Incidence Of Adenovirus Research Articles

Impact of the coronavirus disease 2019 pandemic on the incidence of other infectious diseases in the hematology hospital in Korea.

Since the coronavirus disease 2019 (COVID-19) outbreak, hospitals have implemented infection control measures to minimize the spread of the virus within facilities. This study aimed to investigate the impact of COVID-19 on the incidence of healthcare-associated infections (HCAIs) and common respiratory virus (cRV) infections in hematology units. This retrospective study included all patients hospitalized in Catholic Hematology Hospital between 2019 and 2020. Patients infected with vancomycin-resistant Enterococci (VRE), carbapenemase-producing Enterobacterales (CPE), Clostridium difficile infection (CDI), and cRV were analyzed. The incidence rate ratio (IRR) methods and interrupted time series analyses were performed to compare the incidence rates before and after the pandemic. The incidence rates of CPE and VRE did not differ between the two periods. However, the incidence of CDI increased significantly (IRR: 1.41 [p = 0.002]) after the COVID-19 pandemic. The incidence of cRV infection decreased by 76% after the COVID-19 outbreak (IRR: 0.240 [p < 0.001]). The incidence of adenovirus, parainfluenza virus, and rhinovirus infection significantly decreased in the COVID-19 period (IRRs: 0.087 [p = 0.003], 0.031 [p < 0.001], and 0.149 [p < 0.001], respectively). The implementation of COVID-19 infection control measures reduced the incidence of cRV infection. However, CDI increased significantly and incidence rates of CPE and VRE remained unchanged in hematological patients after the pandemic. Infection control measures suitable for each type of HCAI, such as stringent hand washing for CDI and enough isolation capacities, should be implemented and maintained in future pandemics, especially in immunocompromised patients.

Molecular epidemiological study of adenovirus causing acute respiratory infection in children in Hebei Province

Objective To analyze the molecular epidemiology of adenovirus (ADV) causing acute respiratory diseases and to investigate the mixed infection of ADV and other respiratory pathogens in Hebei Province. Methods Sputum samples were collected from inpatient children with acute respiratory diseases at Children′s Hospital of Hebei Province between June 2017 and May 2018. Multiplex reverse transcription PCR assay was used to detecte 13 kinds of respiratory pathogens. Nested PCR was performed to amplify ADV hexon gene and the amplified products were then sequenced. Results A total of 353 ADV-positive specimens were detected in 8 839 specimens with a positive rate of 3.99%. Significant difference in the positive rate of ADV was not observed between male and female patients (χ2=0.000 3, P=0.99), but found among different age groups (χ2=115.69, P<0.001). All isolated ADV strains belonged to 11 serotypes, which were type 1 (16.15%, 57/353), type 2 (35.98%, 127/353), type 3 (21.25%, 75/353), type 4 (1.13%, 4/353), type 5 (11.33%, 40/353), type 6 (3.97%, 14/353), type 7 (8.22%, 29/353), type 31 (0.28%, 1/353), type 41 (0.28%, 1/353), type 55 (0.28%, 1/353) and type 57 (1.13%, 4/353). Among the 353 ADV-positive specimens, 259 were mixed infections mainly caused by ADV and human rhinovirus (35.52%). ADV and respiratory syncytial virus co-infections accounted for 12.74% and 33.20% of the mixed infections involved three or more pathogens. ADV could be detected throughout the year, especially in September and April to May. The predominant serotypes were types 1, 2 and 3. The average ages of the two groups of ADV infection alone and ADV mixed infection were (27.56±24.67) months and (21.33 ±20.28) months, respectively, and the difference between them was statistically significant (P=0.037). The incidence of ADV 2 infection alone was 25.77% (25/97), which was lower than that of ADV 2-involved mixed infection [39.84% (102/256), χ2=6.05, P=0.014]. However, the rate of ADV 7 infection alone was significantly higher than that of ADV 7-involved mixed infection [16.49% 16/97) vs 5.08% (13/256), χ2=6.05, P<0.001]. Conclusion ADV 1, ADV 2 and ADV 3 were the predominant serotypes circulating in Hebei Province from June 2017 to May 2018, especially in September and April to May. The younger the patients were, the higher the incidence would be. ADV 2 was prone to cause mixed infections with other respiratory pathogens, while ADV 7 was less common in mixed infections. Younger patients were more susceptible to mixed infections. The most common co-infection was caused by ADV and human rhinovirus. Key words: Adenovirus; Children; Molecular epidemiology; Mixed infection

