon-Ramirez S, Chaisavaneeyakorn S, Ferrolino JA, Allison KJ, Peterson M, Dallas RH, Suliman A, Hayden RT, Maron G, Hijano DR. Clinical Outcomes of Human Rhinovirus/Enterovirus Infection in Pediatric Hemopoietic Cell Transplant Patients. J Pediatric Infect Dis Soc 2024; 13:75-83. [PMID: 38019957 PMCID: PMC10824257 DOI: 10.1093/jpids/piad106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/27/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Respiratory viral infections are common among pediatric transplant patients, with human rhinovirus (HRV) being the most frequent. In pediatric patients undergoing hemopoietic cell transplant (HCT), infection with HRV has been associated with progression to lower respiratory tract infection (LRTI) and adverse outcomes. We describe the clinical presentation and outcomes of HRV infection in children undergoing HCT. METHODS Single-center retrospective study. HCT recipients who were positive for HRV/EV (HRV+) or negative for any respiratory virus (VN) by BioFire® FilmArray® panel between October 2014 and December 2017, were included. Primary outcomes were progression to LRTI, ICU admission, all-cause mortality at 3 and 6 months, and respiratory event-related mortality at 6 months. RESULTS 227 patients (160 allogeneic HCT) were included. Of all patients, 108/227 (47.6%) were HRV+. From all HRV+, 95/108 (88%) were symptomatic and 68/107 (63.6%) of the diagnosis were made pretransplant. The median age of HRV+ was significantly lower than VN patients (5 vs 10 years). Cough and rhinorrhea were more frequently observed in HRV+ (53.7 and 60% vs 19.8 and 22.8%, respectively). No differences were found between both groups pretransplant and overall in rates progression to LRTI, ICU admission, mechanical ventilation, all-cause within 3 and 6 months, and mortality related with respiratory failure. No significant association was found between the severity of respiratory disease and the type of conditioning, type of transplant, or absolute lymphocyte count. CONCLUSIONS HRV infection is frequently detected in HCT recipients but is not associated with severity of respiratory disease, need for intensive care unit or mortality, including those diagnosed before transplant, suggesting that delaying HCT in this scenario may not be needed. Multicenter larger studies are required to confirm these findings.
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Affiliation(s)
- Sandra Castejon-Ramirez
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
- Department of Pediatrics, University of Tennessee Health Science Center College of Medicine, USA
| | | | - Jose A Ferrolino
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Kim J Allison
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Megan Peterson
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Ronald H Dallas
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Ali Suliman
- Department of Transplant Cellular Therapy, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Randall T Hayden
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Gabriela Maron
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
- Department of Pediatrics, University of Tennessee Health Science Center College of Medicine, USA
| | - Diego R Hijano
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
- Department of Pediatrics, University of Tennessee Health Science Center College of Medicine, USA
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2
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Marinelli T, Wee LYA, Rowe E, Chhetri R, Friel O, Higgins G, Bardy P, Singhal D, Pradhan A, Crawford L, Hiwase DK. Respiratory Viruses Cause Late Morbidity in Recipients of Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant 2019; 26:782-788. [PMID: 31866345 DOI: 10.1016/j.bbmt.2019.12.724] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 12/04/2019] [Accepted: 12/16/2019] [Indexed: 02/07/2023]
Abstract
Common respiratory viral infections (CRVIs) frequently complicate hematopoietic stem cell transplantation (HSCT). We conducted a retrospective, single-center, observational cohort study to determine the incidence of CRVI in patients who received an allogeneic (allo) or autologous (auto) HSCT at the Royal Adelaide Hospital between 2009 and 2017. The median follow-up was 8.9 and 4.5 years for auto- and allo-HSCT recipients, respectively. There were 149 CRVI episodes in 74 patients, with rhinovirus being the most commonly isolated virus (n = 81, 47%). The majority of CRVIs (113/149, 75.8%) occurred more than 100 days post-HSCT and 67% were diagnosed in the outpatient setting. There was evidence of lower respiratory tract infection (LRTI) in 45.6% (68/149) of CRVIs. On multivariate logistic regression analysis, coviral infections and cytomegalovirus viremia were independent risk factors for progression of CRVI to LRTI. Ten (6.7%) CRVI episodes resulted in admission to intensive care for ventilatory support and 8 (5.4%) patients died within 30 days of CRVI diagnosis. In our study, 10.4% of HSCT recipients experienced a CRVI post-transplant, primarily causing late morbidity and potentially mortality. Prevention with strict infection control practices, vaccination, and patient education is essential.
