Molecular Characterization of Influenza Strains in Patients Admitted to Intensive Care Units during the 2017-2018 Season

This study aimed at assessing the frequency and the distribution of influenza virus types/subtypes in 172 laboratory-confirmed influenza-positive patients admitted to intensive care units (ICUs) during the 2017-2018 season in the Lombardy region (Northern Italy), and to investigate the presence of m...

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Bibliographic Details
Published in:International journal of molecular sciences 2019-05, Vol.20 (11), p.2664
Main Authors: Piralla, Antonio, Pariani, Elena, Giardina, Federica, Galli, Cristina, Sapia, Davide, Pellegrinelli, Laura, Novazzi, Federica, Anselmi, Giovanni, Rovida, Francesca, Mojoli, Francesco, Cereda, Danilo, Senatore, Sabrina, Baldanti, Fausto
Format: Article
Language:English
Subjects:
Drug resistance
Epidemiology
Hemagglutinins
Illnesses
Infections
Influenza
Influenza A
Influenza B
influenza virus
Intensive care
intensive care unit
Intensive care units
Laboratories
lower respiratory tract infection
Lungs
Mutation
Pandemics
Pathogenicity
Patients
Pediatrics
Phylogenetics
Respiratory tract
severe respiratory infections
Strains (organisms)
Vaccines
viral load
Virology
Viruses
Womens health
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Summary:This study aimed at assessing the frequency and the distribution of influenza virus types/subtypes in 172 laboratory-confirmed influenza-positive patients admitted to intensive care units (ICUs) during the 2017-2018 season in the Lombardy region (Northern Italy), and to investigate the presence of molecular pathogenicity markers. A total of 102/172 (59.3%) patients had influenza A infections (83 A/H1N1pdm09, 2 H3N2 and 17 were untyped), while the remaining 70/172 (40.7%) patients had influenza B infections. The 222G/N mutation in the hemagglutinin gene was identified in 33.3% (3/9) of A/H1N1pdm09 strains detected in the lower respiratory tract (LRT) samples and was also associated with more severe infections, whereas no peculiar mutations were observed for influenza B strains. A single-point evolution was observed in site 222 of A/H1N1pdm09 viruses, which might advantage viral evolution by favouring virus binding and replication in the lungs. Data from 17 paired upper respiratory tract (URT) and LRT samples showed that viral load in LRT samples was mostly higher than that detected in URT samples. Of note, influenza viruses were undetectable in 35% of paired URT samples. In conclusion, LRT samples appear to provide more accurate clinical information than URT samples, thus ensuring correct diagnosis and appropriate treatment of patients with severe respiratory infections requiring ICU admission.
ISSN:1422-0067
1661-6596
1422-0067
DOI:10.3390/ijms20112664