1
|
Mariani A, Cavallo F, La Bella S, Graziano G, Passarelli M, Crescenzi C, Trotta D, Aricò M. A High Copy Number from a Pharyngeal Swab Is Not Associated with Different Presenting Features in 100 Children with Acute Adenovirus Infection from a Cluster in Italy. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1788. [PMID: 38002879 PMCID: PMC10670188 DOI: 10.3390/children10111788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023]
Abstract
Human mastadenoviruses, frequently denominated adenoviruses (HAdVs), may cause respiratory tract, gastrointestinal or, less frequently, other involvements. Epidemics of HAdV infections occur globally, in communities, and in closed or crowded settings. In our institution, a cluster of infants and children admitted for HAdV infection was recently observed. The aim of this study was to describe the pattern of their presenting features and investigate the possible correlation between the HAdV copy number and the clinical picture. Two main patterns of clinical presentation were observed: 68 patients had mainly respiratory symptoms (pharyngitis n = 67, cough n = 44; tonsillar exudate n = 17; other respiratory signs n = 4) while 26 patients showed prevalent gastrointestinal involvement (diarrhea n = 26, vomiting n = 8). Patients with respiratory symptoms had a significantly higher count of WBC, PMN, and platelets, while CRP level approached statistical significance (p = 0.07) for higher values in the patients with diarrhea. In order to explore the impact of selected presenting features, the possible association between the level of CRP and the presence of pharyngeal exudate, cough, vomiting, diarrhea, duration of fever, number of neutrophils, and administration of antibiotics was analyzed. Patients falling in the tertile with more elevated CRP values had tonsillar exudate and diarrhea significantly more often, while those in the lower tertile had a 4.4-day duration fever vs. ≥5.0 days in the remaining patients. Antibiotic therapy was administered more frequently to patients with higher values of CRP (p = 0.006). The duration of hospitalization was not associated with the CRP level. The median time from the receipt of a positive HAdV PCR test result to patient discharge was 1 day in 73% of cases. The number of copies of HAdV detected via PCR ranged between 47 million and 15/μL. Falling in the highest tertile of copy number was significantly associated with pharyngitis. The 24 patients with evidence of viral coinfection had no difference in the demographics or presenting features, with the only exception being a significantly higher leukocyte count. The rapid turn-around of the results of the molecular testing of the HAdV genome on a pharyngeal swab allowed us to rapidly diagnose HAdV infection, allowing us to stop antibiotic therapy and immediately discharge the patients, with reduced discomfort for the families and more appropriate use of hospital beds. A high copy number of HAdV from a pharyngeal swab should not be taken as an indicator of worse prognosis, thus allowing for the preferential use of qualitative rather than quantitative assay.
Collapse
Affiliation(s)
- Anthea Mariani
- Pediatrics, S. Spirito Hospital, Azienda Sanitaria Pescara, 65124 Pescara, Italy; (A.M.); (F.C.); (D.T.)
| | - Federica Cavallo
- Pediatrics, S. Spirito Hospital, Azienda Sanitaria Pescara, 65124 Pescara, Italy; (A.M.); (F.C.); (D.T.)
| | - Saverio La Bella
- Postgraduate School of Pediatrics, University of Chieti-Pescara, 66100 Chieti, Italy; (S.L.B.); (M.P.)
| | - Giusi Graziano
- CORESEARCH (Center for Outcomes Research and Clinical Epidemiology), 65122 Pescara, Italy;
| | - Martina Passarelli
- Postgraduate School of Pediatrics, University of Chieti-Pescara, 66100 Chieti, Italy; (S.L.B.); (M.P.)
| | - Carlo Crescenzi
- Clinical Microbiology and Virology, S. Spirito Hospital, 65124 Pescara, Italy;
| | - Daniela Trotta
- Pediatrics, S. Spirito Hospital, Azienda Sanitaria Pescara, 65124 Pescara, Italy; (A.M.); (F.C.); (D.T.)
| | - Maurizio Aricò
- Pediatrics, S. Spirito Hospital, Azienda Sanitaria Pescara, 65124 Pescara, Italy; (A.M.); (F.C.); (D.T.)
