Respiratory Tract Infections In China Research Articles

Sub-Inhibitory Concentrations of Sodium Houttuyfonate in Combination with Erythromycin Inhibit Biofilm Formation and Expression of IcaA in Staphylococcus epidermidis

Background: Staphylococcus epidermidis is an important opportunistic pathogenic bacterium causing infections on implanted medical devices by biofilm formation. Sodium houttuyfonate (SH), which is the active modified compound of Houttuynia cordata is commonly applied for treating chronic bronchitis, purulent skin infections, and respiratory tract infections in China. Objectives: We aimed to investigate the in vitro effects of SH in combination with erythromycin on the production of IcaA and expression of icaA to shed the light on the mechanism of SH and erythromycin in inhibiting biofilm formation of S. epidermidis. Methods: The morphology of the biofilm of S. epidermidis was examined under a scanning electron microscope. Furthermore, inhibitory effects of SH and erythromycin on the production of IcaA and the expression of icaA were detected by Western blotting and quantitative reverse transcription PCR, respectively. Results: First, the morphological results indicated that combing SH and erythromycin at sub-MIC concentrations can effectively inhibit biofilm formation of S. epidermidis. Furthermore, our presented results showed that combing SH and erythromycin at sub-MIC concentration can significantly downregulate the expression of icaA and repress the protein production of IcaA at irreversible attachment and maturation stages of biofilm formation of S. epidermidis. Conclusions: Therefore, our findings suggest that the potent antibiofilm activity of SH in combination with erythromycin against S. epidermidis may be partially due to inactivation of icaA.

ATYPICAL ATYPICALS: TWO CASES OF MACROLIDE-RESISTANT MYCOPLASMA PNEUMONIAE INFECTIONS

SESSION TITLE: Monday Fellow Case Report Posters SESSION TYPE: Fellow Case Report Posters PRESENTED ON: 10/21/2019 02:30 PM - 03:15 PM INTRODUCTION: Mycoplasma pneumoniae pneumonia is self-limiting in most cases, and is usually treated with macrolide antibiotics. However, macrolide resistance is increasingly recorded especially in South East Asia, where prevalence has been reported to be as high as 90%. The following cases describe two patients at a U.S. hospital who had severe community-acquired M. pneumoniae pneumonia (CAP) that did not respond to macrolide therapy. CASE PRESENTATION: Patient 1: A 45-year-old female was admitted to the hospital with acute hypoxemic respiratory failure and a left lower lobe pneumonia on imaging. She reported a week of respiratory symptoms, which had been treated with amoxicillin-clavulanate without improvement. The serum Mycoplasma IgM antibody titer was elevated (4.89, threshold 0.91) on admission. Patient 2: A 74-year-old female was re-admitted to the hospital with worsening hypoxemic respiratory failure. She had been admitted a week prior with similar symptoms. During that hospitalization her Mycoplasma IgM antibody titer was below diagnostic threshold (0.09). On re-admission, the Mycoplasma IgM titer had significantly increased (3.59), and she had a right middle lobe predominant pneumonia.. In each case, Mycoplasma PCR was positive, and azithromycin was started. However the patients remained profoundly hypoxemic requiring oxygen via high flow nasal cannula and the antibiotic regimen was expanded to include vancomycin and piperacllin-tazobactam without much clinical change. Azithromycin was switched to levofloxacin around hospital day 3 in each case, considering the possibility of macrolide resistance. The patients' hypoxemia and radiographic abnormalities began to improve significantly with fluoroquinolone therapy. DISCUSSION: M. pneumoniae lacks a cell wall and is thus intrinsically resistant to antibiotics that target the cell wall. The mainstays of therapy include macrolides, ketolides, tetracyclines and fluroquinolones. Resistance to antibiotic therapy occurs through acquired mutations affecting the ribosomal targets of macrolide antibiotics, most commonly the A2058G mutation in the 23S rRNA. The prevalence of macrolide resistance is extremely high in Asia, with rates up to 100% being reported in countries like China. In North America, macrolide resistance rates are 3-13% across various studies. Europe, in contrast, has lower rates of resistance (0-10%) with the exception of Italy (26%). While most studies have reported similar clinical severity amongst M. pneumoniae infections regardless of susceptibility, the patients in our series had significant hypoxemia and were at risk of poor outcomes without the change in antibiotic regimen based on recognition of potential macrolide resistance. CONCLUSIONS: Macrolide-resistant M. pneumoniae infections represent a clinical entity that should be recognized early to initiate prompt antibiotic changes and initiate effective treatment. Reference #1: Pereyre S, Goret J, Bébéar C. Mycoplasma pneumoniae: Current Knowledge on Macrolide Resistance and Treatment. Front Microbiol. 2016;7:974. Reference #2: To KKW, Chan KH, Fung YF, Yuen KF, Ho PL. Azithromycin treatment failure in macrolide-resistant Mycoplasma pneumoniae pneumonia. Eur Resp Journal 2010 36: 969-971. Reference #3: Cao B, Zhao CJ, Yin YD, et. al. High prevalence of macrolide resistance in Mycoplasma pneumoniae isolates from adult and adolescent patients with respiratory tract infection in China. Clin Infect Dis. 2010 Jul 15;51(2):189-94. DISCLOSURES: No relevant relationships by Alok Bhatt, source=Web Response No relevant relationships by John Munger, source=Web Response

