Respiratory Viruses in Pediatric Necropsies: An Immunohistochemical Study

Infections of the respiratory system are responsible for the majority of hospitalizations and deaths in pediatric patients in developing countries. We selected 177 necropsies of pediatric patients who died as a result of serious respiratory infections. The histopathological findings and epidemiological data were reviewed, and lung tissue samples were separated for immunohistochemistry testing. Conventional immunohistochemistry techniques were used to detect viral antigens in formalin-fixed, paraffin-embedded (FF-PE) lung tissue samples using a pool of monoclonal antibodies against respiratory viruses (respiratory syncytial virus, influenza A and B, adenovirus, and parainfluenza 1, 2, and 3 viruses) as primary antibodies. The histopathological findings were classified into bronchopneumonia (BCP) and interstitial pneumonitis (IP) patterns. The immunohistochemistry results were compared with histopathological patterns and epidemiological data. Positive results for viruses were found in 34% and 62.5% of the BCP and IP cases, respectively. Males and infants below 1 year of age were more frequent in the group that had positive results for viruses. Acute enteritis was the main cause of hospitalization and sepsis the most frequent cause of death in this group. A clear seasonal distribution was observed, with the majority of cases occurring in the 2nd and 3rd trimesters (autumn and winter) of each year in the period studied. Immunohistochemistry is an affordable and easy-to-perform method for viral-antigen detection in FF-PE tissue samples. Although BCP is a classic histopathological pattern found in bacterial infections, it is possible that children with serious respiratory infections had concomitant viral and bacterial infections, regardless of their previous immunologic state.

Download Full-text

Epidemiological and clinical characteristics of respiratory viruses in 4403 pediatric patients from multiple hospitals in Guangdong, China

BMC Pediatrics ◽

10.1186/s12887-021-02759-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yajie Zhang ◽

Lin Qiao ◽

Jinxiu Yao ◽

Nan Yu ◽

Xiaoping Mu ◽

...

Keyword(s):

Influenza A ◽

Clinical Characteristics ◽

Detection Rate ◽

Pediatric Patients ◽

Respiratory Infections ◽

Respiratory Viruses ◽

Influenza B Virus ◽

Direct Immunofluorescence ◽

Influenza B ◽

Detection Rates

Abstract Background Acute respiratory infections (ARI) cause considerable morbidity and mortality worldwide, especially in children. Unfortunately, there are limited multi-center data on common viral respiratory infections in south China. Methods A total of 4403 nasal swabs were collected from children in 10 cities in Guangdong, China in 2019. Seven respiratory viruses, influenza A virus (IFA), influenza B virus (IFB), respiratory syncytial virus (RSV), adenoviruses (ADV) and parainfluenza virus types 1–3 (PIV1, PIV2 and PIV3), were detected by direct immunofluorescence antibody assay. The personal information and clinical characteristics were recorded and analyzed. Results The results showed that at least one virus was detected in 1099 (24.96 %) samples. The detection rates of RSV, IFA, ADV, PIV3, PIV1 and PIV2 were 7.13 % (314/4403), 5.31 % (234/4403), 4.02 % (177/4403), 3.04 % (134/4403), 1.70 % (75/4403) and 1.16 % (51/4403), respectively. The detection rate of RSV was highest in 0–6-month-old children at 18.18 % (106/583), while the detection rate of IFA was highest in 12–18-year-old children at 20.48 % (17/83). The total detection rates in winter and spring were 35.67 % (219/614) and 34.56 % (403/1166), higher than those in summer, 17.41 % (284/1631), and autumn, 19.46 % (193/992). Conclusions RSV and IFA were the main respiratory viruses in children. With increasing age the detection rate of RSV decreased in children, but the trends for the detection rates of IFA and IFB were the opposite. This study provided the viral etiology and epidemiology of pediatric patients with ARI in Guangdong, China.

