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Haider SA, Jamal Z, Tahir F, Salman M, Umair M. Genomic characterization of human respiratory syncytial virus circulating in Islamabad, Pakistan, during an outbreak in 2022-2023. Arch Virol 2024; 169:106. [PMID: 38644429 DOI: 10.1007/s00705-024-06036-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/26/2024] [Indexed: 04/23/2024]
Abstract
In this study, conducted at the National Institute of Health, Islamabad, during an outbreak of human respiratory syncytial virus (hRSV) from December 2022 to January 2023, the first whole-genome sequences of hRSV isolates from Islamabad, Pakistan, were determined. Out of 10 positive samples, five were sequenced, revealing the presence of two genotypes: RSV-A (GA2.3.5, ON1 strain) and RSV-B (GB5.0.5.a, BA-10 strain). A rare non-synonymous substitution (E232G) in G the protein and N276S in the F protein were found in RSV-A. In RSV-B, the unique mutations K191R, Q209R, and I206M were found in the F protein. These mutations could potentially influence vaccine efficacy and viral pathogenicity. This research underscores the importance of genomic surveillance for understanding RSV diversity and guiding public health responses in Pakistan.
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Affiliation(s)
- Syed Adnan Haider
- Department of Virology, National Institute of Health, Park Rd, Chak Shahzad, Islamabad, 45500, Pakistan
| | - Zunera Jamal
- Department of Virology, National Institute of Health, Park Rd, Chak Shahzad, Islamabad, 45500, Pakistan
| | - Faheem Tahir
- Department of Virology, National Institute of Health, Park Rd, Chak Shahzad, Islamabad, 45500, Pakistan
| | - Muhammad Salman
- Department of Virology, National Institute of Health, Park Rd, Chak Shahzad, Islamabad, 45500, Pakistan
| | - Massab Umair
- Department of Virology, National Institute of Health, Park Rd, Chak Shahzad, Islamabad, 45500, Pakistan.
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Rajbanshi A, Giri P, Laha S, Poddar S. Epidemiology, clinical presentation, and respiratory sequelae of severe adenoviral pneumonia in children admitted in a tertiary care pediatric intensive care unit from Eastern India: A single-center observational study. JOURNAL OF PEDIATRIC CRITICAL CARE 2022. [DOI: 10.4103/jpcc.jpcc_84_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Xie LY, Zeng SZ, Yu T, Hu X, Wang T, Yang L, Zhong LL, Li JS, Duan ZJ, Zhang B. Viral loads in nasopharyngeal aspirates and tracheal aspirates among children hospitalized with invasive ventilation for human adenovirus pneumonia. Virol J 2021; 18:238. [PMID: 34847913 PMCID: PMC8638111 DOI: 10.1186/s12985-021-01711-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/22/2021] [Indexed: 11/19/2022] Open
Abstract
Purpose To evaluate viral loads in children with human adenovirus (HAdV) pneumonia at different stages of disease and compare the viral load between upper and lower respiratory tract samples. Methods We prospectively enrolled children who required invasive ventilation for HAdV pneumonia. Nasopharyngeal aspirate (NPA) and tracheal aspirate (TA) samples were collected throughout the entire period of invasive ventilation. Viral detection and quantification were performed using quantitative real-time polymerase chain reaction. Results Ninety-four children were enrolled. The median age of the children was 12.0 months (IQR: 11.0–24.0), and > ninety percent of patients were aged between 6 and 59 months. Seven hundred and nine paired NPA-TA samples were collected. The median viral loads of the NPA and TA samples were 7.31 log10 and 7.50 log10 copies/mL, respectively. Viral loads generally decreased steadily over time. The median viral load after 1, 2, 3, and > 3 weeks of the disease course was 8.65, 7.70, 6.69, and 5.09 log10 copies/mL, respectively, in NPA samples and 8.67, 7.79, 7.08, and 5.53 log10 copies/mL, respectively, in TA samples. Viral load showed a significant negative correlation with time since symptom onset in both NPA samples (Spearman r = − 0.607, P = 0.000) and TA samples (Spearman r = − 0.544, P = 0.000). The predicted duration of HAdV shedding was 60.17 days in the NPA group and 65.81 days in the TA group. Viral loads in NPA and TA from the same subjects correlated well with each other (R2 = 0.694). HAdV loads in NPA and TA were most comparable during the early phase of infection (95% limits of agreement, − 1.36 to 1.30 log10 copies/mL, R2 = 0.746). Variation increased during the late phase of infection (i.e., in follow-up samples), with viral loads remaining significantly higher in TA than NPA. Conclusions In children with HAdV pneumonia, viral loads in both NPA and TA steadily decreased during the course of the disease, and the predicted duration of viral shedding was more than 2 months. The HAdV DNA load of NPA is highly correlated with that of TA, especially in the initial phase of infection.
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Affiliation(s)
- Le-Yun Xie
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 61 Jie-Fang west road, Fu-Rong District, Changsha, 410005, China.,Hunan Provincial Key Laboratory of Pediatric Respirology, Changsha, 410005, China
| | - Sai-Zhen Zeng
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 61 Jie-Fang west road, Fu-Rong District, Changsha, 410005, China. .,Hunan Provincial Key Laboratory of Pediatric Respirology, Changsha, 410005, China.
| | - Tian Yu
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 61 Jie-Fang west road, Fu-Rong District, Changsha, 410005, China.,Hunan Provincial Key Laboratory of Pediatric Respirology, Changsha, 410005, China
| | - Xian Hu
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 61 Jie-Fang west road, Fu-Rong District, Changsha, 410005, China.,Hunan Provincial Key Laboratory of Pediatric Respirology, Changsha, 410005, China
| | - Tao Wang
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 61 Jie-Fang west road, Fu-Rong District, Changsha, 410005, China.,Hunan Provincial Key Laboratory of Pediatric Respirology, Changsha, 410005, China
| | - Le Yang
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 61 Jie-Fang west road, Fu-Rong District, Changsha, 410005, China.,Hunan Provincial Key Laboratory of Pediatric Respirology, Changsha, 410005, China
| | - Li-Li Zhong
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 61 Jie-Fang west road, Fu-Rong District, Changsha, 410005, China.,Hunan Provincial Key Laboratory of Pediatric Respirology, Changsha, 410005, China
| | - Jin-Song Li
- MOH Key Laboratory for Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, China CDC, Beijing, 100052, China
| | - Zhao-Jun Duan
- MOH Key Laboratory for Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, China CDC, Beijing, 100052, China
| | - Bing Zhang
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 61 Jie-Fang west road, Fu-Rong District, Changsha, 410005, China. .,Hunan Provincial Key Laboratory of Pediatric Respirology, Changsha, 410005, China.
