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      Molecular typing of human adenoviruses among hospitalized patients with respiratory tract infections in a tertiary Hospital in Guangzhou, China between 2017 and 2019

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          Abstract

          Background

          Human Adenoviruses (HAdVs) cause a wide array of illnesses in all age groups. They particularly cause frequent morbidity among children. In China, human adenovirus types 3, 4, 7, 11, 14, 21, and 55 have caused at least seven outbreaks since 2000. However, limited studies are available regarding the epidemiological patterns and diversity of HAdVs types among hospitalized patients with respiratory tract infections (RTIs).

          Methods

          To understand the epidemiology and subtype distribution of HAdV infections associated with RTIs in China, nasal swab (NS) clinical samples were collected from 4129 patients in a Guangzhou hospital between August 2017 and October 2019. PCR, sequencing, and phylogenetic analysis were performed on these specimens to identify HAdV subtypes.

          Results

          HAdV was successfully sequenced in 99 (2.4%) of the 4129 NS specimens, with the highest HAdV prevalence (6.3%) found in children between the ages of 5 and 10 years. Among HAdV-positive specimens, the most prevalent genotypes identified were HAdV-B3 (55.6%) and HAdV-B7 (25.3%). The most common symptoms in the HAdV-infected patients were fever (100%), cough (80.8%), and rhinorrhea (71.8%). HAdV infections were detected throughout the year with a relatively higher prevalence in summer.

          Conclusion

          All ages suffer adenovirus infections, but young children are at the greatest risk. This study data demonstrates that at least three species of HAdVs (species B, C, and E) are circulating in Guangzhou City, China. As antiviral therapies and type-specific vaccines become available, such epidemiological data will be useful in guiding therapy and public health interventions.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12879-021-06412-0.

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          Adenovirus infections in immunocompetent and immunocompromised patients.

          Thomas Lion (2014)
          Human adenoviruses (HAdVs) are an important cause of infections in both immunocompetent and immunocompromised individuals, and they continue to provide clinical challenges pertaining to diagnostics and treatment. The growing number of HAdV types identified by genomic analysis, as well as the improved understanding of the sites of viral persistence and reactivation, requires continuous adaptions of diagnostic approaches to facilitate timely detection and monitoring of HAdV infections. In view of the clinical relevance of life-threatening HAdV diseases in the immunocompromised setting, there is an urgent need for highly effective treatment modalities lacking major side effects. The present review summarizes the recent progress in the understanding and management of HAdV infections.
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            Adenovirus: Epidemiology, Global Spread of Novel Serotypes, and Advances in Treatment and Prevention

            Joseph P Lynch, Adriana E Kajon (2016)
            Adenoviruses (AdVs) are DNA viruses that typically cause mild infections involving the upper or lower respiratory tract, gastrointestinal tract, or conjunctiva. Rare manifestations of AdV infections include hemorrhagic cystitis, hepatitis, hemorrhagic colitis, pancreatitis, nephritis, or meningoencephalitis. AdV infections are more common in young children, due to lack of humoral immunity. Epidemics of AdV infection may occur in healthy children or adults in closed or crowded settings (particularly military recruits). The disease is more severe and dissemination is more likely in patients with impaired immunity (e.g., organ transplant recipients, human immunodeficiency virus infection). Fatality rates for untreated severe AdV pneumonia or disseminated disease may exceed 50%. More than 50 serotypes of AdV have been identified. Different serotypes display different tissue tropisms that correlate with clinical manifestations of infection. The predominant serotypes circulating at a given time differ among countries or regions, and change over time. Transmission of novel strains between countries or across continents and replacement of dominant viruses by new strains may occur. Treatment of AdV infections is controversial, as prospective, randomized therapeutic trials have not been conducted. Cidofovir is the drug of choice for severe AdV infections, but not all patients require treatment. Live oral vaccines are highly efficacious in reducing the risk of respiratory AdV infection and are in routine use in the military in the United States, but currently are not available to civilians.
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              Molecular typing of human adenoviruses by PCR and sequencing of a partial region of the hexon gene.