Adenovirus and BK Virus Co-Infection in the Pediatric Recipient of Stem Cell Transplant with CMV Infection.

Background: Viral infections are a common cause of complication following hemopoietic stem cell transplantation (HSCT). Cytomegalovirus (CMV) is known to be a concerning pathogen and most transplant centers have implemented CMV monitoring as a standard of care. With improvement of virological diagnostic methods, the role of other viruses including adenovirus (ADV) and polyomaviruses (PMV) as pathogens causing major infection are also increasingly appreciated, however, evidence to support routine monitoring of these viruses following HSCT is lacking. In addition, there is a paucity of data on the incidence of ADV and/or PMV co-infection in children who develop CMV infection following HSCT. The aim of this study was to uncover the incidence of CMV and ADV or PMV co-infection in pediatric recipients of allogeneic- HSCT and to correlate the finding with degree of CMV viremia.Methods: We retrospectively performed Q-RT- PCR of ADV, BKV and JCV in 219 blood samples from 77 pediatric patients following allogeneic- HSCT, initially taken for quantitative real-time PCR of CMV (monthly post engraftment, as a routine CMV monitoring, or weekly if CMV syndrome was suspected). These patients were known to have varying degree of CMV viremia.We defined high graded, low to moderate graded and undetectable CMV viremia as CMV viral load > 10,000, 400-< 10,000 and < 400 copies/ml.The lower limit of viral load detection is 400 and 10 copies/ml for CMV and for ADV, BKV and JCV.Results: Twenty-eight patients (36%) had CMV viremia, of which were high graded (peak viral load 32,000->100,000 copies/ml) in 13 patients (17%), in at least one moment of follow up. Twelve patients (15%) had ADV viremia, whereas 40 (52%) had BKV viremia. ADV and BKV viremia occurred in 3 (23%) and 10 (77%) of patients with high-graded CMV viremia and they were mostly high graded (ADV and BKV peak viral load 11,400–367,000 and 10–2,120 copies/ml). In patients with non-high graded CMV viremia, most of them had lower graded ADV and BKV viremia (peak viral load 1,830–14,800 and 10–441 copies/ml), except for one patient who had ADV viral load 3,140,000 copies/ml and BKV viral load of 10 copies/ml. Five patients (6.5%) had CMV, ADV and BKV co-viremia, which were most frequent in patients with high-graded CMV viremia (15%).Two patients (2.5%) had very low JCV viremia (viral load 10 and 13 copies/ml). See Table for summarized results.Conclusion: In pediatric allogeneic HSCT, CMV, BKV and ADV infection is common. High-graded, BKV, ADV or BKV and ADV co-viremia occurred most frequently in patients with high-graded CMV viremia. Low-graded BKV and ADV viremia mostly occurred in patient without high-graded CMV viremia. JCV viremia was not common and occurred irrespective of CMV infection. From our study, monitoring of ADV and BKV should be considered in patients with high-graded CMV viremia following pediatric allogeneic HSCT.CMV viral load (copies/ml)>10,000400- <10,000< 400Number of patients (%)Total patientsCytomegalovirus13(17%)15(19%)49(64%)77(100%)Adenovirus3(23%)1(6%)8(16%)12(15%)BK virus10(77%)3(23%)27(55%)40(52%)JC virus002(4%)2(2.5%)Adenovirus and BK virus2(15%)1(6%)2(4%)5(6.5%)

Incidence of Adenovirus and BK Virus Reactivation and Diseases Following Reduced-Intensity Cord Blood Transplantation for Adult Patients.

