Frequency of respiratory virus infections and next-generation analysis of influenza A-H1N1pdm09 dynamics in the lower respiratory tract of patients admitted to the ICUReportar como inadecuado




Frequency of respiratory virus infections and next-generation analysis of influenza A-H1N1pdm09 dynamics in the lower respiratory tract of patients admitted to the ICU - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Recent molecular diagnostic methods have significantly improved the diagnosis of viral pneumonia in intensive care units ICUs. It has been observed that 222G-N changes in the HA gene of H1N1pdm09 are associated with increased lower respiratory tract LRT replication and worse clinical outcome. In the present study, the frequency of respiratory viruses was assessed in respiratory samples from 88 patients admitted to 16 ICUs during the 2014–2015 winter-spring season in Lombardy. Sixty-nine out of 88 78.4% patients were positive for a respiratory viral infection at admission. Of these, 57-69 82.6% were positive for influenza A 41 A-H1N1pdm09 and 15 A-H3N2, 8-69 11.6% for HRV, 2-69 2.9% for RSV and 2-69 2.9% for influenza B. Phylogenetic analysis of influenza A-H1N1pdm09 strains from 28-41 ICU-patients and 21 patients with mild respiratory syndrome not requiring hospitalization, showed the clear predominance of subgroup 6B strains. The median influenza A load in LRT samples of ICU patients was higher than that observed in the upper respiratory tract URT p<0.05. Overall, a greater number of H1N1pdm09 virus variants were observed using next generation sequencing on partial HA sequences codons 180–286 in clinical samples from the LRT as compared to URT. In addition, 222G-N-A mutations were observed in 30% of LRT samples from ICU patients. Finally, intra-host evolution analysis showed the presence of different dynamics of viral population in LRT of patients hospitalized in ICU with a severe influenza infection.



Autor: Antonio Piralla, Francesca Rovida, Alessia Girello, Marta Premoli, Francesco Mojoli, Mirko Belliato, Antonio Braschi, Giorgio Iot

Fuente: http://plos.srce.hr/



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