| |
Collapse
|
2
|
Wang Y, Wang M, Bao R, Wang L, Du X, Qiu S, Yang C, Song H. A novel humanized tri-receptor transgenic mouse model of HAdV infection and pathogenesis. J Med Virol 2023; 95:e29026. [PMID: 37578851 DOI: 10.1002/jmv.29026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 07/17/2023] [Accepted: 07/27/2023] [Indexed: 08/16/2023]
Abstract
Human adenovirus (HAdV) is a highly virulent respiratory pathogen that poses clinical challenges in terms of diagnostics and treatment. Currently, no effective therapeutic drugs or prophylactic vaccines are available for HAdV infections. One factor contributing to this deficiency is that existing animal models, including wild-type and single-receptor transgenic mice, are unsuitable for HAdV proliferation and pathology testing. In this study, a tri-receptor transgenic mouse model expressing the three best-characterized human cellular receptors for HAdV (hCAR, hCD46, and hDSG2) was generated and validated via analysis of transgene insertion, receptor mRNA expression, and protein abundance distribution. Following HAdV-7 infection, the tri-receptor mice exhibited high transcription levels at the early and late stages of the HAdV gene, as well as viral protein expression. Furthermore, the tri-receptor mice infected with HAdV exhibited dysregulated cytokine responses and multiple tissue lesions. This transgenic mouse model represents human HAdV infection and pathogenesis with more accuracy than any other reported animal model. As such, this model facilitates the comprehensive investigation of HAdV pathogenesis as well as the evaluation of potential vaccines and therapeutic modalities for HAdV.
Collapse
Affiliation(s)
- Yawei Wang
- College of Public Health, Zhengzhou University, Zhengzhou, China
- Infectious Disease Control and Prevention Department, Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Min Wang
- Infectious Disease Control and Prevention Department, Chinese PLA Center for Disease Control and Prevention, Beijing, China
- College of Public Heaith, China Medical University, Shenyang, China
| | - Renlong Bao
- Infectious Disease Control and Prevention Department, Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Ligui Wang
- Infectious Disease Control and Prevention Department, Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Xinying Du
- Infectious Disease Control and Prevention Department, Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Shaofu Qiu
- Infectious Disease Control and Prevention Department, Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Chaojie Yang
- Infectious Disease Control and Prevention Department, Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Hongbin Song
- College of Public Health, Zhengzhou University, Zhengzhou, China
- Infectious Disease Control and Prevention Department, Chinese PLA Center for Disease Control and Prevention, Beijing, China
| |
Collapse
|
3
|
Mandato C, Vajro P. Pediatric Acute Liver Failure. Pediatr Rep 2023; 15:426-430. [PMID: 37489413 PMCID: PMC10366751 DOI: 10.3390/pediatric15030039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/26/2023] Open
Abstract
Pediatric acute liver failure (PALF) has recently become a subject of great interest when multiple clusters of non-A to non-E severe acute hepatitis in otherwise healthy young children with a median age of 2 years were reported around the world [...].