Download Full-text

Current Issues of Empirical Therapy of Severe Bacterial Community-Acquired Pneumonia During the Season of Respiratory Viral Infections

Antibiotics and Chemotherapy ◽

10.37489/0235-2990-2020-65-9-10-64-70 ◽

2020 ◽

Vol 65 (9-10) ◽

pp. 64-70

Author(s):

V. B. Beloborodov ◽

I. A. Kovalev ◽

G. V. Sapronov

Keyword(s):

Antimicrobial Therapy ◽

Influenza A ◽

Bacterial Infections ◽

Randomized Clinical Trials ◽

Respiratory Infections ◽

Molecular Genetic ◽

Seasonal Fluctuation ◽

Empirical Therapy ◽

Community Acquired Pneumonia ◽

Adverse Event Rate

Progredient growth of morbidity and mortality of patients with community-acquired pneumonia (CAP) requires optimization of treatment including antibacterial therapy. Implementation of molecular-genetic methods of diagnostics of viral and viral-bacterial infections in clinical practice has significantly augmented the conception of etiology of community-acquired pneumonia. Seasonal fluctuation of CAP prevalence corresponds with growth of morbidity of acute respiratory infections and influenza which contribute to the etiological structure of CAP by increasing the risk of infection caused by staphylococci. The synergy between influenza A virus and S.aureus has been shown; it is associated with an increase of virus replication in the presence of specific staphylococcal proteases and the ability of viruses to increase adhesion of S.aureusin the respiratory tract, to decrease phagocytosis of S.aureus by macrophages/neutrophils and production of antimicrobial peptides, as well as to increase the probability of secondary bacterial co-infection. Therefore, the most important requirement for the empiric therapy agents of CAP is high streptococcal and staphylococcal activity. According to the current guidelines on antimicrobial therapy of severe CAP, antipneumococcic cephalosporins, macrolides, and fluoroquinolones are the basic treatment agents, but none of them have the combined high antistaphylococcal and antipneumococcal activity inherent in ceftaroline. The advantages of ceftaroline over ceftriaxone and levofloxacin in terms of the probability of reaching target concentrations for clinically relevant pharmacokinetic/pharmacodynamic parameters are shown. Meta-analysis of randomized clinical trials showed the higher clinical efficacy of ceftaroline in comparison to ceftriaxone with similar adverse event rate. Summarized analysis of antibiotic susceptibility data, pharmacokinetic/pharmacodynamic and clinical data, as well as negative epidemiological trends confirms the necessity of optimization of antimicrobial therapy of CAP for implementation of ceftaroline advantages against pneumococci and staphylococci in comparison to other β-lactams. Therefore, empiric treatment with ceftaroline is the most rational option for the therapy of CAP in critically ill patients during the season of respiratory viral infection.

Download Full-text

Diagnostic performance of four SARS-CoV-2 antibody assays in patients with COVID-19 or with bacterial and non-SARS-CoV-2 viral respiratory infections

European Journal of Clinical Microbiology & Infectious Diseases ◽

10.1007/s10096-021-04285-4 ◽

2021 ◽

Author(s):

Timo Huber ◽

Philipp Steininger ◽

Pascal Irrgang ◽

Klaus Korn ◽

Matthias Tenbusch ◽

...

Keyword(s):