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Adenovirus and RSV infections during pregnancy and their relationship to orofacial clefts. Biologia (Bratisl) 2020. [DOI: 10.2478/s11756-019-00404-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Chen X, Lv J, Qin L, Zou C, Tang L. Severe Adenovirus Pneumonia Requiring Extracorporeal Membrane Oxygenation Support in Immunocompetent Children. Front Pediatr 2020; 8:162. [PMID: 32351920 PMCID: PMC7174628 DOI: 10.3389/fped.2020.00162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/23/2020] [Indexed: 12/12/2022] Open
Abstract
Objective: To highlight severe adenovirus pneumonia in immunocompetent patients by analysis of severe adenovirus pneumonia associated with acute respiratory distress syndrome in whom extracorporeal membrane oxygenation (ECMO) support is required. Methods:Pediatric patients with adenovirus pneumonia and ECMO supports in our hospital from February 2018 to May 2019 were retrospectively analyzed, and having 100 common adenovirus pneumonia children as a control. Results:A total of 8 patients, including 4 boys (50.0%), were enrolled. They were previously immunocompetent with a median age of 31 months. They were admitted as persistent fever and cough for more than one week. Median time prior to development of respiratory failure requiring intubation and invasive mechanical ventilation was 5 days. Venoarterial ECMO support as rescue ventilation was instituted after a median time of 24.5 h of conventional mechanical ventilator support. The median duration on ECMO support was 9 days and mechanical ventilation was 14 days, respectively. Six patients (75%) were recovered and 2 (25%) died. Median length of stay in ICU and hospital were 27.5 days and 47.5 days, respectively. Conclusion:The promising outcomes of our cases suggested that ECMO support for rescue ventilation may be considered when symptoms deteriorated in adenovirus pneumonia patients, and may improve outcome. However, sequelae of adenovirus pneumonia and ECMO-related complications should also be taken into account.
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Affiliation(s)
- Xuefei Chen
- Department of Endocrinology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Jianhai Lv
- Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.,Department of Pediatrics, Shangyu People's Hospital, Shaoxing, China
| | - Lu Qin
- Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Chaochun Zou
- Department of Endocrinology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Lanfang Tang
- Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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Thornton H, Turner K, Harrison S, Hammond A, Hawcroft C, Hay A. Assessing the potential of upper respiratory tract point-of-care testing: a systematic review of the prognostic significance of upper respiratory tract microbes. Clin Microbiol Infect 2019; 25:1339-1346. [PMID: 31254715 PMCID: PMC7129693 DOI: 10.1016/j.cmi.2019.06.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 05/31/2019] [Accepted: 06/17/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Microbial point-of-care testing (POCT) has potential to revolutionize clinical care. Understanding the prognostic value of microbes identified from the upper respiratory tract (a convenient sampling site) is a necessary first step to understand potential for upper respiratory tract POCTs in assisting antimicrobial treatment decisions for respiratory infections (RTIs). The aim was to investigate the relationship between upper respiratory tract microbial detection and disease prognosis, including effects of antimicrobial use. METHODS Data sources were the MEDLINE and Embase databases. Study eligibility criteria consisted of quantitative studies reporting microbiological and prognostic data from patients of all age groups presenting with RTI. Patients presenting to healthcare or research settings with RTI participated. Interventions included upper respiratory tract swab. The methods used were systematic review and meta-analysis. RESULTS Searches identified 5156 articles, of which 754 were duplicates and 4258 excluded on title or abstract. A total of 144 full texts were screened; 21 articles were retained. Studies reported data for 15 microbes and 26 prognostic measures (390 potential associations). One hundred and seven (27%) associations were investigated statistically, of which 38 (36%) were significant. Most studies reported only prognostic value of test positive results. Meta-analyses suggested hospitalization duration was longer for patients with respiratory syncytial virus than adenovirus and influenza, but significant heterogeneity was observed between studies. CONCLUSIONS A quarter of potential prognostic associations have been investigated. Of these, a third were significant, suggesting considerable potential for POCT. Future research should investigate prognostic value of positive and negative tests, and interactions between test results, use of antimicrobials and microbial resistance.
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Affiliation(s)
- H.V. Thornton
- Centre for Academic Primary Care, NIHR School for Primary Care Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
| | - K.M.E. Turner
- School of Veterinary Science, University of Bristol, Langford, Bristol, UK
| | - S. Harrison
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
| | - A. Hammond
- Centre for Academic Primary Care, NIHR School for Primary Care Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
| | - C. Hawcroft
- Centre for Academic Primary Care, NIHR School for Primary Care Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
| | - A.D. Hay
- Centre for Academic Primary Care, NIHR School for Primary Care Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK,Corresponding author
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Human adenovirus load in respiratory tract secretions are predictors for disease severity in children with human adenovirus pneumonia. Virol J 2018; 15:123. [PMID: 30086789 PMCID: PMC6081882 DOI: 10.1186/s12985-018-1037-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 08/02/2018] [Indexed: 12/02/2022] Open
Abstract
Background Pneumonia is a serious public health issue and is concerned around the world. This study is to investigate the association between viral load in children with human adenovirus (HAdV) pneumonia and disease severity. Methods A total of 1313 cases of children hospitalized in Hunan Provincial People’s Hospital due to community acquired pneumonia (CAP) from April 2011 to May 2014 were enrolled in this study. Samples of nasopharyngeal aspirate were collected for the cohort. WHO criteria for CAP grading was emerged for pneumonia severity classification. Real-time fluorescence quantitative PCR (qRT-PCR) was used to detect 12 kinds of respiratory viruses. HAdV types were identified by nested PCR. The relationship between HAdV load and severity of disease was there by analyzed. Results Finally, 174 cases (174/1313, 13.3%) were positive for HAdV, and HAdV type 7 (HAdV-7) was the main serotype (76/174, 43.7%). Among the 174 cases, 70 cases were with HAdV infection alone and 104 cases were accompanied by other viruses. The patients were divided into mild pneumonia group (n = 108 cases) and severe pneumonia group (n = 66 cases). HAdV load of children in severe pneumonia group was higher than that in mild pneumonia group. Similar result was obtained in the 70 cases with HAdV infection alone after subgrouping. Relevant factors analysis results showed that severe pneumonia children presented lower onset age, more prone to fever, longer fever time, and longer hospital stay compared with that of mild pneumonia children. Children with HAdV-7 infection developed more frequently severe pneumonia. Multivariate regression analysis showed that HAdV load, age, and fever time were risk factors for pneumonia severity. Conclusion The severity of HAdV infection is significantly correlated with viral load and serotype.
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8
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Mazur NI, Bont L, Cohen AL, Cohen C, von Gottberg A, Groome MJ, Hellferscee O, Klipstein-Grobusch K, Mekgoe O, Naby F, Moyes J, Tempia S, Treurnicht FK, Venter M, Walaza S, Wolter N, Madhi SA. Severity of Respiratory Syncytial Virus Lower Respiratory Tract Infection With Viral Coinfection in HIV-Uninfected Children. Clin Infect Dis 2017; 64:443-450. [PMID: 27927871 PMCID: PMC5712444 DOI: 10.1093/cid/ciw756] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 11/20/2016] [Indexed: 12/21/2022] Open
Abstract
Background. Molecular diagnostics enable sensitive detection of respiratory viruses, but their clinical significance remains unclear in pediatric lower respiratory tract infection (LRTI). We aimed to determine whether viral coinfections increased life-threatening disease in a large cohort. Methods. Molecular testing was performed for respiratory viruses in nasopharyngeal aspirates collected from children aged <5 years within 24 hours of hospital admission during sentinel surveillance for severe acute respiratory illness (SARI) hospitalization conducted in South Africa during February 2009–December 2013. The primary outcome was life-threatening disease, defined as mechanical ventilation, intensive care unit admission, or death. Results. Of 2322 HIV-uninfected children with respiratory syncytial virus (RSV)–associated LRTI, 1330 (57.3%) had RSV monoinfection, 38 (1.6%) had life-threatening disease, 575 (24.8%) had rhinovirus, 347 (14.9%) had adenovirus (ADV), and 30 (1.3%) had influenza virus. RSV and any other viral coinfection was not associated with severe disease (odds ratio [OR], 1.4; 95% confidence interval [CI], OR, 0.74; 95% CI, .39–1.4), ADV coinfection had increased odds of life-threatening disease (adjusted OR, 3.4; 95% CI, 1.6–7.2; P = .001), and influenza coinfection had increased odds of life-threatening disease and prolonged length of stay (adjusted OR, 2.1; 95% CI, 1.0–4.5; P = .05) compared with RSV monoinfection. Conclusions. RSV coinfection with any respiratory virus is not associated with more severe disease when compared to RSV alone in this study. However, increased life-threatening disease in RSV-ADV and RSV-influenza coinfection warrants further study.