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Affiliation(s)
- Tina Marinelli
- Department of Infectious Diseases, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, Australia
| | - Li Yan A Wee
- Department of Haematology, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, Australia; Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Emily Rowe
- Department of Infectious Diseases, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, Australia; Discipline of Medicine, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Rakchha Chhetri
- Department of Haematology, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, Australia; Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, Australia; Discipline of Medicine, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Oisin Friel
- Department of Haematology, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, Australia
| | - Geoffrey Higgins
- Department of Infectious Diseases, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, Australia; SA Pathology, Central Adelaide Local Health Network, Adelaide, Australia
| | - Peter Bardy
- Department of Haematology, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, Australia; Discipline of Medicine, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Deepak Singhal
- Department of Haematology, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, Australia; Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, Australia; Discipline of Medicine, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Alyssa Pradhan
- Department of Infectious Diseases, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, Australia
| | - Lucy Crawford
- Discipline of Medicine, Adelaide Medical School, The University of Adelaide, Adelaide, Australia; SA Pathology, Central Adelaide Local Health Network, Adelaide, Australia
| | - Devendra K Hiwase
- Department of Haematology, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, Australia; Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, Australia; Discipline of Medicine, Adelaide Medical School, The University of Adelaide, Adelaide, Australia.
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3
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Kuypers J, Perchetti GA, Chu HY, Newman KL, Katz J, Khatry SK, LeClerq SC, Jerome KR, Tielsch JM, Englund JA. Phylogenetic characterization of rhinoviruses from infants in Sarlahi, Nepal. J Med Virol 2019; 91:2108-2116. [PMID: 31389049 PMCID: PMC6800797 DOI: 10.1002/jmv.25563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 08/01/2019] [Indexed: 12/29/2022]
Abstract
Problem Rhinoviruses (RVs), the most common causes of acute respiratory infections in young children and infants, are highly diverse genetically. Objective To characterize the RV types detected with respiratory illness episodes in infants in Nepal. Study methods Infants born to women enrolled in a randomized trial of maternal influenza immunization in rural, southern Nepal were followed with household‐based weekly surveillance until 180 days of age. Infants with respiratory symptoms had nasal swabs tested for twelve respiratory viruses. A subset with RV alone was selected for sequencing of the VP4/2 gene to identify RV types. Results Among 547 RV‐only positive illnesses detected from December 2012 to April 2014, 285 samples (52%) were sequenced. RV‐A, B, and C species were detected in 193 (68%), 18 (6%), and 74 (26%) specimens, respectively. A total of 94 unique types were identified from the sequenced samples, including 52 RV‐A, 11 RV‐B, and 31 RV‐C. Multiple species and types circulated simultaneously throughout the study period. No seasonality was observed. The median ages at illness onset were 88, 104, and 88 days for RV‐A, B, and C, respectively. The median polymerase chain reaction cycle threshold values did not differ between RV species. No differences between RV species were observed for reported respiratory symptoms, including pneumonia, or for medical care‐seeking. Conclusions Among very young, symptomatic infants in rural Nepal, all three species and many types of RV were identified; RV‐A was detected most frequently. There was no association between RV species and disease severity. RV infections were common among infants less than six months old in southern Nepal. All three species and 94 types of RV were identified by sequencing the VP4/2 gene. Multiple species and types circulated simultaneously throughout the study period. No symptomatic differences between RV species or types were observed.