Legionella Pneumophila ◽

False Positive ◽

Bacterial Infections ◽

Viral Infections ◽

Respiratory Infections ◽

Chlamydia Psittaci ◽

Specific Flow ◽

Antibody Assays ◽

Positive Results ◽

Viral Respiratory

AbstractSARS-CoV-2 antibody assays are used for epidemiological studies and for the assessment of vaccine responses in highly vulnerable patients. So far, data on cross-reactivity of SARS-CoV-2 antibody assays is limited. Here, we compared four enzyme-linked immunosorbent assays (ELISAs; Vircell SARS-CoV-2 IgM/IgA and IgG, Euroimmun SARS-CoV-2 IgA and IgG) for detection of anti-SARS-CoV-2 antibodies in 207 patients with COVID-19, 178 patients with serological evidence of different bacterial infections, 107 patients with confirmed viral respiratory disease, and 80 controls from the pre-COVID-19 era. In COVID-19 patients, the assays showed highest sensitivity in week 3 (Vircell-IgM/A and Euroimmun-IgA: 78.9% each) and after week 7 (Vircell-IgG: 97.9%; Euroimmun-IgG: 92.1%). The antibody indices were higher in patients with fatal disease. In general, IgM/IgA assays had only limited or no benefit over IgG assays. In patients with non-SARS-CoV-2 respiratory infections, IgG assays were more specific than IgM/IgA assays, and bacterial infections were associated with more false-positive results than viral infections. The specificities in bacterial and viral infections were 68.0 and 81.3% (Vircell-IgM/IgA), 84.8 and 96.3% (Euroimmun-IgA), 97.8 and 86.0% (Vircell-IgG), and 97.8 and 99.1% (Euroimmun-IgG), respectively. Sera from patients positive for antibodies against Mycoplasma pneumoniae, Chlamydia psittaci, and Legionella pneumophila yielded particularly high rates of unspecific false-positive results in the IgM/IgA assays, which was revealed by applying a highly specific flow-cytometric assay using HEK 293 T cells expressing the SARS-CoV-2 spike protein. Positive results obtained with anti-SARS-CoV-2 IgM/IgA ELISAs require careful interpretation, especially if there is evidence for prior bacterial respiratory infections.

Download Full-text

Epidemiology of Respiratory Pathogens among Elderly Nursing Home Residents with Acute Respiratory Infections in Corsica, France, 2013–2017

BioMed Research International ◽

10.1155/2017/1423718 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Shirley Masse ◽

Lisandru Capai ◽

Alessandra Falchi

Keyword(s):

Nursing Home ◽

Influenza A ◽

Respiratory Infections ◽

Nursing Home Residents ◽

Respiratory Viruses ◽

Sudden Onset ◽

Influenza Viruses ◽

Influenza B ◽

Acute Respiratory Infections ◽

Respiratory Pathogens

Background. The current study aims to describe the demographical and clinical characteristics of elderly nursing home (NH) residents with acute respiratory infections (ARIs) during four winter seasons (2013/2014–2016/2017), as well as the microbiological etiology of these infections. Methods. Seventeen NHs with at least one ARI resident in Corsica, France, were included. An ARI resident was defined as a resident developing a sudden onset of any constitutional symptoms in addition to any respiratory signs. Nasopharyngeal swabs from ARI residents were screened for the presence of 21 respiratory agents, including seasonal influenza viruses. Results. Of the 107 ARI residents enrolled from NHs, 61 (57%) were positive for at least one of the 21 respiratory pathogens. Forty-one (38.3%) of the 107 ARI residents had influenza: 38 (92%) were positive for influenza A (100% A(H3N2)) and three (8%) for influenza B/Victoria. Axillary fever (≥38°C) was significantly more common among patients infected with influenza A(H3N2). Conclusion. The circulation of seasonal respiratory viruses other than influenza A(H3N2) seems to be sporadic among elderly NH residents. Investigating the circulation of respiratory viruses in nonwinter seasons seems to be important in order to understand better the dynamic of their year-round circulation in NHs.

Download Full-text

The prevalence of enteroviruses that cause respiratory infections in patients with influenzavirus A/H1N1 hospitalized in the Lublin province

Current Issues in Pharmacy and Medical Sciences ◽

10.1515/cipms-2015-0015 ◽

2014 ◽

Vol 27 (3) ◽

pp. 199-201

Author(s):

Adrian Jarzynski ◽

Agata Dubas ◽

Malgorzata Polz-Dacewicz

Keyword(s):

Respiratory Tract ◽

Influenza A ◽

Respiratory Tract Infections ◽

Clinical Symptoms ◽

Respiratory Infections ◽

Genetic Material ◽

Respiratory Viruses ◽

Influenza A H1n1 ◽

Tract Infections ◽

Viral Respiratory

ABSTRACT Viruses that cause respiratory tract infections are the most common agents of infectious diseases in humans throughout the world. A virus that infects the respiratory system, may induce various clinical symptoms. What is more, the same symptoms may be caused by different viruses. The aim of the study was to analyze the prevalence of enteroviruses that cause respiratory infections in patients with influenzavirus A/H1N1 hospitalized in the Lublin province. The experimental material was throat and nose swabs taken from patients hospitalized in Lublin and Tomaszow Lubelski. In the group of 44 patients (20 women and 24 men) infected with influenza A/H1N1, the genetic material of enteroviruses was detected in 13 patients (29.5%). Respiratory viruses co-infections are very common in hospitalized patients. Studies show that co-infection with influenza virus and enterovirus are more common in children than in adults. Moreover, viral respiratory tract infections are independent from the patients’ gender.