The antibiotic resistance and pathogenicity of a multidrug-resistant Elizabethkingia anophelis isolate.

Elizabethkingia anophelis 12012‐2 PRCM was isolated from a patient with multiple organ dysfunction syndrome and lower respiratory tract infection in China. Minimum inhibitory concentration (MIC) analysis demonstrated that it was resistant to 20 antibiotics including trimethoprim/sulfamethoxazole and ciprofloxacin, which were effective for the elimination of other Elizabethkingia infections. To investigate multidrug resistance and pathogenicity mechanisms, we analyzed genome features of 12012‐2 PRCM and compared them to the other Elizabethkingia species. The draft genome size was 4.02 Mb with a GC content of 32%, comparable to that of other E. anophelis strains. Phylogenetic analysis showed that E. anophelis 12012‐2 PRCM formed a sister group with E. anophelis 502, distinct from clades formed by other clinical and environmental E. anophelis isolates. E. anophelis 12012‐2 PRCM contained multiple copies of β‐lactamase genes as well as genes predicted to function in antimicrobial efflux. It also contained 92 genes that were potentially involved in virulence, disease, and defense, and were associated with resistance and pathogenicity. Comparative genomic analysis showed high homology among three clinical and two environmental E. anophelis strains having a variety of similar antibiotic resistance and virulence factor genes, and similar genomic structure. Applications of this analysis will contribute to understanding the antibiotic resistance and pathogenic mechanisms of E. anophelis infections, which will assist in the management of infections as it increases in prevalence.

Cost-effectiveness analysis of a multi-dimensional intervention to reduce inappropriate antibiotic prescribing for children with upper respiratory tract infections in China.

We developed a multifaceted intervention to reduce antibiotic prescription rate for children with upper respiratory tract infections (URTIs) among primary care doctors in township hospitals in China. The intervention achieved a 29% (95% CI 16-42) absolute risk reduction in antibiotic prescribing. This study was to assess the cost-effectiveness of our intervention at reducing antibiotic prescribing in rural primary care facilities as measured by the intervention's effect on the antibiotic prescription rates for childhood URTIs. We took a healthcare provider perspective, measuring costs of consultation (time cost of doctor), prescription monitoring process and peer-review meetings (time cost of participants) and medication costs. Costs on provider side were collected through a bespoke questionnaire from all 25 township hospitals in December 2016, while medication costs were collected prospectively in the trial. Incremental cost-effectiveness ratios were calculated by dividing the mean difference in cost of the two trial arms by the mean difference in antibiotic prescribing rate. This showed an incremental cost of $0.03 per percentage point reduction in antibiotic prescribing. In addition to this incremental cost, the cost of implementing the intervention, including training and materials delivered by township hospitals, was $390.65 (SD $145.68) per healthcare facility. This study shows that a multifaceted intervention programme, when embedded into routine practice, is very cost-effective at reducing antibiotic prescribing in primary care facilities and has the potential of scale up in similar resource limited settings.

