Introduction: Human adenoviruses (HAdV) play an important role in the aetiology of severe acute lower respiratory infection, especially in immunocompromised individuals. The aim of the present study was to detect HAdV using two different methods, direct fluorescence assay (DFA) and nested polymerase chain reaction (nested PCR), in samples collected from patients with acute respiratory infection (ARI) within 7 days of symptom onset. Methods: Samples (n=643) were collected from patients in different risk groups from 2001 to 2010: 139 adult emergency room patients (ERP); 205 health care workers (HCW); 69 renal transplant outpatients (RTO); and 230 patients in a haematopoietic stem cell transplantation program (HSCT). Results: Adenovirus was detected in 13.2% of the 643 patients tested by DFA and/or PCR: 6/139 (4.3%) adults in the ERP group, 7/205 (3.4%) in the HCW group, 4/69 (5.8%) in the RTO group and 68/230 (29.5%) in the HSCT patient group. Nested PCR had a higher detection rate (10%) compared with the DFA test (3.8%) (p<0.001). HSCT patients exhibited a significantly higher rate of HAdV infection. Conclusions: The adenovirus detection rate of the nested PCR assay was higher than that of the DFA test. However, the use of molecular methods in routine diagnostic laboratory work should be evaluated based on the specific circumstances of individual health services.
Pandemic H1N1 2009 influenza virus had disseminated globally after being identified in Mexico and the United States in April. The H1N1 2009 morbidity and mortality were particularly severe in Brazil during the first pandemic wave. H1N1 2009 has been associated with a higher severity rate among some risk groups and young adults than seasonal influenza. 1 The frequency of viral coinfections with seasonal or pandemic Infuenza A and clinical correlation is not well known.The purpose of this study was to investigate coinfection of confirmed influenza A and other respiratory virus in samples collected from hospitalized patients during the first pandemic wave in a Brazilian Sentinel Hospital.We conducted a retrospective study including inpatients at the Universidade de São Paulo Hospital, São Paulo City, Brazil from August 19 to November 31, 2009. A total of 159 nasal/ throat swab samples were collected from enrolled patients. Patient inclusion criteria were fever plus cough plus dyspnea plus hospitalization due to clinical suspicion of H1N1 2009 infection, according to the National Program Protocol. Viral RNA were extracted using QIAamp Viral RNA extraction Kit (QIAGEN -Germany) and DNA using QIAamp DNA B l o o d K i t ( Q I A G E N -G e r m a n y ) , a c c o r d i n g t o t h e manufacturer's instructions. Influenza A seasonal (IAV) and H1N1 2009 detections were performed following the real time protocol published by the CDC. Seasonal influenza virus B (IBV), human rhinovirus (HRV), human metapneumovirus (hMPV), adenovirus (AdV), human respiratory syncytial virus (HRSV) and human coronavirus ( H C o V ) d e t e c t i o n s w e r e p e r f o r m e d a s p r e v i o u s l y described. [2][3][4][5][6][7][8] Demographic, clinical, laboratory and radiologic data were obtained from medical records. Nosocomial acquisition of the H1N1 2009 was defined as an onset of illness after more than 72 hours of hospital admission.Descriptive statistics consisted of the characterization of the studied individuals and the assessment of coinfection through calculation of the respective median value and range. Chi-squared test was used in univariate analysis comparing
Influenza A coinfections with other respiratory viruses were investigated in 25.8% (41/159) of the samples from patients hospitalized in 2009 at our University Hospital. Out of the 41 influenza A cases, nine cases (21.9%) were coinfected with other viruses, with a similar frequency among children and adults (p = 0.47), and seasonal influenza cases were more prevalent than H1N1 2009 influenza virus. Adenovirus was the most frequently detected (4/9) among coinfected cases. Coinfection was not associated with higher morbidity or mortality (p = 0.75).
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