Abstract
Respiratory syncytial virus (RSV) is the leading cause of hospitalization especially in young children with respiratory tract infections (RTI). Patterns of circulating RSV genotypes can provide a better understanding of the molecular epidemiology of RSV infection. We retrospectively analyzed the genetic diversity of RSV infection in hospitalized children with acute RTI admitted to University Hospital Heidelberg/Germany between October 2012 and April 2013. Nasopharyngeal aspirates (NPA) were routinely obtained in 240 children younger than 2 years of age who presented with clinical symptoms of upper or lower RTI. We analyzed NPAs via PCR and sequence analysis of the second variable region of the RSV G gene coding for the attachment glycoprotein. We obtained medical records reviewing routine clinical data. RSV was detected in 134/240 children. In RSV-positive patients the most common diagnosis was bronchitis/bronchiolitis (75.4%). The mean duration of hospitalization was longer in RSV-positive compared to RSV-negative patients (3.5 vs. 5.1 days; p<0.01). RSV-A was detected in 82.1%, RSV-B in 17.9% of all samples. Phylogenetic analysis of 112 isolates revealed that the majority of RSV-A strains (65%) belonged to the novel ON1 genotype containing a 72-nucleotide duplication. However, genotype ON1 was not associated with a more severe course of illness when taking basic clinical/laboratory parameters into account. Molecular characterization of RSV confirms the co-circulation of multiple genotypes of subtype RSV-A and RSV-B. The duplication in the G gene of genotype ON1 might have an effect on the rapid spread of this emerging RSV strain.
Highlights
Respiratory syncytial virus (RSV) is the major pathogen of lower respiratory tract infections (RTI) in infants and young children
Detection of RSV Between October 2012 and April 2013, a total of 242 samples from hospitalized infants and children were analyzed for RSV infection by PCR resulting in 134 (55.4%) RSV-positive samples
RSV accounts for a significant burden of acute respiratory tract infections in infants and young children in need for hospital care [30]
Summary
Respiratory syncytial virus (RSV) is the major pathogen of lower respiratory tract infections (RTI) in infants and young children. By the age of 2 years, virtually all children have been infected at least once with RSV [1]. Strain variation is thought to contribute to its ability to cause frequent re-infections [3] enabling RSV to remain present at high levels in the population [4]. The main differences between RSV-A and RSVB are found in the attachment (G) glycoprotein [7]. The G protein is a type II surface glycoprotein of about 300 amino acids in length, consisting of a cytoplasmic domain, a transmembrane domain and an ectodomain. The amino acid sequence positions of potential glycosylation sites are poorly conserved [8]
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