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Affiliation(s)
- Jane Kuypers
- Department of Laboratory Medicine, University of Washington, Seattle, Washington
| | - Garrett A Perchetti
- Department of Laboratory Medicine, University of Washington, Seattle, Washington
| | - Helen Y Chu
- Department of Medicine, University of Washington, Seattle, Washington
| | - Kira L Newman
- Department of Medicine, University of Washington, Seattle, Washington
| | - Joanne Katz
- Department of International Health, Johns Hopkins University, Baltimore, Maryland
| | | | - Steven C LeClerq
- Department of International Health, Johns Hopkins University, Baltimore, Maryland.,Nepal Nutrition Intervention Project, Kathmandu, Nepal
| | - Keith R Jerome
- Department of Laboratory Medicine, University of Washington, Seattle, Washington
| | - James M Tielsch
- Department of Global Health, George Washington University, Washington, District of Colombia
| | - Janet A Englund
- Seattle Children's Hospital and Research Foundation, Seattle, Washington
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4
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Fontana L, Strasfeld L. Respiratory Virus Infections of the Stem Cell Transplant Recipient and the Hematologic Malignancy Patient. Infect Dis Clin North Am 2019; 33:523-544. [PMID: 30940462 PMCID: PMC7126949 DOI: 10.1016/j.idc.2019.02.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Respiratory virus infections in hematologic stem cell transplant recipients and patients with hematologic malignancies are increasingly recognized as a cause of significant morbidity and mortality. The often overlapping clinical presentation makes molecular diagnostic strategies imperative for rapid diagnosis and to inform understanding of the changing epidemiology of each of the respiratory viruses. Most respiratory virus infections are managed with supportive therapy, although there is effective antiviral therapy for influenza. The primary focus should remain on primary prevention infection control procedures and isolation precautions, avoidance of ill contacts, and vaccination for influenza.
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Affiliation(s)
- Lauren Fontana
- Division of Infectious Disease, Department of Medicine, Oregon Health and Science University, 3181 Southwest Sam Jackson Park Road, Mail Code L457, Portland, OR 97239, USA.
| | - Lynne Strasfeld
- Division of Infectious Disease, Department of Medicine, Oregon Health and Science University, 3181 Southwest Sam Jackson Park Road, Mail Code L457, Portland, OR 97239, USA
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5
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Waghmare A, Xie H, Kuypers J, Sorror ML, Jerome KR, Englund JA, Boeckh M, Leisenring WM. Human Rhinovirus Infections in Hematopoietic Cell Transplant Recipients: Risk Score for Progression to Lower Respiratory Tract Infection. Biol Blood Marrow Transplant 2018; 25:1011-1021. [PMID: 30537551 PMCID: PMC6511300 DOI: 10.1016/j.bbmt.2018.12.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 12/04/2018] [Indexed: 12/22/2022]
Abstract
Risk factors for rhinovirus lower respiratory tract infection are not well characterized. Several risk factors in hematopoietic cell transplant recipients were identified. A risk score for progression to lower respiratory tract infection was developed.
Human rhinovirus lower respiratory tract infection (LRTI) is associated with mortality after hematopoietic cell transplantation (HCT); however, risk factors for LRTI are not well characterized. We sought to develop a risk score for progression to LRTI from upper respiratory tract infection (URTI) in HCT recipients. Risk factors for LRTI within 90 days were analyzed using Cox regression among HCT recipients with rhinovirus URTI between January 2009 and March 2016. The final multivariable model included factors with a meaningful effect on the bootstrapped optimism corrected concordance statistic. Weighted score contributions based on hazard ratios were determined. Cumulative incidence curves estimated the probability of LRTI at various score cut-offs. Of 588 rhinovirus URTI events, 100 (17%) progressed to LRTI. In a final multivariable model allogeneic grafts, prior rhinovirus URTI, low lymphocyte count, low albumin, positive cytomegalovirus serostatus, recipient statin use, and steroid use ≥2 mg/kg/day were associated with progression to LRTI. A weighted risk score cut-off with the highest sensitivity and specificity was determined. Risk scores above this cut-off were associated with progression to LRTI (cumulative incidence 28% versus 11% below cut-off; P < .001). The weighted risk score for progression to rhinovirus LRTI can help identify and stratify patients for clinical management and for future clinical trials of therapeutics in HCT recipients.
