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

作者:Cao, Bin; Huang, Guo-Hong; Pu, Zeng-Hui; Qu, Jiu-Xin; Yu, Xiao-Min; Zhu, Zhen; Dong, Jian-Ping; Gao, Yan; Zhang, Yong-Xiang; Li, Xiao-Hui; Liu, Jian-Hua; Wang, Hong; Xu, Qian; Li, Hui; Xu, Wenbo; Wang, Chen*
来源:Chest, 2014, 145(1): 79-+.
DOI:10.1378/chest.13-1186

摘要

Background: Since 2008, severe cases of emerging human adenovirus (HAdV) type 55 (HAdV-55) were reported sporadically in China. But no comparative studies had been conducted to discern the differences in epidemiologic and clinical abnormalities between HAdV-55 and other types (HAdV-7, HAdV-3, HAdV-14, HAdV-50, and HAdV-C). @@@ Methods: A multicenter surveillance study for adult and adolescent community-acquired pneumonia (CAP) was conducted prospectively in Beijing and Yan Tai between November 2010 and April 2012. A standardized data form was used to record clinical information. The viral DNA extracted from the clinical samples or adenovirus viral isolates was sequenced. @@@ Results: Among 969 cases, 48 (5%) were identified as adenovirus pneumonia. Six branches were clustered: HAdV-55 in 21, HAdV-7 in 11, HAdV-3 in nine, HAdV-14 in four, HAdV-50 in two, and HAdV-C in one. Most HAdV-55 cases were identified during February and March. All the hypervariable regions of the hexon genes of the 21 HAdV-55 strains were completely identical. Patients who had HAdV-55 were about 10 years older (P = .027) and had higher pneumonia severity index scores (P = .030) compared with those with other types (HAdV-7, HAdV-3, HAdV-14, HAdV-50, and HAdV-C). Systemic BP was also higher among patients in the HAdV-55 group (P = .006). Unilateral or bilateral consolidations were the most common radiologic findings in both patients with HAdV-55 and those with other types (57.9% vs 36%). More than one-half of the patients were admitted to hospital; oxygen therapy was given to 29.2% of the 48 patients, and two needed mechanical ventilation. @@@ Conclusions: 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.