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Affiliation(s)
- Natalie I Mazur
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa.,Wilhelmina Children's Hospital, Utrecht, The Netherlands.,Julius Global Health Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - Louis Bont
- Wilhelmina Children's Hospital, Utrecht, The Netherlands.,Respiratory Syncytial Virus Network (ReSViNET) Ultrecht, The Netherlands
| | - Adam L Cohen
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Influenza Program, Centers for Disease Control and Prevention-South Africa, Pretoria, South Africa
| | - Cheryl Cohen
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Michelle J Groome
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa.,Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
| | - Orienka Hellferscee
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Kerstin Klipstein-Grobusch
- Julius Global Health Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.,Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Omphile Mekgoe
- Klerksdorp Hospital, Klerksdorp, North West Province, South Africa
| | - Fathima Naby
- Department of Pediatrics, Pietermaritzburg Metropolitan Hospital, University of KwaZulu-Natal, KwaZulu-Natal South Africa
| | - Jocelyn Moyes
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Stefano Tempia
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Influenza Program, Centers for Disease Control and Prevention-South Africa, Pretoria, South Africa
| | - Florette K Treurnicht
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Marietje Venter
- Global Disease Detection Center South Africa, Division of Global Health Protection, Centers for Disease Control and Prevention, Pretoria, South Africa.,Department of Medical Virology, University of Pretoria, South Africa
| | - Sibongile Walaza
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Nicole Wolter
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Shabir A Madhi
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa.,Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
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Jeon JS, Park JW, Kim JK. Correlation between Infection with Multiple Respiratory Viruses and Length of Hospital Stay in Patients from Cheonan, Korea. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2017. [DOI: 10.15324/kjcls.2017.49.1.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Jae-Sik Jeon
- Department of Laboratory Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Jin-Wan Park
- Department of Obstetrics and Gynecology, College of Medicine, Dankook University, Cheonan, Korea
| | - Jae Kyung Kim
- Department of Biomedical Laboratory Science, Dankook University College of Health Sciences, Cheonan, Korea
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Niang MN, Diop NS, Fall A, Kiori DE, Sarr FD, Sy S, Goudiaby D, Barry MA, Fall M, Dia N. Respiratory viruses in patients with influenza-like illness in Senegal: Focus on human respiratory adenoviruses. PLoS One 2017; 12:e0174287. [PMID: 28328944 PMCID: PMC5362214 DOI: 10.1371/journal.pone.0174287] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 03/06/2017] [Indexed: 12/20/2022] Open
Abstract
Background Human adenoviruses (HAdVs) are highly contagious pathogens that are associated with a wide spectrum of human illnesses involving the respiratory tract. In the present study, we investigate the epidemiologic and viral molecular features of HAdVs circulating in Senegal after 4 consecutive years of sentinel surveillance of influenza-like Illness cases. Methodology and results From January 2012 to December 2015 swabs were collected from consenting ILI outpatients. Adenoviral detection is performed by rRT-PCR with the Anyplex™ II RV16 Detection kit (Seegene) and molecular characterization was performed using a partial hexon gene sequence. 6381 samples were collected. More than half of patients (51.7%; 3297/6381) were children of ≤ 5 years. 1967 (30.8%) were positive for HAdV with 1561 (79.4%) found in co-infection with at least one another respiratory virus. The most common co-detections were with influenza viruses (53.1%; 1045/1967), rhinoviruses (30%; 591/1967), enteroviruses (18.5%; 364/1967) and RSV (13.5%; 266/1967). Children under 5 were the most infected group (62.2%; 1224/1967; p <0.05). We noted that HAdV was detected throughout the year at a high level with detection peaks of different amplitudes without any clear seasonality. Phylogenetic analysis revealed species HAdV-C in majority, species HAdV-B and one HAdV- 4 genome type. The 9 HAdV-B species like strains from Senegal grouped with genome types HAdV-7, HAdV-55 and HAdV-11 as shown by a phylogenetic branch with a high bootstrap value of (88%). Conclusion In conclusion, the results of the present study suggest strong year-round HAdV activity in Senegal, especially in children up to 5 years of age. Molecular studies revealed that the dominant species in circulation in patients with ILI appears to be HAdV-C and HAdV-B species. The circulation of though HAdV-7 and HAdV-55 genome types is of note as these serotypes are recognized causes of more severe and even fatal acute respiratory infections.
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Affiliation(s)
| | - Ndeye Sokhna Diop
- Institut Pasteur de Dakar, Unité de Virologie Médicale, Dakar, Sénégal
| | - Amary Fall
- Institut Pasteur de Dakar, Unité de Virologie Médicale, Dakar, Sénégal
| | - Davy E. Kiori
- Institut Pasteur de Dakar, Unité de Virologie Médicale, Dakar, Sénégal
| | - Fatoumata Diene Sarr
- Institut Pasteur de Dakar, Unité d’Epidémiologie des maladies infectieuses, Dakar, Sénégal
| | - Sara Sy
- Institut Pasteur de Dakar, Unité de Virologie Médicale, Dakar, Sénégal
| | - Déborah Goudiaby
- Institut Pasteur de Dakar, Unité de Virologie Médicale, Dakar, Sénégal
| | - Mamadou Aliou Barry
- Institut Pasteur de Dakar, Unité d’Epidémiologie des maladies infectieuses, Dakar, Sénégal
| | - Malick Fall
- Département de Biologie Animale Faculté des Sciences et Techniques Université Cheikh Anta DIOP de Dakar, Dakar, Senegal
| | - Ndongo Dia
- Institut Pasteur de Dakar, Unité de Virologie Médicale, Dakar, Sénégal
- * E-mail:
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Lee HJ, Seo YE, Han SB, Jeong DC, Kang JH. Clinical Impact of Mixed Respiratory Viral Infection in Children with Adenoviral Infection. Infect Chemother 2016; 48:309-316. [PMID: 27883373 PMCID: PMC5204010 DOI: 10.3947/ic.2016.48.4.309] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 09/25/2016] [Indexed: 01/24/2023] Open
Abstract
Background Although adenovirus (ADV) infection occurs steadily all year round in Korea and the identification of respiratory viral coinfections has been increasing following the introduction of multiplex real-time polymerase chain reaction tests, the clinical impact of viral coinfection in children with ADV infection has rarely been reported. Materials and Methods Medical records of children diagnosed with ADV infection were retrospectively reviewed. The enrolled children were divided into two groups based on the identified respiratory viruses: ADV group and coinfection group. Clinical and laboratory parameters were compared between the two groups. Results In total, 105 children (60 males and 45 females) with a median age of 29 months (range: 0-131 months) diagnosed with an ADV infection were enrolled. Fever (99.0%) was by far the most frequent symptom, followed by respiratory (82.9%), and gastrointestinal (22.9%) symptoms. Upper and lower respiratory tract infections were diagnosed in 56 (53.3%), and 32 (30.5%) children, respectively. Five (4.8%) children received oxygen therapy, and no child died due to ADV infection. Coinfection was diagnosed in 32 (30.5%) children, with rhinovirus (46.9%), and respiratory syncytial virus (21.9%) being the most frequent. The proportions of children younger than 24 months (P <0.001), with underlying medical conditions (P = 0.020), and diagnosed with lower respiratory tract infection (P = 0.011) were significantly higher in the coinfection group than in the ADV group. In a multivariate analysis, only the younger age was significantly associated with coinfection (P <0.001). Although more children in the coinfection group received oxygen therapy (P = 0.029), the duration of fever and hospitalization was not significantly different between the two groups. Conclusion Respiratory viral coinfection with ADV occurred more frequently in children younger than 24 months of age compared with children aged 24 months or older. Respiratory viral coinfection may increase the severity of ADV infection, however, appropriate therapy prevented prolonged hospitalization and poor prognosis due to coinfection.