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Affiliation(s)
- Alpana Waghmare
- Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Pediatrics, University of Washington, Seattle, WA; Department of Pediatrics, Seattle Children's Hospital, Seattle, WA.
| | - Hu Xie
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Jane Kuypers
- Department of Laboratory Medicine, University of Washington, Seattle, WA
| | - Mohamed L Sorror
- Department of Medicine, University of Washington, Seattle, WA; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Keith R Jerome
- Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Laboratory Medicine, University of Washington, Seattle, WA
| | - Janet A Englund
- Department of Pediatrics, University of Washington, Seattle, WA; Department of Pediatrics, Seattle Children's Hospital, Seattle, WA
| | - Michael Boeckh
- Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Medicine, University of Washington, Seattle, WA
| | - Wendy M Leisenring
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
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6
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Abstract
Viral pneumonias in patients with hematologic malignancies and recipients of hematopoietic stem cell transplantation cause significant morbidity and mortality. Advances in diagnostic techniques have enabled rapid identification of respiratory viral pathogens from upper and lower respiratory tract samples. Lymphopenia, myeloablative and T-cell depleting chemotherapy, graft-versus-host disease, and other factors increase the risk of developing life-threatening viral pneumonia. Chest imaging is often nonspecific but may aid in diagnoses. Bronchoscopy with bronchoalveolar lavage is recommended in those at high risk for viral pneumonia who have new infiltrates on chest imaging.
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7
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Ratnamohan VM, Zeng F, Donovan L, MacIntyre CR, Kok J, Dwyer DE. Phylogenetic analysis of human rhinoviruses collected over four successive years in Sydney, Australia. Influenza Other Respir Viruses 2016; 10:493-503. [PMID: 27383422 PMCID: PMC5059946 DOI: 10.1111/irv.12404] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2016] [Indexed: 01/09/2023] Open
Abstract
Background Human rhinoviruses (HRV) cause a wide spectrum of disease, ranging from a mild influenza‐like illness (ILI) to severe respiratory infection. Molecular epidemiological data are limited for HRV circulating in the Southern Hemisphere. Objectives To identify the species and genotypes of HRV from clinical samples collected in Sydney, Australia, from 2006 to 2009. Methods Combined nose and throat swabs or nasopharyngeal aspirates collected from individuals with ILI were tested for HRV using real‐time reverse‐transcriptase polymerase chain reaction (RT‐PCR). Sequencing data of 5′UTR and VP4/VP2 coding regions on RT‐PCR‐positive specimens were analysed. Results Human rhinoviruses were detected by real‐time PCR in 20.9% (116/555) of samples tested. Phylogenetic analysis of 5′UTR and VP4/VP2 on HRV‐positive samples was concordant in the grouping of HRV A and B species but not HRV C species. Eighty per cent (16/20) of sequences that grouped as HRV C in the VP4/VP2 tree clustered as HRV A, alongside some previously described C strains as subspecies C/A. Discordant branching was seen within HRV A group: two sequences clustering as A in the VP4/VP2 tree branched within the C/A subspecies in the 5′UTR tree, and one sequence showed identity to different HRV A strains in the two genes. The prevalence of HRV C and C/A species was greater in paediatric compared to adult patients (47.9% vs 25.5%, P = .032). Conclusion Human rhinoviruses are a common cause of respiratory infections, and HRV C is present in the Southern Hemisphere. Sequencing of multiple HRV regions may be necessary to determine exact phylogenetic relationships.