Molecular epidemiology of WU polyomavirus in hospitalized children with acute respiratory tract infection in China.

To explore the molecular epidemiology and clinical characteristics of Washington University polyomavirus (WUPyV) infection in pediatric patients with acute respiratory tract infections in China. A laboratory surveillance was performed to recruit pediatric patients with acute respiratory tract infections. WUPyV was detected using real-time PCR and complete genome was sequenced for randomly selected positive nasopharyngeal aspirate. Altogether 122 (7.5%) of 1617 children found to be infected with WUPyV and 88 (72.1%) were coinfected with other viruses during 2012-2015. The phylogenetic analysis showed that 14 strains from our study formed two new clusters (Id and IIIc) within the Branch I and Branch III, respectively. WUPyV is persistently circulating in China. Surveillance on WUPyV infection in wider areas and long persistence is warranted.

Pharmacokinetics and Disposition of Circulating Iridoids and Organic Acids in Rats Intravenously Receiving ReDuNing Injection.

ReDuNing injection, prepared from a combination of Gardenia Jasminoides fruits, Lonicera japonica flower buds, and the Artemisia annua aerial part, is extensively used for treatment of viral upper respiratory tract infections in China. Iridoids, organic acids, and flavonoids are likely important compounds of the herbal injection because of their reported pharmacological properties. This study was designed to characterize pharmacokinetics and disposition of the major circulating herbal compounds in rats that received the injection intravenously. ReDuNing injection was found to contain 19 iridoids (content levels 0.01-27.93 mM), 16 organic acids (0.04-19.06 mM), and 11 flavonoids (<0.08 mM). After dosing the injection, the iridoids geniposide, secologanic acid, secoxyloganin, genipin-1-β-gentiobioside, geniposidic acid, sweroside, and shanzhiside and the organic acids chlorogenic acid, quinic acid, cryptochlorogenic acid, and neochlorogenic acid were found to be the major circulating compounds, with mean elimination half-lives of 0.2-0.9 hour; the other plasma compounds were at low exposure levels. These major circulating compounds exhibited small apparent volumes of distribution (0.03-0.34 l/kg). Most of the iridoids were eliminated predominantly via renal excretion of the unchanged compounds, whereas the organic acids were eliminated via methylation and sulfation and were excreted into urine as the unchanged and metabolized compounds. The methylated metabolites also underwent subsequent conjugations before hepatobiliary and renal excretion. In vitro data suggested that the metabolism of the organic acids in rats also occurred in humans. The current pharmacokinetic research could serve as a crucial step in identifying the chemical basis responsible for the therapeutic action of ReDuNing injection.

A Systematic Review of Antibiotic Prescription Associated With Upper Respiratory Tract Infections in China.

Overuse of antibiotics among patients with upper respiratory tract infection (URTI) is a worldwide problem, and the problem is especially serious in developing countries, such as China. This systematic review is aimed at summarizing previous findings on outpatient prescriptions of antibiotics associated with URTI in China in order to help policymakers and the public understand and tackle the problem.We systematically searched and reviewed studies of antibiotic prescribing patterns for outpatients with URTI in China that were published in Chinese or English before December 31, 2014. The study quality was assessed, and the overall rates of URTI cases prescribed antibiotics were calculated by using random-effects model. Subgroup analyses were performed to explore the potential sources of heterogeneity among studies.We included 45 eligible studies with a total of 52,072 URTI outpatients. The overall percentage of URTI outpatients prescribed antibiotics was 83.7% (95% confidence interval [CI]: 80.6%-86.4%). Of the URTI outpatients prescribed antibiotics, 79.7% (95% CI: 72.8%-85.2%) were prescribed 1 antibiotic, 18.4% (95% CI: 13.6%-24.5%) prescribed 2 antibiotics, and 1.1% (95% CI: 0.7%-1.6%) prescribed 3 or more antibiotics. The rates of antibiotic prescription varied greatly across hospitals and showed a downward trend over time.An extremely high percentage of URTI patients in China were prescribed antibiotics and, the overuse is especially problematic in lower-level hospitals. Although there appears a downward trend, likely attributable to China's recent efforts in curbing antibiotic abuse, greater efforts are needed to promote the rational use of antibiotics.