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Affiliation(s)
- Hyun Jun Lee
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Eun Seo
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung Beom Han
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.,The Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| | - Dae Chul Jeong
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.,The Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin Han Kang
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.,The Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Lee J. Mixed Respiratory Viral Infections in Children with Adenoviral Infections. Infect Chemother 2016; 48:347-349. [PMID: 28032489 PMCID: PMC5204018 DOI: 10.3947/ic.2016.48.4.347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jin Lee
- Department of Pediatrics, Hanil General Hospital, Seoul, Korea.
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13
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Liu C, Xiao Y, Zhang J, Ren L, Li J, Xie Z, Xu B, Yang Y, Qian S, Wang J, Shen K. Adenovirus infection in children with acute lower respiratory tract infections in Beijing, China, 2007 to 2012. BMC Infect Dis 2015; 15:408. [PMID: 26429778 PMCID: PMC4591558 DOI: 10.1186/s12879-015-1126-2] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 09/17/2015] [Indexed: 01/13/2023] Open
Abstract
Background Human adenoviruses (HAdV) play a significant role in pediatric respiratory tract infections. To date, over 60 types of HAdV have been identified. Here, HAdV types are characterized in children in the Beijing area with acute lower respiratory tract infections (ALRTIs) and the clinical features and laboratory findings of hospitalized HAdV-infected cases are described. Methods Respiratory specimens were collected from pediatric patients with ALRTIs in the emergency department or from those admitted to Beijing Children’s Hospital between March 2007 and December 2012. Infections with common respiratory viruses were determined by PCR or RT-PCR. HAdV positive samples were further typed by PCR and sequencing. Results Among 3356 patients with ALRTIs, 194 (5.8 %) were found to have HAdV infection. HAdV infection was primarily confined to children (88.35 %) less than 5 years of age. A total of 11 different types of HAdV were detected throughout the study period, with HAdV-B7 (49.0 %) and HAdV-B3 (26.3 %) as the most prevalent types, followed by HAdV-C2 (7.7 %) and HAdVC1 (4.6 %). Newly emerging and re-emergent types or variants, HAdV-B55 (n = 5), HAdV-C57 (n = 3), and HAdV-B14p1 (n = 1), were identified. Results also included the reported first case of co-infection with HAdV-C2 and HAdV-C57. Clinical entities of patients with single HAdV infection (n = 49) were similar to those with mixed HAdV/respiratory syncytial virus (RSV) infections (n = 41). Patients with HAdV-B7 infection had longer duration of fever and higher serum levels of muscle enzymes than HAdV-B3-infected patients. Conclusions During the study period, HAdV-B7 and HAdV-B3 were the predominant types identified in pediatric ALRTIs. HAdV-B7 infection tends to have more severe clinical consequences. The presence of newly emerging types or variants and co-infection with different types of HAdV highlights the need for constant and close surveillance of HAdV infection.
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Affiliation(s)
- Chunyan Liu
- Beijing Children's Hospital, Capital Medical University, Beijing, 100045, P. R. China. .,Beijing Pediatric Research Institute, Beijing, 100045, P. R. China.
| | - Yan Xiao
- MOH Key Laboratory of Systems Biology of Pathogens and Dr. Christophe Mérieux Laboratory, IPB, CAMS-Fondation Mérieux, Institute of Pathogen Biology (IPB), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, Beijing, 100730, P. R. China.
| | - Jing Zhang
- MOH Key Laboratory of Systems Biology of Pathogens and Dr. Christophe Mérieux Laboratory, IPB, CAMS-Fondation Mérieux, Institute of Pathogen Biology (IPB), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, Beijing, 100730, P. R. China.
| | - Lili Ren
- MOH Key Laboratory of Systems Biology of Pathogens and Dr. Christophe Mérieux Laboratory, IPB, CAMS-Fondation Mérieux, Institute of Pathogen Biology (IPB), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, Beijing, 100730, P. R. China.
| | - Jianguo Li
- MOH Key Laboratory of Systems Biology of Pathogens and Dr. Christophe Mérieux Laboratory, IPB, CAMS-Fondation Mérieux, Institute of Pathogen Biology (IPB), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, Beijing, 100730, P. R. China.
| | - Zhengde Xie
- Beijing Children's Hospital, Capital Medical University, Beijing, 100045, P. R. China. .,Beijing Pediatric Research Institute, Beijing, 100045, P. R. China.
| | - Baoping Xu
- Beijing Children's Hospital, Capital Medical University, Beijing, 100045, P. R. China.
| | - Yan Yang
- Beijing Children's Hospital, Capital Medical University, Beijing, 100045, P. R. China.
| | - Suyun Qian
- Beijing Children's Hospital, Capital Medical University, Beijing, 100045, P. R. China.
| | - Jianwei Wang
- MOH Key Laboratory of Systems Biology of Pathogens and Dr. Christophe Mérieux Laboratory, IPB, CAMS-Fondation Mérieux, Institute of Pathogen Biology (IPB), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, Beijing, 100730, P. R. China.
| | - Kunling Shen
- Beijing Children's Hospital, Capital Medical University, Beijing, 100045, P. R. China.
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Rodríguez-Martínez CE, Rodríguez DA, Nino G. Respiratory syncytial virus, adenoviruses, and mixed acute lower respiratory infections in children in a developing country. J Med Virol 2015; 87:774-81. [PMID: 25648409 DOI: 10.1002/jmv.24139] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2014] [Indexed: 11/10/2022]
Abstract
There is growing evidence suggesting greater severity and worse outcomes in children with mixed as compared to single respiratory virus infections. However, studies that assess the risk factors that may predispose a child to a mixture of respiratory syncytial virus (RSV) and adenoviral infections, are scarce. In a retrospective cohort study, the study investigated the epidemiology of RSV and adenovirus infections and predictors of mixed RSV-adenoviral infections in young children hospitalized with acute lower respiratory infection in Bogota, Colombia, South America, over a 2-year period 2009-2011. Of a total of 5,539 children admitted with a diagnosis of acute lower respiratory infection, 2,267 (40.9%) who were positive for RSV and/or adenovirus were selected. Out the total number of cases, 1,416 (62.5%) infections occurred during the 3-month period from March to May, the first rainy season of Bogota, Colombia. After controlling for gender, month when the nasopharyngeal sample was taken, and other pre-existing conditions, it was found that an age greater than 6 months (OR:1.74; CI 95%:1.05-2.89; P = 0.030) and malnutrition as a comorbidity (OR:9.92; CI 95%:1.01-100.9; P = 0.049) were independent predictors of mixed RSV-adenoviral infections in the sample of patients. In conclusion, RSV and adenovirus are significant causes of acute lower respiratory infection in infants and young children in Bogota, Colombia, especially during the first rainy season. The identified predictors of mixed RSV-adenoviral infections should be taken into account when planning intervention, in order to reduce the burden of acute lower respiratory infection in young children living in the country.