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Affiliation(s)
- Vigneswary M Ratnamohan
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Pathology West, Westmead Hospital, Westmead, NSW, Australia
| | - Frank Zeng
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Pathology West, Westmead Hospital, Westmead, NSW, Australia
| | - Linda Donovan
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Pathology West, Westmead Hospital, Westmead, NSW, Australia
| | - Chandini R MacIntyre
- School of Public Health and Community Medicine, University of New South Wales, Kensington, NSW, Australia
| | - Jen Kok
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Pathology West, Westmead Hospital, Westmead, NSW, Australia. .,Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead Hospital, University of Sydney, Westmead, NSW, Australia. .,Centre for Research Excellence in Critical Infections, Westmead Hospital, University of Sydney, Westmead, NSW, Australia.
| | - Dominic E Dwyer
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Pathology West, Westmead Hospital, Westmead, NSW, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead Hospital, University of Sydney, Westmead, NSW, Australia.,Centre for Research Excellence in Critical Infections, Westmead Hospital, University of Sydney, Westmead, NSW, Australia
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8
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Ljungman P, Snydman D, Boeckh M. Rhinovirus, Coronavirus, Enterovirus, and Bocavirus After Hematopoietic Cell Transplantation or Solid Organ Transplantation. TRANSPLANT INFECTIONS 2016. [PMCID: PMC7123292 DOI: 10.1007/978-3-319-28797-3_32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Respiratory viral infections represent a significant cause of morbidity and mortality in immunocompromised hosts. Newer molecular detection assays have allowed for the characterization of several respiratory viruses not previously recognized as having significant clinical impact in the immunocompromised population. Human rhinoviruses are the most common respiratory viruses detected in the upper respiratory tract of hematopoietic cell transplant and lung transplant recipients, and evidence on the impact on clinical outcomes is mounting. Other respiratory viruses including enteroviruses (EVs), coronaviruses (CoVs), and bocavirus may also contribute to pulmonary disease; however, data is limited in the immunocompromised population. Further studies are needed to define the epidemiology, risk factors, and clinical outcomes of these infections; this data will help inform decisions regarding development of antiviral therapy and infection prevention strategies.
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Affiliation(s)
- Per Ljungman
- Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - David Snydman
- Tufts University School of Medicine Tufts Medical Center, Boston, Massachusetts USA
| | - Michael Boeckh
- University of Washington Fred Hutchinson Cancer Research Center, Seattle, Washington USA
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9
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Jacobs SE, Lamson DM, Soave R, Guzman BH, Shore TB, Ritchie EK, Zappetti D, Satlin MJ, Leonard JP, van Besien K, Schuetz AN, Jenkins SG, George KS, Walsh TJ. Clinical and molecular epidemiology of human rhinovirus infections in patients with hematologic malignancy. J Clin Virol 2015; 71:51-8. [PMID: 26370315 PMCID: PMC4750469 DOI: 10.1016/j.jcv.2015.07.309] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 07/22/2015] [Accepted: 07/25/2015] [Indexed: 10/26/2022]
Abstract
BACKGROUND Human rhinoviruses (HRVs) are common causes of upper respiratory tract infection (URTI) in hematologic malignancy (HM) patients. Predictors of lower respiratory tract infection (LRTI) including the impact of HRV species and types are poorly understood. OBJECTIVES This study aims to describe the clinical and molecular epidemiology of HRV infections among HM patients. STUDY DESIGN From April 2012-March 2013, HRV-positive respiratory specimens from symptomatic HM patients were molecularly characterized by analysis of partial viral protein 1 (VP1) or VP4 gene sequence. HRV LRTI risk-factors and outcomes were analyzed using multivariable logistic regression. RESULTS One hundred and ten HM patients presented with HRV URTI (n=78) and HRV LRTI (n=32). Hypoalbuminemia (OR 3.0; 95% CI, 1.0-9.2; p=0.05) was independently associated with LRTI, but other clinical and laboratory markers of host immunity did not differ between patients with URTI versus LRTI. Detection of bacterial co-pathogens was common in LRTI cases (25%). Among 92 typeable respiratory specimens, there were 58 (64%) HRV-As, 12 (13%) HRV-Bs, and 21 (23%) HRV-Cs, and one Enterovirus 68. LRTI rates among HRV-A (29%), HRV-B (17%), and HRV-C (29%) were similar. HRV-A infections occurred year-round while HRV-B and HRV-C infections clustered in the late fall and winter. CONCLUSIONS HRVs are associated with LRTI in HM patients. Illness severity is not attributable to specific HRV species or types. The frequent detection of bacterial co-pathogens in HRV LRTIs further substantiates the hypothesis that HRVs predispose to bacterial superinfection of the lower airways, similar to that of other community-acquired respiratory viruses.
