Viruses are the major contributors to the morbidity and mortality of upper and lower
acute respiratory infections (ARIs) for all age groups. The aim of this study was to
determine the frequencies for a large range of respiratory viruses using a sensitive
molecular detection technique in specimens from outpatients of all ages with ARIs.
Nasopharyngeal aspirates were obtained from 162 individuals between August
2007-August 2009. Twenty-three pathogenic respiratory agents, 18 respiratory viruses
and five bacteria were investigated using multiplex real-time reverse transcriptase
polymerase chain reaction (RT-PCR) and indirect immunofluorescence assay (IIF).
Through IIF, 33 (20.4%) specimens with respiratory virus were recognised, with
influenza virus representing over half of the positive samples. Through a multiplex
real-time RT-PCR assay, 88 (54.3%) positive samples were detected; the most prevalent
respiratory viral pathogens were influenza, human rhinovirus and respiratory
syncytial virus (RSV). Six cases of viral co-detection were observed, mainly
involving RSV. The use of multiplex real-time RT-PCR increased the viral detection by
33.9% and revealed a larger number of respiratory viruses implicated in ARI cases,
including the most recently described respiratory viruses [human bocavirus, human
metapneumovirus, influenza A (H1N1) pdm09 virus, human coronavirus (HCoV) NL63 and
HCoV HKU1].
publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. braz j infect dis 2 0 1 8;2 2(5):402-411 Pediatric intensive care unit Severe acute respiratory infection (SARI) Child a b s t r a c t Objectives: The role of viral co-detection in children with severe acute respiratory infection is not clear. We described the viral detection profile and its association with clinical characteristics in children admitted to the Pediatric Intensive Care Unit (PICU) during the 2009 influenza A(H1N1) pandemic. Method: Longitudinal observational retrospective study, with patients aged 0-18 years, admitted to 11 PICUs in Rio de Janeiro, with suspected H1N1 infection, from June to November, 2009. The results of respiratory samples which were sent to the Laboratory of Fiocruz/RJ and clinical data extracted from specific forms were analyzed. Results: Of 71 samples, 38% tested positive for H1N1 virus. Of the 63 samples tested for other viruses, 58 were positive: influenza H1N1 (43.1% of positive samples), rhinovirus/enterovirus (41.4%), respiratory syncytial vírus (12.1%), human metapneumovirus (12.1%), adenovirus(6.9%), and bocavirus (3.5%). Viral codetection occured in 22.4% of the cases. H1N1-positive patients were of a higher median age, had higher frequency of fever, cough and tachypnea, and decreased leukometry when compared to H1N1-negative patients. There was no difference in relation to severity outcomes (number of organic dysfunctions, use of mechanical ventilation or amines, hospital/PICU length of stay or death). Comparing the groups with mono-detection and co-dection of any virus, no difference was found regarding the association with any clinical variable.
Conclusions: Other viruses can be implicated in SARI in children. The role of viral codetectionhas not yet been completely elucidated.
After the World Health Organization officially declared the end of the first pandemic
of the XXI century in August 2010, the influenza A(H1N1)pdm09 virus has been
disseminated in the human population. In spite of its sustained circulation, very
little on phylogenetic data or oseltamivir (OST) resistance is available for the
virus in equatorial regions of South America. In order to shed more light on this
topic, we analysed the haemagglutinin (HA) and neuraminidase (NA) genes of influenza
A(H1N1)pdm09 positive samples collected during the pandemic period in the Pernambuco
(PE), a northeastern Brazilian state. Complete HA sequences were compared and amino
acid changes were related to clinical outcome. In addition, the H275Y substitution in
NA, associated with OST resistance, was investigated by pyrosequencing. Samples from
PE were grouped in phylogenetic clades 6 and 7, being clustered together with
sequences from South and Southeast Brazil. The D222N/G HA gene mutation, associated
with severity, was found in one deceased patient that was pregnant. Additionally, the
HA mutation K308E, which appeared in Brazil in 2010 and was only detected worldwide
the following year, was identified in samples from hospitalised cases. The resistance
marker H275Y was not identified in samples tested. However, broader studies are
needed to establish the real frequency of resistance in this Brazilian region.
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