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Affiliation(s)
- Carlos E Rodríguez-Martínez
- Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia; Research Unit, Military Hospital of Colombia, Bogota, Colombia; Department of Pediatric Pulmonology and Pediatric Critical Care Medicine, School of Medicine, Universidad El Bosque, Bogota, Colombia
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Kim TH, Yim CH, Ahn SY, Kang KJ, Choi YM, Ko JH, Choi KE, Lee JH, Lee WW. Clinical features of respiratory adenovirus infections in pediatric inpatients in a single medical center. ALLERGY ASTHMA & RESPIRATORY DISEASE 2015. [DOI: 10.4168/aard.2015.3.6.402] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Tae Hyun Kim
- Department of Pediatrics, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
| | - Chung Hyuk Yim
- Department of Pediatrics, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
| | - Sung Yoon Ahn
- Department of Pediatrics, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
| | - Kook Jin Kang
- Department of Pediatrics, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
| | - Yu Mi Choi
- Department of Pediatrics, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
| | - Jeong Hee Ko
- Department of Pediatrics, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
| | - Kyong Eun Choi
- Department of Pediatrics, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
| | - Jung Hyun Lee
- Department of Pediatrics, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
| | - Won Wook Lee
- Department of Pediatrics, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
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16
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Bardach A, Rey-Ares L, Cafferata ML, Cormick G, Romano M, Ruvinsky S, Savy V. Systematic review and meta-analysis of respiratory syncytial virus infection epidemiology in Latin America. Rev Med Virol 2014; 24:76-89. [PMID: 24757727 DOI: 10.1002/rmv.1775] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Respiratory syncytial virus (RSV) is a frequent cause of acute respiratory infection and the most common cause of bronchiolitis in infants. The aim of this systematic review and meta-analysis was to obtain a comprehensive epidemiological picture of the data available on disease burden, surveillance, and use of resources in Latin America. Pooled estimates are useful for cross-country comparisons. Data from published studies reporting patients with probable or confirmed RSV infection in medical databases and gray literature were included from 74 studies selected from the 291 initially identified. When considering all countries, the largest pooled percentage RSV in low respiratory tract infection patients was found in the group between 0 and 11 months old, 41.5% (95% CI 32.0–51.4). In all countries, percentages were increasingly lower as older children were included in the analyses. The pooled percentage of RSV in LRTIs in the elderly people was 12.6 (95% CI 4.2–24.6). The percentage of RSV infection in hospitalized newborns was 40.9% (95% CI 28.28–54.34). The pooled case fatality ratio for RSV infection was 1.74% (95% CI 1.2–2.4) in the first 2 years of life. The average length of stay excluding intensive care unit admissions among children with risk factors for severe disease was 12.8 (95% CI 8.9–16.7) days, whereas it averaged 7.3 (95% CI 6.1/8.5) days in otherwise healthy children.We could conclude that infants in their first year of age were the most vulnerable population. To our knowledge, this is the first systematic review on RSV disease burden and use of health resources in Latin America.
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Luchsinger V, Ampuero S, Palomino MA, Chnaiderman J, Levican J, Gaggero A, Larrañaga CE. Comparison of virological profiles of respiratory syncytial virus and rhinovirus in acute lower tract respiratory infections in very young Chilean infants, according to their clinical outcome. J Clin Virol 2014; 61:138-44. [PMID: 24994006 PMCID: PMC7185600 DOI: 10.1016/j.jcv.2014.06.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 05/27/2014] [Accepted: 06/03/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) and rhinovirus (HRV) are the main cause of acute lower respiratory tract infections (ALRTIs) in infants. Viral and host-related risk factors for severe disease have also not been clearly established. OBJECTIVE To assess whether certain viral features of RSV and, or HRV are associated with severe ALRTI. STUDY DESIGN RSV and HRV were studied in nasopharyngeal samples of infants by immunofluorescence, Luminex(®) and/or real-time RT-PCR assays. Quantitation and genotyping of RSV and HRV by PCR were done. RESULTS Of 124 virus positive specimens, 74 (59.7%) had RSV; 22 (17.7%) HRV and 28 (22.6%) RSV-HRV co-infection. Hospitalization was required in 57/74 RSV infants (77.0%); in 10/22 HRV cases (45.5%) (p=0.006) and in 15/28 co-infected by both viruses (53.6%) (p=0.003). Severe cases were 33/74 (44.6%) RSV infections, 2/22 HRV cases (9.1%), (p<0.002) and 6/28 (21.4%) patients co-infected by RSV-HRV (p<0.026). Three genotypes (NA1, B7, B9) of RSV circulated during the study. In 33 severe infants, NA1 was detected in 19 cases (57.6%); B7 in 13 (39.4%) and B9 in 1 (3.0%) (p<0.01; OR=10.0). RSV loads were similar between outpatients and hospitalized infants (p=0.7) and among different severities (p=0.7). NA1 loads were higher than other strains (p=0.049). Three geno-groups of HRV circulated homogeneously. CONCLUSION In very young infants, RSV cause more severe disease than HRV. Co-infection does not increase the severity of illness. NA1 RSV genotype was associated with major frequency of hospitalization, severe respiratory disease and higher viral load.
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Affiliation(s)
- Vivian Luchsinger
- Program of Virology of the Institute of Science in Biomedicine, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Sandra Ampuero
- Program of Virology of the Institute of Science in Biomedicine, Faculty of Medicine, University of Chile, Santiago, Chile
| | - M Angélica Palomino
- Department of Pediatrics, Hospital Roberto del Río, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Jonás Chnaiderman
- Program of Virology of the Institute of Science in Biomedicine, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Jorge Levican
- Program of Virology of the Institute of Science in Biomedicine, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Aldo Gaggero
- Program of Virology of the Institute of Science in Biomedicine, Faculty of Medicine, University of Chile, Santiago, Chile.
| | - Carmen E Larrañaga
- Program of Virology of the Institute of Science in Biomedicine, Faculty of Medicine, University of Chile, Santiago, Chile.