Collapse
Affiliation(s)
- Claudia Mandato
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" University of Salerno, 84081 Baronissi, Salerno, Italy
| | - Pietro Vajro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" University of Salerno, 84081 Baronissi, Salerno, Italy
| |
Collapse
|
4
|
Li J, Hu X, Yan X, Wu C, Nan Y. Clinical characteristics and possible etiology in children with acute severe hepatitis of unknown etiology. Chin Med J (Engl) 2022; 135:3019-3021. [PMID: 36580652 PMCID: PMC10106159 DOI: 10.1097/cm9.0000000000002445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Indexed: 12/31/2022] Open
Affiliation(s)
- Jie Li
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu 210093, China
| | - Xinyu Hu
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Xuebing Yan
- Department of Infectious Disease, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221006, China
| | - Chao Wu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu 210093, China
| | - Yuemin Nan
- Department of Traditional and Western Medical Hepatology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China
| |
Collapse
|
5
|
Frediansyah A, Sallam M, Yufika A, Sharun K, Iqhrammullah M, Chandran D, Mamada SS, Sallam DE, Khader Y, Lemu YK, Yusuf F, Kretchy JP, Abdeen Z, Smith Torres-Roman J, Acharya Y, Bondarenko A, Ikram A, Jamil KF, Kotfis K, Koyanagi A, Smith L, Megawati D, Rademaker M, Emran TB, Memish ZA, Vento S, Nainu F, Harapan H. Acute severe hepatitis of unknown etiology in children: A mini-review. NARRA J 2022; 2:e83. [PMID: 38449700 PMCID: PMC10914120 DOI: 10.52225/narra.v2i2.83] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/07/2022] [Indexed: 09/01/2023]
Abstract
The emergence of acute, severe non hepA-E hepatitis of unknown etiology (ASHUE) has attracted global concern owing to the very young age of the patients and its unknown etiology. Although this condition has been linked to several possible causes, including viral infection, drugs and/or toxin exposure, the exact cause remains unknown; this makes treatment recommendation very difficult. In this review, we summarize recent updates on the clinical manifestations, complemented with laboratory results, case numbers with the global distribution and other epidemiological characteristics, and the possible etiologies. We also provide the proposed actions that could be undertaken to control and prevent further spread of this hepatitis. Since many etiological and pathological aspects of the acute non hepA-E hepatitis remain unclear, further research is needed to minimize the severe impact of this disease.
Collapse
Affiliation(s)
- Andri Frediansyah
- National Research and Innovation Agency (BRIN), Yogyakarta, Indonesia
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman Jordan
- Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Amanda Yufika
- Department of Family Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Khan Sharun
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Muhammad Iqhrammullah
- Graduate School of Mathematics and Applied Sciences, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Deepak Chandran
- Department of Veterinary Sciences and Animal Husbandry, Amrita School of Agricultural Sciences, Amrita Vishwa Vidyapeetham University, Coimbatore, India
| | - Sukamto S. Mamada
- Department of Pharmacy, Faculty of Pharmacy, Hasanuddin University, Makassar, Indonesia
| | - Dina E. Sallam
- Pediatrics and Pediatric Nephrology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Yousef Khader
- Jordan University of Science and Technology, Irbid, Jordan
- Eastern Mediterranean Public Health Network, Jordan
| | - Yohannes K. Lemu
- Department of Health, Behavior and Society, Jimma University, Jimma, Ethiopia
| | - Fauzi Yusuf
- Gastroenterohepatology Division, Internal Medicine Department, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - James-Paul Kretchy
- Public Health Unit, School of Medicine and Health Sciences, Central University, Accra, Ghana
| | - Ziad Abdeen
- Al-Quds Nutrition and Health Research Institute, Faculty of Medicine, Al-Quds University, Abu Dies, Palestine
| | | | - Yogesh Acharya
- Western Vascular Institute, University Hospital Galway, National University of Ireland Galway, Galway, Ireland
| | - Anastasia Bondarenko
- Pediatric Infectious Disease and Pediatric Immunology Department, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
| | - Aamer Ikram
- National Institutes of Health, Islamabad, Pakistan
| | - Kurnia F. Jamil
- Division of Tropical Medicine & Infectious Disease, Department of Internal Medicine Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Katarzyna Kotfis
- Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, ICREA, CIBERSAM, ISCIII, Barcelona, Spain
| | - Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Dewi Megawati
- Department of Veterinary Pathobiology, University of Missouri, Columbia, US
- Department of Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Warmadewa University, Denpasar, Indonesia
