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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
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...
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Published in: | PloS one 2017-06, Vol.12 (6), p.e0178926-e0178926 |
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creator | Piralla, Antonio Rovida, Francesca Girello, Alessia Premoli, Marta Mojoli, Francesco Belliato, Mirko Braschi, Antonio Iotti, Giorgio Pariani, Elena Bubba, Laura Zanetti, Alessandro R Baldanti, Fausto |
description | 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 |
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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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0178926</identifier><identifier>PMID: 28591230</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Anesthesiology ; Base Sequence ; Biology and Life Sciences ; Causes of ; Codons ; Diagnosis ; Diagnostic systems ; Disease prevention ; Dynamics ; Evolution ; Genetic aspects ; High-Throughput Nucleotide Sequencing - methods ; Hospitalization ; Hospitals ; Humans ; Infections ; Influenza ; Influenza A ; Influenza A Virus, H1N1 Subtype - genetics ; Influenza B ; Influenza viruses ; Intensive care ; Intensive Care Units ; Laboratories ; Longitudinal Studies ; Medicine and Health Sciences ; Microbiology ; Mutation ; Pain ; Pandemics ; Patients ; Pediatrics ; Phylogeny ; Physiological aspects ; Pneumonia ; Polymorphism, Genetic ; Replication ; Research and analysis methods ; Respiratory System - virology ; Respiratory tract ; Respiratory tract infections ; Respiratory Tract Infections - epidemiology ; Respiratory Tract Infections - virology ; Seasons ; Sequences ; Spring (season) ; Surgery ; Surveillance ; Viral infections ; Viral Load ; Virology ; Viruses ; Winter</subject><ispartof>PloS one, 2017-06, Vol.12 (6), p.e0178926-e0178926</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Piralla et al. 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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.</description><subject>Anesthesiology</subject><subject>Base Sequence</subject><subject>Biology and Life Sciences</subject><subject>Causes of</subject><subject>Codons</subject><subject>Diagnosis</subject><subject>Diagnostic systems</subject><subject>Disease prevention</subject><subject>Dynamics</subject><subject>Evolution</subject><subject>Genetic aspects</subject><subject>High-Throughput Nucleotide Sequencing - methods</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infections</subject><subject>Influenza</subject><subject>Influenza A</subject><subject>Influenza A Virus, H1N1 Subtype - genetics</subject><subject>Influenza B</subject><subject>Influenza viruses</subject><subject>Intensive care</subject><subject>Intensive Care 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Elena</au><au>Bubba, Laura</au><au>Zanetti, Alessandro R</au><au>Baldanti, Fausto</au><au>Schildgen, Oliver</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2017-06-07</date><risdate>2017</risdate><volume>12</volume><issue>6</issue><spage>e0178926</spage><epage>e0178926</epage><pages>e0178926-e0178926</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28591230</pmid><doi>10.1371/journal.pone.0178926</doi><tpages>e0178926</tpages><orcidid>https://orcid.org/0000-0002-3358-8969</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1932-6203 |
ispartof | PloS one, 2017-06, Vol.12 (6), p.e0178926-e0178926 |
issn | 1932-6203 1932-6203 |
language | eng |
recordid | cdi_plos_journals_1907227618 |
source | Open Access: PubMed Central; Publicly Available Content Database |
subjects | Anesthesiology Base Sequence Biology and Life Sciences Causes of Codons Diagnosis Diagnostic systems Disease prevention Dynamics Evolution Genetic aspects High-Throughput Nucleotide Sequencing - methods Hospitalization Hospitals Humans Infections Influenza Influenza A Influenza A Virus, H1N1 Subtype - genetics Influenza B Influenza viruses Intensive care Intensive Care Units Laboratories Longitudinal Studies Medicine and Health Sciences Microbiology Mutation Pain Pandemics Patients Pediatrics Phylogeny Physiological aspects Pneumonia Polymorphism, Genetic Replication Research and analysis methods Respiratory System - virology Respiratory tract Respiratory tract infections Respiratory Tract Infections - epidemiology Respiratory Tract Infections - virology Seasons Sequences Spring (season) Surgery Surveillance Viral infections Viral Load Virology Viruses Winter |
title | 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 |
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