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Affiliation(s)
- Samantha E Jacobs
- Division of Infectious Diseases, Weill Cornell Medical Center, New York, NY, USA.
| | - Daryl M Lamson
- Virology Laboratory, Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Rosemary Soave
- Division of Infectious Diseases, Weill Cornell Medical Center, New York, NY, USA
| | | | - Tsiporah B Shore
- Division of Hematology and Medical Oncology, Weill Cornell Medical Center, New York, NY, USA
| | - Ellen K Ritchie
- Division of Hematology and Medical Oncology, Weill Cornell Medical Center, New York, NY, USA
| | - Dana Zappetti
- Division of Pulmonary and Critical Care Medicine, New York Presbyterian Hospital/ Weill Cornell Medical College, New York, NY, USA
| | - Michael J Satlin
- Division of Infectious Diseases, Weill Cornell Medical Center, New York, NY, USA
| | - John P Leonard
- Division of Hematology and Medical Oncology, Weill Cornell Medical Center, New York, NY, USA
| | - Koen van Besien
- Division of Hematology and Medical Oncology, Weill Cornell Medical Center, New York, NY, USA
| | - Audrey N Schuetz
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical Center, New York, NY, USA
| | - Stephen G Jenkins
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical Center, New York, NY, USA
| | - Kirsten St George
- Virology Laboratory, Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Thomas J Walsh
- Division of Infectious Diseases, Weill Cornell Medical Center, New York, NY, USA
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10
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Loria C, Domm JA, Halasa NB, Heitman E, Miller EK, Xu M, Saville BR, Frangoul H, Williams JV. Human rhinovirus C infections in pediatric hematology and oncology patients. Pediatr Transplant 2015; 19:94-100. [PMID: 25377237 PMCID: PMC4280346 DOI: 10.1111/petr.12383] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/02/2014] [Indexed: 12/31/2022]
Abstract
Children with cancer and HSCT recipients are at high risk for common viral infections. We sought to define the viral etiology of ARI and identify risk factors. Nasal wash samples were collected from pediatric hematology-oncology patients and HSCT recipients with ARI during the 2003-2005 winter seasons. Real-time RT-PCR was performed to detect Flu A, influenza B, RSV, PIV 1-3, human MPV, and HRV. HRV specimens were sequenced and genotyped. Seventy-eight samples from 62 children were included. Viruses were detected in 31 of 78 samples (40%). HRV were detected most frequently, in 16 (52%) including five HRVC; followed by seven (22%) RSV, five (16%) Flu A, four (13%) MPV, and two (6%) PIV2. There was a trend toward higher risk of viral infection for children in day care. Only 8% of the study children had received influenza vaccine. HRV, including the recently discovered HRVC, are an important cause of infection in pediatric oncology and HSCT patients. Molecular testing is superior to conventional methods and should be standard of care, as HRV are not detected by conventional methods.