| | - Marius Rademaker
- Waikato Clinical Campus, University of Auckland Medical School, Hamilton, New Zealand
| | - Talha B. Emran
- Department of Pharmacy, BGC Trust University Bangladesh Chittagong, Bangladesh
| | - Ziad A. Memish
- Research & Innovation CentreKing Saud Medical City, Ministry of Health Riyadh, Saudi Arabia
- College of Medicine, AlFaisal University, Riyadh, Saudi Arabia
| | - Sandro Vento
- Faculty of Medicine, University of Puthisastra, Phnom Penh, Cambodia
| | - Firzan Nainu
- Department of Pharmacy, Faculty of Pharmacy, Hasanuddin University, Makassar, Indonesia
| | - Harapan Harapan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| |
Collapse
|
6
|
Rabaan AA, Bakhrebah MA, Nassar MS, Natto ZS, Al Mutair A, Alhumaid S, Aljeldah M, Garout M, Alfouzan WA, Alshahrani FS, Sulaiman T, AlFonaisan MK, Alfaresi M, Alshamrani SA, Nainu F, Yong SJ, Choudhary OP, Ahmed N. Suspected Adenovirus Causing an Emerging HEPATITIS among Children below 10 Years: A Review. Pathogens 2022; 11:712. [PMID: 35889958 PMCID: PMC9317240 DOI: 10.3390/pathogens11070712] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/16/2022] [Accepted: 06/20/2022] [Indexed: 02/01/2023] Open
Abstract
In October 2021, a case of acute hepatic failure without any known cause was identified in the United States of America. Upon further investigation, other children aged 1-6 years were reported to have the same liver failure, and some of them were positive for adenovirus 41 type F. On 21 April 2022, the Centers for Disease Control and Prevention (CDC) released an alert after 74 cases were identified in United Kingdom (UK) between 5 and 8 April in children below 10 years of age, some of whom were also found to be positive for SARS-CoV-2. All the patients showed symptoms such as vomiting, diarrhea, jaundice, and abdominal pain. The patients' liver enzymes were remarkably increased. A total of 650 cases had been reported from 33 countries as of 27 May 2022, among which 222 cases were reported in the UK alone. No connection with SARS-CoV-2 or its vaccine has been found so far. However, the suspected cause is adenovirus, including its genomic variations, because its pathogenesis and laboratory investigations have been positively linked. Until further evidence emerges, hygiene precautions could be helpful to prevent its spread.
Collapse
Affiliation(s)
- Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan
| | - Muhammed A. Bakhrebah
- Life Science and Environment Research Institute, King Abdulaziz City for Science and Technology (KACST), Riyadh 11442, Saudi Arabia; (M.A.B.); (M.S.N.)
| | - Majed S. Nassar
- Life Science and Environment Research Institute, King Abdulaziz City for Science and Technology (KACST), Riyadh 11442, Saudi Arabia; (M.A.B.); (M.S.N.)
| | - Zuhair S. Natto
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Abbas Al Mutair
- Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia;
- College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
- School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia
- Nursing Department, Prince Sultan Military College of Health Sciences, Dhahran 33048, Saudi Arabia
| | - Saad Alhumaid
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia;
| | - Mohammed Aljeldah
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hafr Al Batin, Hafr Al Batin 39831, Saudi Arabia;
| | - Mohammed Garout
- Department of Community Medicine and Health Care for Pilgrims, Faculty of Medicine, Umm Al-Qura University, Makkah 21955, Saudi Arabia;
| | - Wadha A. Alfouzan
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat 13110, Kuwait;
- Microbiology Unit, Department of Laboratories, Farwania Hospital, Farwania 85000, Kuwait
| | - Fatimah S. Alshahrani
- Department of Internal Medicine, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia;
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University Medical City, King Saud University, Riyadh 11451, Saudi Arabia
| | - Tarek Sulaiman
- Infectious Diseases Section, Medical Specialties Department, King Fahad Medical City, Riyadh 12231, Saudi Arabia;
| | | | - Mubarak Alfaresi
- Department of Pathology and Laboratory Medicine, Sheikh Khalifa General Hospital, Umm Al Quwain P.O. Box 499, United Arab Emirates;
- Department of Pathology, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 505055, United Arab Emirates
| | - Saleh A. Alshamrani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Najran University, Najran 61441, Saudi Arabia;
| | - Firzan Nainu
- Department of Pharmacy, Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia;
| | - Shin Jie Yong
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Subang Jaya 47500, Selangor, Malaysia;
| | - Om Prakash Choudhary
- Department of Veterinary Anatomy and Histology, College of Veterinary Sciences and Animal Husbandry, Central Agricultural University (I), Selesih, Aizawl 796 015, Mizoram, India;
| | - Naveed Ahmed
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| |
Collapse
|