The cost-effectiveness of OM-85 in managing respiratory tract infections in China

Objectives:To demonstrate the health economic impact of OM-85, a bacterial lysates based immunostimulant, for its approved indications in China.Methods:A cost-effectiveness decision tree model was constructed comparing OM-85 with the best supportive care/placebo therapy for managing the acute exacerbation of chronic bronchitis and rhinosinusitis in the Chinese population. Clinical efficacy and adverse events (AE) data were included in the model based on a thorough literature review. All localized direct treatment costs, including drug cost, AE costs, and medical treatment costs for underlining diseases were included from a Chinese third party payer perspective. A Key Opinion Leaders (KOL) survey was conducted with 20 senior physicians specialized in respiratory, ENT, allergy, and immunology fields from tertiary hospitals in Beijing, Shanghai, Guangzhou, Hangzhou, Shenyang, and Wuhan to validate the local treatment costs. Incremental cost-effectiveness ratio (ICER) was calculated based on the above efficacy and cost information.Results:OM-85 is a cost-effective therapy when compared with placebo (standard care). OM-85 can treat/prevent one additional full episode exacerbation of chronic bronchitis and one additional full episode exacerbation of rhinosinusitis with only additional costs of RMB 653 and RMB 1182.84, respectively. In comparison, each acute exacerbation of chronic bronchitis will cost RMB 4510.10, and each acute exacerbation of rhinosinuisitis will cost RMB 1807.21 in a Chinese clinical management setting. One-way sensitivity analyses were performed and the ICER result was demonstrated to be consistent.>Conclusions:OM 85 reduces acute exacerbations among patients with chronic bronchitis and chronic rhinosinusitis when compared with Placebo (standard care). From a Chinese payer perspective, OM 85 is a cost-effective therapy in the clinical management of both chronic bronchitis and rhinosinusitis in the adult population.

Prevalence of human rhinovirus in children admitted to hospital with acute lower respiratory tract infections in Changsha, China

Human rhinovirus (HRV) is a causative agent of acute respiratory tract infections. This study analyzed the prevalence and clinical characteristics of three HRV groups (HRV‐A, ‐B, and ‐C) among 1,165 children aged 14 years or younger who were hospitalized with acute lower respiratory tract infection in China. PCR or reverse transcription‐PCR was performed to detect 14 respiratory viruses in nasopharyngeal aspirates collected from September 2007 to August 2008 in Changsha, China. HRV was detected in 202 (17.3%) of the 1,165 children; 25.3% of the HRV‐positive children were 13–36 months of age (χ2 = 22.803, P = 0.000). HRV was detected year round and peaked between September and December. Fifty‐three percent of the HRV‐positive samples were also positive for other respiratory viruses; respiratory syncytial virus (RSV) was the most common secondary virus. Phylogenetic analysis using the VP4/VP2 region grouped the HRV‐positive strains as follows: 101 HRV‐A (50.0%), 21 HRV‐B (10.4%), and 80 HRV‐C (39.6%). HRV‐A infections occurred predominantly in spring and autumn, and the peak prevalence of HRV‐C was in early winter and late autumn. HRV‐B infections were less common in spring (χ2 = 31.914, P = 0.000). No significant difference in clinical severity or presentation was found between patients with HRV single infection and HRV co‐detections. Furthermore, the clinical characterizations did not differ among the three HRV species. These results suggest that HRV‐C is an important viral agent along with HRV‐A and HRV‐B and that among hospitalized children with acute lower respiratory tract infection in China, the three HRV genotypes have similar clinical characteristics. J. Med. Virol. 86:1983–1989, 2014. © 2014 Wiley Periodicals, Inc.