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Rodríguez DA, Rodríguez-Martínez CE, Cárdenas AC, Quilaguy IE, Mayorga LY, Falla LM, Nino G. Predictors of severity and mortality in children hospitalized with respiratory syncytial virus infection in a tropical region. Pediatr Pulmonol 2014; 49:269-76. [PMID: 23401345 PMCID: PMC4002290 DOI: 10.1002/ppul.22781] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2012] [Revised: 10/13/2012] [Accepted: 11/12/2012] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Respiratory syncytial virus (RSV) is one of the leading causes of acute lower respiratory infection (ALRI) in infants and young children. Although ALRI is a major public health problem in developing countries located in tropical areas, studies about RSV epidemiology in these regions are scarce. METHODS In a retrospective cohort study, we investigated the epidemiology and predictive variables that reflect disease severity and mortality in young children hospitalized with ALRI due to RSV in Colombia, South-America, during a 2-year period (2009-2011). RESULTS Of a total of 6,344 children with a diagnosis of ALRI, we selected 2,147 (33.8%) that were positive for RSV. After controlling for pre-existing conditions, we found that independent predictors of severe disease in our population included age <6 months (RR 2.01; CI 95% 1.70-2.38; P < 0.001), prematurity (RR 1.61; CI 95% 1.20-2.17; P = 0.001), congenital heart disease (RR 2.03; CI 95% 1.16-3.54; P = 0.013), and mixed RSV-adenovirus infection (RR 2.09; CI 95% 1.60-2.73; P < 0.001). Multivariate analysis identified that cancer (RR 31.60; CI 95% 5.97-167.13; P < 0.001) is a predictor of mortality in our RSV-infected pediatric population independently of age and other co-morbidities. CONCLUSIONS RSV is an important cause of ALRI in infants and young children living in tropical regions, especially during the rainy season. The identified predictors of severe disease and mortality should be taken into account when planning interventions to reduce the burden of ALRI in young children living in these regions.
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Tapia LI, Ampuero S, Palomino MA, Luchsinger V, Aguilar N, Ayarza E, Mamani R, Larrañaga C. Respiratory syncytial virus infection and recurrent wheezing in Chilean infants: a genetic background? INFECTION GENETICS AND EVOLUTION 2013; 16:54-61. [PMID: 23333336 DOI: 10.1016/j.meegid.2012.12.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 12/17/2012] [Accepted: 12/26/2012] [Indexed: 11/18/2022]
Abstract
UNLABELLED Respiratory syncytial virus (RSV) infection has been associated to recurrent wheezing, but pathogenic mechanisms are unclear. Interleukin-4/Interleukin-13 (IL-4/IL-13) pathway is involved in both conditions. A common host genetic susceptibility may exist in patients whom RSV will trigger severe illness and those who develop recurrent wheezing. OBJECTIVE To assess, by a candidate-gene approach, whether genetic polymorphisms in IL-4/IL-13 pathway are associated with RSV infection severity and its outcome in Chilean children. A cohort of 118 RSV-infected infants was analyzed and followed for one year. Severity of acute infection and later recurrent wheezing were characterized. Alleles and genotypes frequencies were determined for two SNP in each of the genes IL-4, IL-13 and IL-4Rα. Association tests and interaction analyses were performed. Enrollment included 60 moderate and 58 severe cases. Two SNP were found associated to severity during acute infection in IL-4Rα gene (Gln551Arg, Ile50Val). The follow up was completed in 71% of patients (84/118). Later recurrent wheezing was 54% in severe group, versus 31% in moderate cases (p=0.035). In relation to outcome, allele Ile50 in IL-4Rα was more frequent in patients with moderate disease and no wheezing outcome. A common protector genotype is proposed for Chilean children: IL-4Rα Ile/Ile. CONCLUSION Genetic variations in the host are associated to infection severity and outcome. A common genetic background might be influencing both pathologies.
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Affiliation(s)
- Lorena I Tapia
- Programa de Virología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Chile.
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Ampuero JS, Ocaña V, Gómez J, Gamero ME, Garcia J, Halsey ES, Laguna-Torres VA. Adenovirus respiratory tract infections in Peru. PLoS One 2012; 7:e46898. [PMID: 23056519 PMCID: PMC3466214 DOI: 10.1371/journal.pone.0046898] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Accepted: 09/06/2012] [Indexed: 12/13/2022] Open
Abstract
Background Currently, there is a paucity of data regarding human adenovirus (HAdv) circulation in Andean regions of South America. To address this shortcoming, we report the clinical, phylogenetic, and epidemiologic characteristics of HAdv respiratory tract infection from a large sentinel surveillance study conducted among adults and children in Peru. Methods/Principal Findings Oropharyngeal swabs were collected from participants visiting any of 38 participating health centers, and viral pathogens were identified by immunofluorescence assay in cell culture. In addition, molecular characterization was performed on 226 randomly selected HAdv samples. Between 2000 and 2010, a total of 26,375 participants with influenza-like illness (ILI) or severe acute respiratory infection (SARI) were enrolled in the study. HAdv infection was identified in 2.5% of cases and represented 6.2% of all viral pathogens. Co-infection with a heterologous virus was found in 15.5% of HAdv cases. HAdv infection was largely confined to children under the age of 15, representing 88.6% of HAdv cases identified. No clinical characteristics were found to significantly distinguish HAdv infection from other respiratory viruses. Geographically, HAdv infections were more common in sites from the arid coastal regions than in the jungle or highland regions. Co-circulation of subgroups B and C was observed each year between 2006 and 2010, but no clear seasonal patterns of transmission were detected. Conclusions/Significance HAdv accounted for a significant fraction of those presenting with ILI and SARI in Peru and tended to affect the younger population disproportionately. Longitudinal studies will help better characterize the clinical course of patients with HAdv in Peru, as well as determine the role of co-infections in the evolution of illness.
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A molecular epidemiology survey of respiratory adenoviruses circulating in children residing in Southern Palestine. PLoS One 2012; 7:e42732. [PMID: 22880092 PMCID: PMC3411832 DOI: 10.1371/journal.pone.0042732] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 07/10/2012] [Indexed: 01/28/2023] Open
Abstract
A molecular epidemiology survey was performed in order to establish and document the respiratory adenovirus pathogen profiles among children in Southern Palestine. Three hundred and thirty-eight hospitalized pediatric cases with adenovirus-associated respiratory tract infections were analyzed. Forty four cases out of the 338 were evaluated in more detail for the adenoviruses types present. All of the children resided in Southern Palestine, that is, in city, village and refugee camp environments within the districts of Hebron and Bethlehem. Human adenoviruses circulated throughout 2005–2010, with major outbreaks occurring in the spring months. A larger percent of the children diagnosed with adenoviral infections were male infants. DNA sequence analysis of the hexon genes from 44 samples revealed that several distinct adenovirus types circulated in the region; these were HAdV-C1, HAdV-C2, HAdV-B3 and HAdV-C5. However, not all of these types were detected within each year. This is the first study ever conducted in Palestine of the genetic epidemiology of respiratory adenovirus infections.