Download Full-text

Viral respiratory infections during the 2009 influenza A(H1N1) outbreak in the West Midlands Region, UK

Epidemiology and Infection ◽

10.1017/s0950268811002251 ◽

2011 ◽

Vol 140 (9) ◽

pp. 1551-1556 ◽

Cited By ~ 5

Author(s):

H. E. TANNER ◽

M. D. CURRAN ◽

E. H. BOXALL ◽

H. OSMAN

Keyword(s):

Influenza A ◽

Respiratory Infections ◽

Respiratory Viruses ◽

Virus Infections ◽

Influenza Outbreak ◽

Influenza A H1n1 ◽

Significant Difference ◽

West Midlands ◽

The Uk ◽

Viral Respiratory Infections

SUMMARYIn spring 2009 a new strain of influenza A(H1N1) emerged and caused a worldwide pandemic. This study utilized a large collection of respiratory specimens from suspected cases of influenza A(H1N1) in the UK West Midlands during the pandemic in order to investigate which other respiratory viruses were circulating and whether they played any role in the increased hospitalization rates seen during that period. Study specimens were selected from community and hospitalized patients positive and negative for influenza A(H1N1) and tested by PCR for other respiratory viruses. A number of infections diagnosed as influenza during the summer influenza outbreak were found to be due to other virus infections (most commonly rhinovirus). No statistically significant difference was found between the rates of respiratory virus co-infection with H1N1 in patients from community or hospital locations suggesting underlying factors were likely to be more significant than viral co-infections in determining severity of influenza A(H1N1) disease.

Download Full-text

Surveillance of Respiratory Viruses in Long Term Care Facilities

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v11i1.9893 ◽

2019 ◽

Vol 11 (1) ◽

Author(s):

Mary Checivich ◽

Shari Barlow ◽

Peter Shult ◽

Erik Residorf ◽

Jonathan L. Temte

Keyword(s):