Detection of enterovirus 68 as one of the commonest types of enterovirus found in patients with acute respiratory tract infection in China

Human enterovirus 68 (HEV-68) is an enterovirus associated with respiratory illness. In China, no information about HEV-68 is available for children yet. This study aimed to investigate the presence of HEV-68 in mainland China between 2009 and 2012 and to explore the migration events of HEV-68 across the world. Among 1565 samples tested from children, 41 (2.6%) were positive for HEV and 223 (14.3%) for human rhinovirus (HRV). Seven (17.1%) of 41 HEVs were HEV-68. Two HEV-68- and five HRV-positive samples were detected in 585 adult samples. HEV-68 is the predominant type of enterovirus in children with acute respiratory tract infection (ARTI), followed by HEV-71 and coxsackievirus A6. Three HEV-68-infected children presented with severe pneumonia and one presented with a severe asthma attack. The viruses were attributed to two novel distinct sublineages of HEV-68 based on phylogenetic analysis of partial VP1 gene sequences. Migration events analysis showed that the USA and the Netherlands were possible geographical sources of HEV-68, from where three strains migrated to China. In conclusion, HEV-68 may play a predominant role among the enteroviruses associated with ARTI in children. Additional surveillance is needed to clarify the reason why HEV-68 causes such a wide spectrum of disease, from asymptomatic to severe respiratory disease and even death.

In vitro activity of cefditoren and other comparators against Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis causing community-acquired respiratory tract infections in China

The aim of this study was to evaluate the in vitro activity of cefditoren and comparators against Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis causing community-acquired respiratory tract infections (CARTIs). A total of 391 Streptococcus pneumoniae, 266 H. influenzae, and 76 M. catarrhalis were isolated from 10 centers located at 6 cities in China from January 2009 to May 2010. The microdilution method was used to determine minimum inhibitory concentrations (MICs). The pneumococci comprised 189 (48.3%) penicillin susceptible, 129 (33.0%) penicillin intermediate, and 73 (18.7%) penicillin resistant. Moxifloxacin and levofloxacin showed the highest activity (99.2% and 97.7%, respectively) against Streptococcus pneumoniae, followed by parenteral penicillin G (95.7%), cefditoren (83.1%) and amoxicillin–clavulanic acid (79.3%). Among the 266 H. influenzae isolates, 26 (9.8%) were ampicillin-resistant β-lactamase–producing strains and 24 (9.0%) were ampicillin-resistant β-lactamase–nonproducing strains (BLNAR). Most of antimicrobial agents demonstrated good activity (>97% susceptibility) against H. influenzae except ampicillin, cefuroxime, and cefaclor, which showed relatively lower activity (81.2%, 88.7%, and 88%, respectively). Cefditoren showed excellent activity with the lowest MIC50 and MIC90 (≤0.016/0.064 μg/mL) among all tested drugs, which is independent of β-lactamase production or ampicillin resistance. Cefditoren at a concentration of 0.5 μg/mL inhibited all BLNAR strains. Seventy of 76 isolates of M. catarrhalis produced β-lactamase. Cefditoren also showed excellent activity with MIC90 of 0.064 μg/mL against β-lactamase–nonproducing strains and 0.5 μg/mL against β-lactamase–producing strains. In conclusion, the excellent intrinsic activity of cefditoren suggests that it may be a good choice for the treatment of CARTIs caused by Streptococcus pneumoniae, H. influenzae, and M. catarrhalis in China, while the activity should be closely monitored.