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[Bronchiolitis obliterans: outcome in the medium term]. An Pediatr (Barc) 2012; 76:58-64. [PMID: 22265374 DOI: 10.1016/j.anpedi.2011.10.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2011] [Revised: 10/13/2011] [Accepted: 10/14/2011] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Bronchiolitis obliterans is a chronic obstructive lung disease that follows a severe insult to the lower respiratory tract. Severity and outcome are different depending on the geographic area. The aim of this study was to communicate the results of our sample. METHODS A retrospective study was performed in a sample of boys and girls with a medical diagnosis of bronchiolitis obliterans (BO) between December 1994 and February 2011. The diagnosis was made by high-resolution computed tomography (HRCT) scan and lung function. Lung biopsy was performed in one case. Pulmonary function testing included; forced spirometry (≥ 3 years old), plethysmography (≥ 5 years), bronchodilator tests (BDT), single-breath determination of carbon monoxide uptake in the lung (D(LCO)) (≥ 6 years) and measurement of exhaled lower respiratory nitric oxide (FE(NO)). Quantitative variables were; age at diagnosis, respiratory morbidity before the diagnosis, time from the start of the symptomatology until the diagnosis, follow-up time, respiratory morbidity after the diagnosis, airway specific resistance (sR(eff)), airway specific conductance (sG(eff)), residual volume, total lung capacity, thoracic gas volume, FEV(1), FVC, FEV(1)/FVC, FEF(25-75), D(LCO) and FE(NO). Qualitative variables were; sex, reason for consulting, viral infections, atopy, smoke exposure, HRCT scan and current treatment. Descriptive analysis was performed and pulmonary function before and after BDT was studied using paired-sample Wilcoxon and Student́s t-test. RESULTS We studied a cohort of 22 cases, 10 (45.4%) boys and 12 (54.5%) girls. The mean age at the diagnosis was 4.87 ± 3, 27 years old. The follow-up period was 5 years (range 1 to 8 years). Related virus were; influenza 2 (9.09%), parainfluenza 2 (9.09%), adenovirus 3 (13.69%), syncytial respiratory virus 1 (4.5%) and rhinovirus 1 (4.54%). HRCT scan: mosaic pattern of lung attenuation 22 (100%) and bronchiectasis 8 (36.36%). Lung function at diagnosis showed fixed airflow obstruction and increased lung volumes. The global analysis showed a progressive decrease in FEV(1), FVC, FVC/FEV(1,) FEF(25-75) and increase in sR(eff) and residual volume with decrease in sG(eff). Individually, there was a tendency to stabilise the lung function comparing with initial values at diagnosis. Respiratory morbidity was low after the diagnosis. CONCLUSIONS In most cases, fixed air-flow obstruction and lung function stability with low respiratory morbidity were observed. HRCT scan and lung function testing supported the diagnosis.
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SP-A1, SP-A2 and SP-D gene polymorphisms in severe acute respiratory syncytial infection in Chilean infants. INFECTION GENETICS AND EVOLUTION 2011; 11:1368-77. [DOI: 10.1016/j.meegid.2011.04.033] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 04/29/2011] [Accepted: 04/30/2011] [Indexed: 11/17/2022]
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García J, Sovero M, Laguna-Torres VA, Gomez J, Chicaiza W, Barrantes M, Sanchez F, Jimenez M, Comach G, de Rivera IL, Agudo R, Arango AE, Barboza A, Aguayo N, Kochel TJ. Molecular characterization of adenovirus circulating in Central and South America during the 2006-2008 period. Influenza Other Respir Viruses 2010; 3:327-30. [PMID: 19903214 PMCID: PMC4941395 DOI: 10.1111/j.1750-2659.2009.00107.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background Human Adenoviruses are recognized pathogens, causing a broad spectrum of diseases. Serotype identification is critical for epidemiological surveillance, detection of new strains and understanding of HAdvs pathogenesis. Little data is available about HAdvs subtypes in Latin America. Methods In this study, we have molecularly characterized 213 adenoviruses collected from ILI presenting patients, during 2006‐08, in Central and South America. Results Our results indicate that 161(76%) adenoviruses belong to subgroup C, 45 (21%) to subgroup B and 7 (3%) to subtype E4.
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Larrañaga CL, Ampuero SL, Luchsinger VF, Carrión FA, Aguilar NV, Morales PR, Palomino MAM, Tapia LF, Avendaño LF. Impaired immune response in severe human lower tract respiratory infection by respiratory syncytial virus. Pediatr Infect Dis J 2009; 28:867-73. [PMID: 19738511 DOI: 10.1097/inf.0b013e3181a3ea71] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a major cause of acute lower respiratory infection in infants. The immune response plays a leading role in the severity of the disease. We hypothesized that severe RSV disease is associated with an impaired immune response characterized by low circulating T lymphocytes and plasma cytokine concentrations. METHODS We evaluate the in vivo immune responses of previously healthy infants with their first proven RSV-acute lower respiratory infection that required hospitalization. According to the clinical severity, defined by using a strict scoring system, the in vivo immune response was compared through the analysis of plasma cytokine values and the phenotyping of peripheral blood lymphocyte and natural killer (NK) cells. RESULTS Absolute blood cell counts of CD4+, CD8+, and CD19+ lymphocytes and NK cells were lower in subjects with RSV than in control infants. Lowest cell counts were observed in more severe RSV-infected infants. Significant low values were obtained in CD8+ lymphocytes (P = 0.03) and nonactive NK cells, that express CD94 antigen (P = 0.046). In contrast, activated NK cells that do not express CD94 molecules were significantly higher in RSV infected infants than in healthy controls (% of cells: P = 0.004). The interferon-gamma and tumor necrosis factor-alpha values in RSV infected patients were lower than in controls subjects. Interleukin-17 cytokine was not detected in healthy infants and the largest concentration was found in moderately ill patients as compared with severe cases (P = 0.033). RSV infection showed significantly higher interleukin-8 chemokine than in control infants (P = 0.024). CONCLUSION We propose that severe RSV infection in very young infants is associated with poor blood proinflammatory cytokine production, low counts of CD8+ T cells and with a greater activity of a group of NK cells, that are independent of the major histocompatibility complex class Ib recognition system.
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Affiliation(s)
- Carmen L Larrañaga
- Programa de Virologia, ICBM, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
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Murtagh P, Giubergia V, Viale D, Bauer G, Pena HG. Lower respiratory infections by adenovirus in children. Clinical features and risk factors for bronchiolitis obliterans and mortality. Pediatr Pulmonol 2009; 44:450-6. [PMID: 19360848 DOI: 10.1002/ppul.20984] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
UNLABELLED Adenovirus (Ad) respiratory infections have a profound impact in Argentina. Severe chronic disease and a high mortality rate are observed in children after acute lower respiratory infections (ALRI) by Ad. METHODS A retrospective observational study was performed to describe clinical characteristics and to analyze risk factors for bronchiolitis obliterans (BO) and death in 415 children hospitalized with ALRI caused by Ad from March 1988 to May 2005. RESULTS Mean age of patients was 10.7 months (+/-9.2) Overall 80% of patients were healthy before ALRI. Forty-nine percent recovered, sequelae were observed in 36% and 15% died. Independent risk factors for BO were: >30 days of hospitalization (odds ratio (OR) 27.2, 95% confidence interval (CI) 14.6-50.9), multifocal pneumonia (OR 26.6, 95% CI 5.3-132) and hypercapnia (OR 5.6, 95% CI 3.5-9). Independent risk factors for death in acute stage of disease were: mechanical assistance (OR 121, 95% CI 18.2-814), multifocal pneumonia (OR 102, 95% CI 9.5-31.1), hypercapnia (OR 42.6, 95% CI 10.2-177.1), coagulation disorders (OR 17, 95% CI 8.25-35), neurological symptoms (OR 12.7, 95% CI 3.5-6.6) and co-infection with measles (OR 9.6, 95% CI 2.1-44.2). CONCLUSIONS High incidence of sequelae and mortality in previously healthy children after Ad infection was observed in a population of children from Argentina.