              Xin Lu, Dean Erdman (2006)
              Human adenoviruses (Ads) are responsible for a substantial disease burden. Type-specific identification of Ads can help guide therapeutic and disease prevention strategies and aid epidemiological investigations. Immunotyping of Ads by serum neutralization (SN) is laborious and time consuming and depends upon type-specific antisera that are in short supply. A rapid molecular typing assay based on polymerase chain reaction (PCR) amplification and sequencing of Ad hexon gene hyper-variable regions 1-6 (HVR(1-6)) known to contain type-specific epitopes was evaluated as an alternative to SN. Deduced amino acid sequences of HVR(1-6) obtained from all 51 currently recognized Ad prototype strains were well resolved, with the exception of types 15 and 29, which were identical. Of 192 temporally and geographically diverse Ad field isolates sequenced in this study, and 111 previously published sequences, all more closely matched their predicted prototype strains. Ads were also detected and correctly identified directly from 24 clinical specimens positive by culture or antigen detection. PCR and sequencing of HVR(1-6) offers a practical alternative to SN for typing most Ads and can be readily adapted for use in laboratories with molecular capabilities.
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                Author and article information

                Contributors
                Xinye Wang: z5288675@unsw.edu.au
                Dawei Wang: david@gzucm.edu.cn
                Sajid Umar: sajid.umar@dukekunshan.edu.cn
                Sheng Qin: b96106@163.com
                Qiong Ling: lingqiong2000@163.com
                Gregory C. Gray: gregory.gray@duke.edu
                Yuntao Liu: iamliuyuntao@163.com
                Journal
                Journal ID (nlm-ta): BMC Infect Dis
                Journal ID (iso-abbrev): BMC Infect Dis
                Title: BMC Infectious Diseases
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-2334
                Publication date (Electronic): 3 August 2021
                Publication date PMC-release: 3 August 2021
                Publication date Collection: 2021
                Volume: 21
                Electronic Location Identifier: 748
                Affiliations
                [1 ]GRID grid.448631.c, ISNI 0000 0004 5903 2808, Global Health Research Center, , Duke Kunshan University, ; Kunshan, China
                [2 ]GRID grid.1005.4, ISNI 0000 0004 4902 0432, Faculty of Medicine, , School of Medical Sciences, University of New South Wales, ; Sydney, NSW Australia
                [3 ]GRID grid.411866.c, ISNI 0000 0000 8848 7685, Emergency Department, , The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, ; No. 111 Dade Road, Yuexiu District, Guangzhou, China
                [4 ]GRID grid.411866.c, ISNI 0000 0000 8848 7685, Laboratory Department, , The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, ; Guangzhou, China
                [5 ]GRID grid.26009.3d, ISNI 0000 0004 1936 7961, Division of Infectious Diseases, , Duke University, School of Medicine, ; DUMC Box 102359, Durham, NC 27710 USA
                [6 ]GRID grid.26009.3d, ISNI 0000 0004 1936 7961, Duke Global Health Institute, Duke University, ; Durham, NC USA
                [7 ]GRID grid.428397.3, ISNI 0000 0004 0385 0924, Program in Emerging Infectious Diseases, , Duke-NUS Medical School, ; Singapore, Singapore
                Article
                Publisher ID: 6412
                DOI: 10.1186/s12879-021-06412-0
                PMC ID: 8330471
                PubMed ID: 34344310
                SO-VID: e248e496-ec83-4ccc-b930-a313df23a4dc
                Copyright © © The Author(s) 2021
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 7 April 2021
                Date accepted : 18 July 2021
                Categories
                Subject: Research
                Custom metadata
                issue-copyright-statement © The Author(s) 2021

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: adenovirus,pcr,genotyping molecular epidemiology,respiratory diseases
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: adenovirus, pcr, genotyping molecular epidemiology, respiratory diseases

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