Intravenous moxifloxacin in routine hospital treatment of respiratory tract infections in China: results of a multicenter, noninterventional study

Objective:To investigate the effectiveness, safety, and tolerability of moxifloxacin (MXF) (intravenous [IV] or sequential therapy [IV followed by oral]) under daily treatment conditions in a large number of patients with respiratory tract infections.Design:Patients with a diagnosis of respiratory tract infection should be treated with MXF IV and/or tablets 400 mg once daily for a duration at the physician’s discretion. For each patient, the physician documented data at an initial visit and at the end of therapy (EOT) visit and/or, in the case of sequential therapy, an interim visit when the patient switched to oral treatment.Results:A total of 1953 patients treated with MXF were documented and were valid for an effectiveness and safety evaluation. An improvement was observed in 98.1% (n = 1911/1949) of patients treated with MXF. Recovery was documented in 89.9% (n = 1754/1951) of the patients. At the EOT visit, severity of infection was assessed to be “relieved” or at least “improved” in 96.5% (n = 1873/1940) of the patients. Physicians assessed overall effectiveness as “good” or “very good” in 93.3% (n = 1822/1953) of all patients. The physicians’ overall tolerability rating was “very good” or “good” in 93.5% (n = 1827/1953) of all patients. The incidence rates of adverse events (AEs) and adverse drug reactions (ADRs) were 0.72% (n = 14) and 0.67% (n = 13), respectively. One serious AE “falling white blood cell count” occurred (0.05%), which was also defined as a serious ADR and resolved.Conclusion:MXF was generally well tolerated and highly effective in the treatment of different respiratory tract infections. The incidence of AEs and ADRs was low. The efficacy, safety, and tolerability information collected in this study confirms the clinical safety profile of MXF and its value as antibiotic treatment for respiratory tract infections.

Human Respiratory Syncytial Virus in Children with Acute Respiratory Tract Infections in China

There are limited data on the prevalence and clinical and molecular characterization of human respiratory syncytial virus (HRSV) in children with acute respiratory tract infections (ARTIs) in China. From December 2006 to March 2009, 894 nasopharyngeal aspirates (NPAs) were collected from children under 14 years of age with ARTIs. Samples were screened for HRSV and genotyped by reverse transcription-PCR (RT-PCR) and sequencing. Demographic and clinical information was recorded. A total of 38.14% (341/894) of samples were positive for HRSV. Phylogenetic analysis revealed that 60.4% of the selected 227 RSV strains were GA2, 34.4% were BA, 4.8% were GB2, and 0.4% were GB3. A total of 40.47% of all of the RSV-positive samples were coinfected with other respiratory viruses, and adenovirus was the most common additional respiratory virus. No statistical differences were found in the frequency of diagnosis and symptoms between the coinfection group and monoinfection group. Additionally, no statistical differences were found in epidemiological characterizations or disease severity between genotype BA- and GA2-positive patients, except for a greater frequency of lower respiratory tract infections (LRTIs) (mostly bronchitis)with BA. HRSV is the most important viral pathogen in Chinese children with ARTIs. Four genotypes (i.e., GA2, BA, GB2, and GB3) circulate locally, and the predominant genotype may shift between seasons. Coinfection with other viruses does not affect disease severity. HRSV genotypes were not associated with different epidemiological characterizations or disease severity.

Prevalence and clinical characteristics of human CoV-HKU1 in children with acute respiratory tract infections in China

Background Human CoV-HKU1 (HCoV-HKU1) has been isolated from a 71-year-old man with pneumonia; however, the impact and role of emerging HCoV-HKU1 have not been defined in children with acute respiratory tract infection (ARTI). Objective To investigate the Prevalence and clinical characteristics of HCoV-HKU1 in children with ARTI in Lanzhou, China. Study design The reverse transcription polymerase chain reaction (RT-PCR) or PCR was employed to screen HCoV-HKU1 and other common respiratory viruses in 645 nasopharyngeal aspirate (NPA) specimens collected from children with ARTI from November 2006 to October 2008. All PCR positive products were sequenced. And the demographic and clinical data were collected for all patients. Results Nineteen of 645 (2.95%) specimens tested positive for HCoV-HKU1, and all HCoV-HKU1 positive specimens were distributed in the winter and spring season. The HCoV-HKU1 co-infection rate with other respiratory viruses was 47.37% (9/19). There was no statistically significant difference in the detection rate between groups by age or gender, except between patients with and without underlying diseases. The phylogenetic analysis indicated that HCoV-HKU1 genotype B was circulating in the years 2007 and 2008 in children with ARTI in Lanzhou, China. Conclusions HCoV-HKU1 is an uncommon virus existing among Chinese children with ARTI. Children with underlying diseases are more vulnerable to viral infection. Only HCoV-HKU1 genotype B circulated locally.

