Emergence of community-acquired adenovirus type 55 as a cause of community-onset pneumonia.
Emergence of community-acquired adenovirus type 55 as a cause of community-onset pneumonia.
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社区获得性 55 型腺病毒的出现是社区发病肺炎的原因。
作者：
Cao B;Huang GH;Pu ZH;Qu JX;Yu XM;Zhu Z;Dong JP;Gao Y;Zhang YX;Li XH;Liu JH;Wang H;Xu Q;Li H;Xu W;Wang C
自2008年以来，中国零星报告了新发人腺病毒（HAdV）55型（HAdV-55）重症病例。但是没有进行比较研究来辨别HAdV-55和其他类型（HAdV-7、HAdV-3、HAdV-14、HAdV-50和HAdV-C）之间的流行病学和临床异常的差异。2010年11月至2012年4月在北京和烟台进行了一项成人和青少年社区获得性肺炎（CAP）的多中心前瞻性监测研究。使用标准化数据表记录临床信息。从临床样品或腺病毒分离物中提取病毒DNA进行测序。在969例病例中，48例（5%）被确定为腺病毒肺炎。六个分支聚集：HAdV-55在21个中，HAdV-7在11个中，HAdV-3在9个中，HAdV-14在4个中，HAdV-50在2个中，HAdV-C在1个中。大多数HAdV-55病例是在2月和3月发现的。21株HAdV-55的六邻体基因的高变区完全相同。与其他类型（HAdV-7、HAdV-3、HAdV-14、HAdV-50和HAdV-C）的患者相比，HAdV-55的患者年龄约为10岁（P = 0.027），肺炎严重程度指数评分较高（P = 0.030）。HAdV-55组患者的全身血压也较高（P = .006）。单侧或双侧实变是HAdV-55和其他类型患者最常见的影像学表现（57.9% vs 36%）。超过一半的患者入院治疗; 48名患者中有29.2%接受了氧疗，2名需要机械通气。HAdV-55已成为中国人群中的主要肺炎病原体，需要进一步监测和监测该病原体是否是CAP的原因。
Since 2008, severe cases of emerging human adenovirus (HAdV) type 55 (HAdV-55) were reported sporadically in China. But no comparative studies had been conducted to discern the differences in epidemiologic and clinical abnormalities between HAdV-55 and other types (HAdV-7, HAdV-3, HAdV-14, HAdV-50, and HAdV-C). A multicenter surveillance study for adult and adolescent community-acquired pneumonia (CAP) was conducted prospectively in Beijing and Yan Tai between November 2010 and April 2012. A standardized data form was used to record clinical information. The viral DNA extracted from the clinical samples or adenovirus viral isolates was sequenced. Among 969 cases, 48 (5%) were identified as adenovirus pneumonia. Six branches were clustered: HAdV-55 in 21, HAdV-7 in 11, HAdV-3 in nine, HAdV-14 in four, HAdV-50 in two, and HAdV-C in one. Most HAdV-55 cases were identified during February and March. All the hypervariable regions of the hexon genes of the 21 HAdV-55 strains were completely identical. Patients who had HAdV-55 were about 10 years older (P = .027) and had higher pneumonia severity index scores (P = .030) compared with those with other types (HAdV-7, HAdV-3, HAdV-14, HAdV-50, and HAdV-C). Systemic BP was also higher among patients in the HAdV-55 group (P = .006). Unilateral or bilateral consolidations were the most common radiologic findings in both patients with HAdV-55 and those with other types (57.9% vs 36%). More than one-half of the patients were admitted to hospital; oxygen therapy was given to 29.2% of the 48 patients, and two needed mechanical ventilation. HAdV-55 has established itself as a major pneumonia pathogen in the Chinese population, and further surveillance and monitoring of this agent as a cause of CAP is warranted.
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