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Affiliation(s)
- Carolina Loria
- Center for Biomedical Ethics and Society, Vanderbilt University School of Medicine, Nashville, TN
| | - Jennifer A. Domm
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN
| | - Natasha B. Halasa
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN
| | - Elizabeth Heitman
- Center for Biomedical Ethics and Society, Vanderbilt University School of Medicine, Nashville, TN
| | - E. Kathryn Miller
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN
| | - Meng Xu
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN
| | - Benjamin R. Saville
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN
| | - Haydar Frangoul
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN
| | - John V. Williams
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN,Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN
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11
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Abstract
Non-influenza respiratory virus infections are common worldwide and contribute to morbidity and mortality in all age groups. The recently identified Middle East respiratory syndrome coronavirus has been associated with rapidly progressive pneumonia and high mortality rate. Adenovirus 14 has been increasingly recognized in severe acute respiratory illness in both military and civilian individuals. Rhinovirus C and human bocavirus type 1 have been commonly detected in infants and young children with respiratory tract infection and studies have shown a positive correlation between respiratory illness and high viral loads, mono-infection, viremia, and/or serologically-confirmed primary infection.
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Affiliation(s)
- James J Dunn
- Department of Pathology and Laboratory Medicine, Cook Children's Medical Center, 801 Seventh Avenue, Fort Worth, TX 76104, USA.
| | - Melissa B Miller
- Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Campus Box 7525, Chapel Hill, NC 27599-7525, USA
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12
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Iwasaki J, Smith WA, Stone SR, Thomas WR, Hales BJ. Species-specific and cross-reactive IgG1 antibody binding to viral capsid protein 1 (VP1) antigens of human rhinovirus species A, B and C. PLoS One 2013; 8:e70552. [PMID: 23950960 PMCID: PMC3737412 DOI: 10.1371/journal.pone.0070552] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 06/23/2013] [Indexed: 11/18/2022] Open
Abstract
Background Human rhinoviruses (HRV) are associated with upper and lower respiratory illnesses, including severe infections causing hospitalization in both children and adults. Although the clinical significance of HRV infections is now well established, no detailed investigation of the immune response against HRV has been performed. The purpose of this study was to assess the IgG1 antibody response to the three known HRV species, HRV-A, -B and -C in healthy subjects. Methods Recombinant polypeptides of viral capsid protein 1 (VP1) from two genotypes of HRV-A, -B and -C were expressed as glutathione S-transferase (GST) fusion proteins and purified by affinity and then size exclusion chromatography. The presence of secondary structures similar to the natural antigens was verified by circular dichroism analysis. Total and species-specific IgG1 measurements were quantitated by immunoassays and immunoabsorption using sera from 63 healthy adults. Results Most adult sera reacted with the HRV VP1 antigens, at high titres. As expected, strong cross-reactivity between HRV genotypes of the same species was found. A high degree of cross-reactivity between different HRV species was also evident, particularly between HRV-A and HRV-C. Immunoabsorption studies revealed HRV-C specific titres were markedly and significantly lower than the HRV-A and HRV-B specific titres (P<0.0001). A truncated construct of HRV-C VP1 showed greater specificity in detecting anti-HRV-C antibodies. Conclusions High titres of IgG1 antibody were bound by the VP1 capsid proteins of HRV-A, -B and -C, but for the majority of people, a large proportion of the antibody to HRV-C was cross-reactive, especially to HRV-A. The improved specificity found for the truncated HRV-C VP1 indicates species-specific and cross-reactive regions could be defined.
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Affiliation(s)
- Jua Iwasaki
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Australia
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Wendy-Anne Smith
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Australia
| | - Shane R. Stone
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Australia
| | - Wayne R. Thomas
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Australia
| | - Belinda J. Hales
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Australia
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
- * E-mail:
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