High Prevalence of Macrolide Resistance inMycoplasma pneumoniaeIsolates from Adult and Adolescent Patients with Respiratory Tract Infection in China

The resistance rate of 67 Mycoplasma pneumoniae isolates from 356 ambulatory adult patients with respiratory tract infection was 69% (46 of 67). All 46 macrolide-resistant strains harbored point mutations in the 23S ribosomal RNA gene. Patients infected with macrolide-resistant M. pneumoniae required significantly longer durations of antibiotic therapy and had longer time to resolution of fever.

Human bocavirus infection in young children with acute respiratory tract infection in Lanzhou, China

Human bocavirus (HBoV) is a recognized human parvovirus associated with acute respiratory tract infection. However, HBoV has yet to be established as a causative agent of respiratory disease. In this study, the epidemiological and virological characteristics of HBoV infection were studied in children with acute respiratory tract infection in China. In total, 406 children younger than 14 years of age with acute respiratory tract infection were included in this prospective 1‐year study. HBoV was detected in 29 (7.1%) of the 406 children. No clear seasonal fluctuation was observed in infection rates of HBoV. Of the 29 children infected with HBoV, 16 (55.2%) were coinfected with other respiratory viruses, most commonly respiratory syncytial virus (RSV). Viral coinfection with HBoV did not affect the severity of the respiratory disease (P = 0.291). The number of HBoV genome copies ranged from 5.80 × 102 to 9.72 × 108 copies/ml in nasopharyngeal aspirates among HBoV‐positive specimens by real‐time PCR, and neither coinfection nor the severity of disease correlated with the viral load (P = 0.148, P = 0.354, respectively). The most common clinical features were cough and acute upper respiratory infection, and acute bronchopneumonia. Additionally, the NP‐1 gene of HBoV showed minimal sequence variation. These data suggest that HBoV is frequent in young children with acute respiratory tract infection in Lanzhou, China, and RSV is the most common coinfecting virus. There was no apparent association between the viral load of HBoV and coinfection or disease severity. The NP‐1 gene was highly conserved in HBoV. J. Med. Virol. 82:282–288, 2010. © 2009 Wiley‐Liss, Inc.

PP-184 Clinical characteristics and detection of human bocavirus in hospitalized children with acute lower respiratory tract infection in China

PP-184 Clinical characteristics and detection of human bocavirus in hospitalized children with acute lower respiratory tract infection in China

Prevalence of Human KI and WU Polyomaviruses in Children with Acute Respiratory Tract Infection in China

The KI and WU polyomaviruses were found in 11 (2.7%) and 17 (4.2%) of 406 nasopharyngeal aspirates, respectively, from children with acute respiratory tract infection (ARTI). The phylogenetic analysis indicates that they are all in the same cluster as the prototype strains. Our findings suggest that they are common in children with ARTI in China.

Quantification of human bocavirus in lower respiratory tract infections in China

A quantitative PCR method was established to quantify human bocavirus (HBoV) genomic copies in clinical specimens from children with lower respiratory tract infections (LRTI) in China. A total of 257 respiratory tract specimens were tested, and 7 (2.7%) of these (all sputum samples) were positive, with genomic copies that ranged from 8.0 × 103 to 8.0 × 109 in the samples. The main clinical symptom of patients who were positive for HBoV DNA was a pneumonia-like syndrome represented by high fever and cough. Our results suggest that HBoV may be an important etiological agent of LRTI in children in China.