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Affiliation(s)
- Patricia Murtagh
- Pediatric Pulmonology Department, Hospital de Pediatria Juan P. Garrahan, Buenos Aires, Argentina
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Escobar C, Luchsinger V, de Oliveira DB, Durigon E, Chnaiderman J, Avendaño LF. Genetic variability of human metapneumovirus isolated from chilean children, 2003-2004. J Med Virol 2009; 81:340-4. [DOI: 10.1002/jmv.21399] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Roh EJ, Chang YP, Kim JK, Rheem IS, Park KS, Chung EH. Clinical significance of codetection of the causative agents for acute respiratory tract infection in hospitalized children. KOREAN JOURNAL OF PEDIATRICS 2009. [DOI: 10.3345/kjp.2009.52.6.661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Eui Jung Roh
- Department of Pediatrics, College of Medicine, Dankook University, Cheonan, Korea
| | - Young Pyo Chang
- Department of Pediatrics, College of Medicine, Dankook University, Cheonan, Korea
| | - Jae Kyung Kim
- Department of Laboratory Medicine, College of Medicine, Dankook University, Cheonan, Korea
| | - In Soo Rheem
- Department of Laboratory Medicine, College of Medicine, Dankook University, Cheonan, Korea
| | - Kwi Sung Park
- Chungcheongnam-Do Health and Environment Research Institute, Daejeon, Korea
| | - Eun Hee Chung
- Department of Pediatrics, College of Medicine, Dankook University, Cheonan, Korea
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Oda K, Yamamoto Y. Serum interferon-gamma, interleukin-4, and interleukin-6 in infants with adenovirus and respiratory syncytial virus infection. Pediatr Int 2008; 50:92-4. [PMID: 18279213 DOI: 10.1111/j.1442-200x.2007.02522.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND To characterize adenoviral (ADV) infection, the clinical symptoms, laboratory findings and serum cytokine concentrations were evaluated in ADV patients and compared with those in patients with respiratory syncytial virus (RSV) infections. METHODS A total of 63 patients who had been diagnosed with ADV infections or RSV on an antigen detection test were enrolled in the present study between December 2002 and March 2004. Forty patients had RSV infection and 23 patients had ADV infection. Serum cytokine (interleukin [IL]-4,6 and interferon [IFN]-gamma) concentrations were analyzed. Concentration of IL-6 in both infection groups was analyzed regardless of whether the patients had been given steroids (dexamethaxone or prednisolone). In addition, IL-6 levels were measured on day 1 and 4 of hospitalization. RESULTS A strong inflammatory response was observed in patients with ADV infection. Serum IL-6 levels in patients with ADV infection on day 4 of hospitalization were significantly higher than those in patients without steroids treatment or in patients with RSV infection. IL-4, and IFN-gamma were not significantly different. CONCLUSION Patients with ADV infections who were given steroids had a temporary increase of IL-6, which might have indicated the development of a severe clinical course if not been administered.
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Affiliation(s)
- Keiko Oda
- Department of Pediatrics, Saiseikai Yahata Hospital, Kitakyusyu, Fukuoka, Japan.
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Larrañaga C, Martínez H J, Palomino M A, Peña C M, Carrión A F, Avendaño C LF. Molecular characterization of hospital-acquired adenovirus infantile respiratory infection in Chile using species-specific PCR assays. J Clin Virol 2007; 39:175-81. [PMID: 17567530 DOI: 10.1016/j.jcv.2007.04.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2006] [Revised: 04/09/2007] [Accepted: 04/18/2007] [Indexed: 11/30/2022]
Abstract
BACKGROUND Adenovirus serotypes 7, 2 and 1 are the second most common cause of viral acute lower respiratory tract infection (ALRI) requiring hospitalization in Chile. Nosocomial outbreaks have high secondary attack and lethality rates, and call for rapid and specific diagnosis. OBJECTIVE We compared the results obtained on ALRI specimens by immunofluorescence (IFA) and virus isolation, plus restriction enzyme digestion (RFLP) typing, with universal, species-specific and 7h-specific PCR typing of adenovirus. A second objective was to determine the type of adenovirus implicated in nosocomial infection and nosocomial cross-infection rates. METHODS Infants hospitalized for ALRI in the Roberto del Río Children's Hospital (Santiago, Chile) in 1995-1996 had nasopharyngeal aspirates obtained at admission and tested by IFA and virus isolation. Adenovirus isolates were identified by RFLP. When an index case was identified, samples were collected from contacts for 2 consecutive days and twice weekly thereafter for 2 weeks. Further typing of adenovirus isolates was undertaken with universal, species-specific and 7h-specific PCR performed in 2003 on the stored frozen samples. RESULTS Fifteen index cases of adenovirus and their 65 contacts were identified. The nosocomial secondary attack rate using PCR was estimated as 46%. PCR had a higher sensitivity (98.7%) compared to virus isolation (90%) and IFA (50%) and facilitated identification of adenovirus strains more easily and accurately than RFLP (91.6% versus 55.8%). Fifty-three percent of the contacts had severe outcomes. The case fatality rate was 16.6% and was associated with adenovirus 7h. CONCLUSIONS Prompt, rapid and sensitive methods to identify adenovirus infection are necessary, especially for hospital-acquired adenovirus infections, because of their ease of spread and high fatality rate.
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Affiliation(s)
- Carmen Larrañaga
- Programa de Virología, ICBM, Facultad de Medicina, Universidad de Chile, Independencia 1027, Santiago de Chile, Chile.
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Castro-Rodriguez JA, Daszenies C, Garcia M, Meyer R, Gonzales R. Adenovirus pneumonia in infants and factors for developing bronchiolitis obliterans: a 5-year follow-up. Pediatr Pulmonol 2006; 41:947-53. [PMID: 16871594 DOI: 10.1002/ppul.20472] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
To describe clinical, pulmonary function, and chest tomography profiles in a 5-year follow-up of infants with adenovirus pneumonia and determine the factors that potentially contributed to the development of bronchiolitis obliterans (BO). We prospectively assessed 45 hospitalized infants with adenovirus pneumonia with additional follow-up for 5 years. At the end of the study, pulmonary function by impulse oscillometry technique (IOS) and chest tomography were performed in the 38 surviving patients (mean 5.7 years of age). We divided the population between those who developed chest tomography evidence of BO and those who did not. Most of the children developed adenovirus infection before 2 years of age. During the 5 years of follow-up, almost half (47.4%) developed BO. Children who developed BO had significantly more respiratory compromise (intensive care admission, need for mechanical ventilation and for oxygen therapy, and systemic corticosteroid and beta agonist use) during their adenovirus pneumonia episode than those who did not develop BO. Only 33.3% of children with BO had normal impedance compared with 85% in the no BO group. Children who developed BO had significantly higher levels of Zrs, R5, X5 and predicted Zrs, R5, and X5 and frequency. However, there were no differences in the beta 2 agonist response between the children with and without BO (94% vs. 80%, respectively). This study represents the spectra of adenovirus pneumonia ranging from relatively mild to severe and fatal cases. Children with severe pulmonary compromise are usually more prone to develop BO.
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Affiliation(s)
- Jose A Castro-Rodriguez
- Department of Pediatric Respiratory Medicine, Faculty of Medical Sciences, University of Santiago de Chile, Santiago, Chile.
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