Influenza A ◽

Nasal Swab ◽

Long Term Care ◽

Respiratory Infections ◽

Respiratory Viruses ◽

Influenza B ◽

Rt Pcr ◽

Term Care ◽

Care Facilities

ObjectiveTo assess the feasibility of conducting respiratory virus surveillance for residents of long term care facilities (LTCF) using simple nasal swab specimens and to describe the virology of acute respiratory infections (ARI) in LCTFs.IntroductionAlthough residents of LTCFs have high morbidity and mortality associated with ARIs, there is very limited information on the virology of ARI in LTCFs.[1,2] Moreover, most virological testing of LCTF residents is reactive and is triggered by a resident meeting selected surveillance criteria. We report on incidental findings from a prospective trial of introducing rapid influenza diagnostic testing (RIDT) in ten Wisconsin LTCFs over a two-year period with an approach of testing any resident with ARI.MethodsAny resident with new onset of respiratory symptoms consistent with ARI had a nasal swab specimen collected for RIDT by nursing staff. Following processing for RIDT (Quidel Sofia Influenza A+B FIA), the residual swab was placed into viral transport medium and forwarded to the Wisconsin State Laboratory of Hygiene and tested for influenza using RT-PCR (IVD CDC Human Influenza Virus Real-Time RT-PCR Diagnostic Panel), and for 17 viruses (Luminex NxTAG Respiratory Pathogen Panel [RPP]). The numbers of viruses in each of 7 categories [influenza A (FluA ), influenza B (FluB), coronaviruses (COR), human metapneumovirus (hMPV), parainfluenza (PARA), respiratory syncytial virus (RSV) and rhinovirus/enterovirus (R/E)], across the two years were compared using chi-square.ResultsTotals of 164 and 190 specimens were submitted during 2016-2017 and 2017-2018, respectively. RPP identified viruses in 56.2% of specimens, with no difference in capture rate between years (55.5% vs. 56.8%). Influenza A (21.5%), influenza B (16.5%), RSV (19.0%) and hMPV (16.5%) accounted for 73.5% of all detections, while coronaviruses (15.5%), rhino/enteroviruses (8.5%) and parainfluenza (2.5%) were less common. Specific distribution of viruses varied significantly across the two years (Table: X2=48.1, df=6; p<0.001).ConclusionsSurveillance in LTCFs using nasal swabs collected for RIDT is highly feasible and yields virus identification rates similar to those obtained in clinical surveillance of ARI with collection of nasopharyngeal specimens by clinicians and those obtained in a school-based surveillance project of ARI with collection of combined nasal and oropharyngeal specimens collected by trained research assistants. Significant differences in virus composition occurred across the two study years. RSV varied little between years while hMPV demonstrated wide variation. Simple approaches to surveillance may provide a more comprehensive assessment of respiratory viruses in LTCF settings.References(1) Uršič T, Gorišek Miksić N, Lusa L, Strle F, Petrovec M. Viral respiratory infections in a nursing home: a six-month prospective study. BMC Infect Dis. 2016; 16: 637. Published online 2016 Nov 4. doi: 10.1186/s12879-016-1962-8(2) Masse S, Capai L, Falchi A. Epidemiology of Respiratory Pathogens among Elderly Nursing Home Residents with Acute Respiratory Infections in Corsica, France, 2013–2017. Biomed Res Int. 2017; 2017: 1423718. Published online 2017 Dec 17. doi: 10.1155/2017/1423718

Download Full-text

Viral Etiology of Acute Respiratory Infections in Pediatric Patients in Lebanon

Mediterranean Journal of Hematology and Infectious Diseases ◽

10.4084/mjhid.2019.059 ◽

2019 ◽

Vol 11 (1) ◽

pp. e2019059

Author(s):

Khaldoun Masoud ◽

Ghassan Matar ◽

Ghassan Dbaibo ◽

Geoarge F Araj ◽

Hasan Zaraket ◽

...

Keyword(s):

High Frequency ◽

Pediatric Patients ◽

Respiratory Infections ◽

Respiratory Viruses ◽

Coxsackie Virus ◽

Acute Respiratory Infections ◽

Viral Etiology ◽

Pcr Assay ◽

Viral Pathogens ◽

Parainfluenza Viruses

Background: Acute respiratory infections (ARI) are the leading cause of death worldwide especially among children. The majority of these infections in children are of viral etiology. In this study, we evaluated the incidence of viral ARI among children in Lebanon. Methods: Children presenting with symptoms of ARI were prospectively recruited between September 2009 to February 2012. Nasopharyngeal aspirates were obtained from patients and screened for 11 respiratory viruses using a multiplex Luminex-based PCR assay. Results: Two hundred twenty-one patients were recruited with a median age of 1 year (IQR: 0 - 5). Out of 221 patients, 116 (52.5%) were positive for at least one virus, the majority (103/116; 88.8%) of which were in children under 6-year of age. Overall 188 viruses were detected. Rhinovirus (RhV) was the most common virus detected in 81 (69.8%) patients followed by coxsackie virus and echovirus (CVEV) which were detected as one target in the panel in 45 (38.8%), and parainfluenza viruses (PIV types: 1, 2, 3, 4) in 24 (20.7%) patients. Coinfection with more than one virus was detected in 49 (42.9%) patients. RhV and CVEV were the most common viruses associated with co-infections and higher risk of rhinorrhea. Conclusion: Viral pathogens account for at least half of the ARIs in Lebanon, with a high frequency of co-infections being detected.