Background Late-onset hemorrhagic cystitis (HC) is a common viral infections after allogeneic hematopoietic stem cell transplantation (HSCT). Most cases of HC occurring after HSCT are self-limited, but they can cause pain, pollakiuria, and prolonged hospitalization. In cases with progression of HC, ureteral stenosis has occurred and occasionaly resulted in obstructive renal failure. Several risk factors associated with HC after bone marrow transplantation(BMT) and peripheral blood stem cell transplantation(PBSCT) have been reported in several studies. However, most of these risk factors for HC after cord blood transplantation(CBT) have not been observed in detail.Subjects and methods We retrospectively analyzed the clinical records of 461 patients who underwent HSCT at Toranomon Hospital between November 2002 and December 2006. Median age of the patients was 53 years (range 17– 79). Source of HSCT was peripheral blood (PB) in 79 patients (17%), cord blood (CB) in 281 patients (61%), bone marrow (BM) in 101 patients (22%). Underlying diseases were AML(n= 146), ALL(n=61), MDS(n=68), ATL(n=34), CML(n=8), NHL (n=109), other(n=35). The most frequently used conditioning regimens were fludarabine (Flu), alkylating agent (melphalan, busulfan or cyclophosphamide) with total body irradination (TBI).The most frequently used prophylaxis regimens for graft-versus-host disease (GVHD) were calcineurin inhibitor (CI) alone or CI plus methotrexate. HC was defined as the presence of sustained microscopic hematuria for more than 7 days at least 10 days after HSCT in the absence of other conditions such as gynecologic-related bleeding, multiple organ dysfunction, or sepsis. HC was graded according to the following criteria: grade0 = no HC, grade1 = microscopic hematuria, grade2 = macroscopic hematuria, grade3 = macroscopic hematuria with clots, grade4 = macroscopic hematuria requiring instrumentation for clot evacuation or causing urinary retention. BK virus and adenovirus were detected by PCR on urinary samples in all patients who developed HC.Results Overall, 73 patients (16%) developed HC. The median day of presentation was 55 days (range 10 to 505 days). HC cases were graded as follows: grade 1 (8%), grade 2 (64%), grade 3 (24%), grade 4 (4%). The following variables were associated with a higher incidence of HC: CB source vs BM vs PB (14.2% vs 19.8% vs 16.5%, p<0.01). Adenovirus was detected in 27 patients (ADV type11 in 16 patients). BK virus was detected in 42 patients. Both virus was detected in 9 patients. The incidence of HC was significantly associated with grade II to IV acute GVHD in CBT (p<0.01).Conclusion We concluded that there is no significant disparity in the rate of HC among CBT and other HSCT, and immune reconstitution in parallel with BK and adenovirus viruria after CBT stand comparison with other HSCT.

Adenovirus Isolation Post Blood and Marrow Transplant (BMT) in Australia and New Zealand- Results of a 4 Year Clinical Multi -Institutional Prospective Cohort Study.

