Clinical and molecular features of adenovirus type 2, 3, and 7 infections in children in an outbreak in Taiwan, 2011.
Clinical and molecular features of adenovirus type 2, 3, and 7 infections in children in an outbreak in Taiwan, 2011.
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DOI：
10.1016/j.cmi.2016.11.004
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发表时间：
2017-03
期刊：
影响因子：
--
通讯作者：
Huang YC
中科院分区：
文献类型：
--
作者：
Lin MR;Yang SL;Gong YN;Kuo CC;Chiu CH;Chen CJ;Hsieh YC;Kuo CY;Fang CW;Tsao KC;Huang YC
我们研究了2011年台湾北方爆发期间感染人类腺病毒（HAdV）的儿科患者，以确定儿童中不同HAdV基因型的临床特征。2011年1月至12月，长庚纪念医院637例<19岁的患者表现出培养确认的腺病毒感染，并提供了可用于多重实时PCR基因分型的标本。回顾性收集临床数据。排除5例多基因型病例，共纳入632例进行分析。HAdV-3（429/632; 67.6%）、HAdV-7（144/632; 22.6%）和HAdV-2（59/632; 9.8%）。中位年龄为4.58岁（范围为2个月至18岁），感染HAdV-3的儿童年龄明显较大（82.9% >3岁; p <0.001）。在621名住院患者中，98.2%有发热，所有患者均表现出呼吸道症状，75名患者（12.1%）有下呼吸道感染，20名（3.2%）需要重症监护（HAdV-2：1; HAdV-3：8;和HAdV-7：11），3名死亡（所有HAdV-7感染）。HAdV-3感染患者更可能出现上呼吸道症状和血清C反应蛋白水平>100 mg/L，而白细胞增多症（白色血细胞计数>15 000/mm 3）在HAdV-2感染患者中更常见（p 0.007）。HAdV-7感染与发热持续时间较长、白细胞减少症（白色血细胞计数<5000/mm 3）、血小板减少症（血小板计数<150 000/mm 3）、下呼吸道感染、住院时间较长和需要重症监护显著相关（所有p <0.001）。儿童HAdV-2、HAdV-3和HAdV-7感染可能表现出不同的临床表现。虽然HAdV-3是2011年台湾爆发期间观察到的最流行的基因型，但HAdV-7引起更严重的疾病特征和结果。
We studied paediatric patients with human adenovirus (HAdV) infection during the 2011 outbreak in northern Taiwan to define the clinical features of different HAdV genotypes in children. Between January and December 2011, 637 patients <19 years of age exhibited culture-confirmed adenoviral infection in Chang Gung Memorial Hospital, and provided specimens available for genotyping by multiplex real-time PCR. Clinical data were collected retrospectively. Excluding five cases with multiple genotypes, 632 cases were included for analysis. Three genotypes were identified, including HAdV-3 (429/632; 67.6%), HAdV-7 (144/632; 22.6%) and HAdV-2 (59/632; 9.8%). Median age was 4.58 years (range 2 months to 18 years), with children infected with HAdV-3 significantly older (82.9% >3 years; p <0.001). Of the 621 inpatients, 98.2% had fevers and all exhibited respiratory symptoms, 75 patients (12.1%) had lower respiratory tract infections, 20 (3.2%) required intensive care (HAdV-2: 1; HAdV-3: 8; and HAdV-7: 11), and three died (all HAdV-7-infected). HAdV-3-infected patients were significantly more likely to have upper respiratory symptoms and a high serum C-reactive protein level >100 mg/L, whereas leucocytosis (white blood cell count >15 000/mm3) was more common in HAdV-2-infected patients (p 0.007). HAdV-7 infections were significantly associated with a longer duration of fever, leucopenia (white blood cell count <5000/mm3), thrombocytopenia (platelet count <150 000/mm3), lower respiratory tract infections, a longer length of hospital stay, and requiring intensive care (all p <0.001). Childhood HAdV-2, HAdV-3 and HAdV-7 infections may exhibit different clinical manifestations. Although HAdV-3 was the most prevalent genotype observed during the 2011 Taiwan outbreak, HAdV-7 caused more severe disease characteristics and outcomes.
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