Download Full-text

Detection and Differentiation of SARS-CoV-2, Influenza, and Respiratory Syncytial Viruses by CRISPR

Diagnostics ◽

10.3390/diagnostics11050823 ◽

2021 ◽

Vol 11 (5) ◽

pp. 823

Author(s):

Huifen Zhou ◽

Jen-Hui Tsou ◽

Molangur Chinthalapally ◽

Hongjie Liu ◽

Feng Jiang

Keyword(s):

Early Detection ◽

Influenza A ◽

Respiratory Infections ◽

Limit Of Detection ◽

Respiratory Viruses ◽

Cross Reaction ◽

Sensitive Detection ◽

Acute Respiratory Infections ◽

Prevention And Treatment ◽

Respiratory Syncytial Viruses

SARS-CoV-2, influenza, and respiratory syncytial viruses (RSVs) cause acute respiratory infections with similar symptoms. Since the treatments and outcomes of these infections are different, the early detection and accurate differentiation of the viruses are clinically important for the prevention and treatment of the diseases. We previously demonstrated that clustered regularly interspaced short palindromic repeats (CRISPR) could rapidly and precisely detect SARS-CoV-2. The objective of this study was to develop CRISPR as a test for simultaneously detecting and accurately distinguishing the viruses. The CRISPR assay with an RNA guide against each virus was performed in the reference standards of SARS-CoV-2, influenza A and B, and RSV. The CRISPR assay had a limit of detection of 1–100 copies/µL for specifically detecting SARS-CoV-2, influenza A and B, and RSV without cross-reaction with other respiratory viruses. The validation of the test in nasopharyngeal specimens showed that it had a 90–100% sensitivity and 100% specificity for the detection of SARS-CoV-2, influenza A and B, and RSV. The CRISPR assay could potentially be used for sensitive detection and specific differentiation of the respiratory viruses.

Download Full-text

Prevalence and Genetic Characteristics of Human Bocaviruses Detected in Patients with Acute Respiratory Infections in Bulgaria

International Journal of Microbiology ◽

10.1155/2021/7035081 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Neli Korsun ◽

Svetla Angelova ◽

Ivelina Trifonova ◽

Silvia Voleva ◽

Iliana Grigorova ◽

...

Keyword(s):

Amino Acid ◽

Influenza A ◽

Respiratory Infections ◽

Single Agent ◽

Respiratory Viruses ◽

Acute Respiratory Infections ◽

Vp2 Gene ◽

Genetic Characteristics ◽

Influenza A H1n1 ◽

Syncytial Virus

Нuman bocaviruses (hBoVs) are often associated with acute respiratory infections (ARIs). Information on the distribution and molecular epidemiology of hBoVs in Bulgaria is currently limited. The objectives of this study were to investigate the prevalence and genetic characteristics of hBoVs detected in patients with ARIs in Bulgaria. From October 2016 to September 2019, nasopharyngeal/oropharyngeal swabs were prospectively collected from 1842 patients of all ages and tested for 12 common respiratory viruses using a real-time RT-PCR. Phylogenetic and amino acid analyses of the hBoV VP1/VP2 gene/protein were performed. HBoV was identified in 98 (5.3%) patients and was the 6th most prevalent virus after respiratory-syncytial virus (20.4%), influenza A(H1N1)pdm09 (11.1%), A(H3N2) (10.5%), rhinoviruses (9.9%), and adenoviruses (6.8%). Coinfections with other respiratory viruses were detected in 51% of the hBoV-positive patients. Significant differences in the prevalence of hBoVs were found during the different study periods and in patients of different age groups. The detection rate of hBoV was the highest in patients aged 0–4 years (6.9%). In this age group, hBoV was the only identified virus in 9.7%, 5.8%, and 1.1% of the children diagnosed with laryngotracheitis, bronchiolitis, and pneumonia, respectively. Among patients aged ≥5 years, hBoV was detected as a single agent in 2.2% of cases of pneumonia. Phylogenetic analysis showed that all Bulgarian hBoV strains belonged to the hBoV1 genotype. A few amino acid substitutions were identified compared to the St1 prototype strain. This first study amongst an all-age population in Bulgaria showed a significant rate of hBoV detection in some serious respiratory illnesses in early childhood, year-to-year changes in the hBoV prevalence, and low genetic variability in the circulating strains.

Download Full-text