Adenovirus (AdV) infection is an important cause of morbidity and mortality post BMT in both children and adults. The incidence of AdV in retrospective or single-centre prospective studies is reported between 4.9% and 41%. There are no published multi-institutional prospective clinical studies. We conducted a prospective cohort study from January 2001 to December 2004 in Australia and New Zealand for allogeneic and autologous BMT in children and adults, to find the incidence of AdV and disease post BMT and confirm risk factors for developing AdV.The 37 centres involved in the study completed a brief questionnaire every month to capture all recognized cases of AdV, and were periodically contacted to collect detailed data on patients who had AdV post transplant. The centres did not change their current practice of surveillance for AdV for this study. No centres were prospectively monitoring for adenoviraemia by polymerase chain reaction (PCR) in blood.We found an overall incidence of AdV disease or infection of 52/3468 (1.5%; 95% Confidence Interval [CI] 1.1 to 2.0), with 46/596, (7.7%; CI 5.7 to 10.2) in the paediatric population and 6/2872 (0.21%; CI 0.1 to 0.45) in the adult population. Although only 596/3468 (17%) of transplants were performed in children, 48% (CI 39 to 69) of all patients with AdV infection were 5 years of age or under. Using the established criteria1 of 52 patients with AdV infection, 14 had definite adenoviral disease and 27 probable adenoviral disease. Four (7.6%) patients died of adenovirus, two of multi-organ failure, one of liver failure and one of pneumonitis.There was a greater risk of developing AdV with an allogeneic transplant than an autologous transplant (RR 9.48, CI 4.2 to 20.9 p<0.001). In autologous transplants none of 1795 adults and only 7 of the 272 children had AdV.Children who had an allogeneic transplant with a T cell depleted graft were at greater risk of developing AdV than those with a T cell replete graft (RR 2.2, CI 1.20 to 4.1, p=0.02) as were those who had an unrelated compared to a related donor (RR 1.99, CI 1.02 to 3.85, p=0.05). Unrelated cord BMT compared to other unrelated transplants was not a statistically significant risk factor for developing AdV in this study (RR 1.1 CI 0.55 to 2.14 p = 0.98).The median day of detection of an AdV isolate for all patients was day 38 post transplant. However, there was a biphasic pattern, with 23.4% of all patients having the first AdV isolate identified greater than Day 100. 38.5% (CI 25.3– 53.0) of patients had isolation of AdV in more than one site. The most common site of an isolate was the gastrointestinal tract in 71% of patients, followed by positive blood PCR in 25%. 31 out of the 52 patients with AdV had another virus isolated apart from AdV; in 15 out of these 31 patients this virus was CMV, either reactivation or CMV disease.This prospective population-based study confirms the importance of AdV in BMT, particularly in paediatric T cell depleted unrelated donor BMT and highlights the occurrence of AdV infection greater than 100 days after transplant.

Incidence of adenoviruses in raw and treated water

Adenoviruses are of major public health importance and are associated with a variety of clinical manifestations, i.e. gastroenteritis, eye infections and respiratory infections. The importance of water in the epidemiology of adenoviruses and the potential health risks constituted by adenoviruses in water sources and supplies are widely recognised. This study was conducted to assess the incidence of human adenoviruses in raw and treated water systems. Various raw and treated water were routinely monitored for the presence of adenoviruses, over a 1-year period (July 2000–June 2001). The supplies were derived from acceptable quality surface water sources using treatment processes, which conform to international standards for the production of safe drinking water. Adenoviruses were detected by firstly amplifying the viruses in cell cultures and then amplifying the extracted nucleic acids of these viruses using molecular techniques (nested PCR). The results indicated human adenoviruses present in 13 (12.75%) of the raw and 9 (4.41%) of the treated water samples tested. The combination of cell culture and nested PCR has proved to be a quick and reliable method for the detection of adenoviruses in water environments.

Incidence of adenovirus and respiratory syncytial virus in chronic otitis media with effusion using the polymerase chain reaction

The aim of this study is to investigate the role of adenovirus and respiratory syncytial virus in the cause of chronic otitis media with effusion by use of the polymerase chain reaction for detection. The polymerase chain reaction has proved to be more sensitive and specific than viral cultures and immunoassays in the detection of viruses in other specimens. Adenovirus and respiratory syncytial virus were chosen because these viruses have been the most commonly isolated viruses in middle ear effusions in studies using other techniques. The effusions (132 total) were sterilely collected from 88 children undergoing myringotomy and ventilation tube placement for chronic otitis media with effusion. Nine (6.8%) specimens were positive for adenovirus by the polymerase chain reaction, and 13 (9.9%) were positive for respiratory syncytial virus by the polymerase chain reaction. Only one specimen was positive for adenovirus and respiratory syncytial virus by viral culture and immunofluorescence, respectively. Our results show that the polymerase chain reaction can be used to detect adenovirus and respiratory syncytial virus in chronic middle ear effusions and that PCR is more sensitive than viral culture and immunofluorescence techniques. (OTOLARYNGOL HEAD NECK SURG 1995;113: 234-41.)