Emergence of Community-Acquired Adenovirus Type 55 as a Cause of Community-Onset Pneumonia

Abstract

HAdV-55 has established itself as a major pneumonia pathogen in the Chinese population, and further surveillance and monitoring of this agent as a cause of CAP is warranted.

Real-time Utilization of Metagenomic Sequencing in the Diagnosis and Treatment Monitoring of an Invasive Adenovirus B55 Infection and Subsequent Herpes Simplex Virus Encephalitis in an Immunocompetent Young Adult

“…Of note, our patient is also a heavy smoker. In most severe and fatal cases, patients start with a sudden onset of respiratory distress that progresses rapidly to respiratory failure, often with imaging showing “lobar pneumonia.” Many patients infected with HAdV-B55, including ours, also had viremia [6, 7, 13]. In 1 study, higher initial HAdV-B55 viral load in the respiratory tract and sustained viremia (more than 2 weeks) were found to be associated with poor outcomes [7].…”

“…Worldwide, although HAdV-B14 and -B11 have caused many outbreaks in Asia, Europe, and the United States, especially among military populations [18–20], HAdV-B55 outbreaks were almost exclusively reported in China. Clinically, HAdV-B55 seems to be highly pathogenic, with numerous fatal cases reported in immunocompetent young patients [6, 7, 13]. Most fatal cases have been reported in males, but no clear risk factors have been identified.…”

“…For treatment, because cidofovir, the firstline drug for adenovirus infection, is not currently available in China, acyclovir, ganciclovir, and ribavirin have all been utilized to treat HAdV-B55 infection [7, 13], although the efficacy of each antiviral drug could not be assessed due to the limited number of patients and lack of a controlled study [8, 9]. In our case, we treated the patient with ribavirin combined with immunoglobulin (4 days) and then thymosin (14 days).…”

“…Interestingly, drug-resistant A. baumannii nosocomial infection has often been reported in severe HAdV-B55 infection–related cases in China [6, 13], resulting in at least 1 reported death directly related to the bloodstream infection by this bacterium [13]. In our case, the patient also developed ventilation-associated nosocomial infection by a pan-drug-resistant A. baumannii and had to be treated with combination antibiotic therapy for a prolonged time (17 days).…”

Outbreak of acute febrile respiratory illness caused by human adenovirus B P14H11F14 in a military training camp in Shandong China

“…When the computational genomic analysis method was used in 2010 by Walsh et al, the results showed that within the context of the molecular evolution of HAdV, this pathogen is a novel adenoviral type and should be designated HAdV-B55 [P14H11F14] [14]. According to a previous study, HAdV-55 has become a major causative agent of acute severe pneumonia in the Chinese population [15].…”