UPMC Univ. Paris 06, ER1 DETIV, F-75013 Paris, France.
J Clin Virol. 2010 Apr;47(4):313-20. doi: 10.1016/j.jcv.2010.01.019. Epub 2010 Feb 20.
According to recent reports, herpes simplex virus type 1 (HSV-1) induces bronchopneumonitis (BPn) in immunocompetent patients undergoing prolonged mechanical ventilation (MV), whose respiratory functions deteriorate with a poor outcome. HSV-1 BPn is associated with HSV symptomatic or symptomless reactivation in the oropharynx.
We sought to systematically and genetically characterize HSV-1 strains isolated from immunocompetent patients receiving prolonged MV and to characterize the genetic relationship of strains sequentially isolated from oropharyngeal samples (OPS) and broncho-alveolar liquids (BAL) to determine the natural course of HSV BPn.
In this molecular epidemiological study, microsatellite technology was used to determine genetic relationships between 211 HSV-1 strains isolated from OPS and/or BAL from 106 patients receiving MV.
Microsatellite haplotypes of HSV-1 strains sequentially isolated from the same individual were identical, and HSV-1 isolates from the lung were genetically indistinguishable from strains isolated from the oral cavity. Each patient was characterized by their own HSV-1 microsatellite haplotype, and no nosocomial transmission of strains between patients was observed.
Our results demonstrate that, in patients who receive MV, the HSV-1 pulmonary infection results from the reactivation of genetically related HSV-1 in the oropharynx, which progressively infects the lower respiratory tract.
根据最近的报告，单纯疱疹病毒 1 型（HSV-1）可导致接受长时间机械通气（MV）的免疫功能正常患者发生支气管肺炎（BPn），其呼吸功能恶化，预后不良。HSV-1 BPn 与口咽部 HSV 有症状或无症状再激活有关。
我们旨在系统地和遗传上对接受长时间 MV 的免疫功能正常患者分离出的 HSV-1 株进行分析，并对从口咽样本（OPS）和支气管肺泡液（BAL）中顺序分离出的株进行遗传关系分析，以确定 HSV BPn 的自然病程。
在这项分子流行病学研究中，微卫星技术用于确定 106 名接受 MV 的患者的 OPS 和/或 BAL 中分离出的 211 株 HSV-1 株之间的遗传关系。
从同一患者中顺序分离出的 HSV-1 株的微卫星单倍型相同，从肺部分离出的 HSV-1 株与从口腔分离出的株在遗传上无法区分。每位患者的 HSV-1 微卫星单倍型均具有特征性，未观察到患者之间的菌株医院内传播。
我们的研究结果表明，在接受 MV 的患者中，HSV-1 肺部感染是由口咽部遗传相关的 HSV-1 再激活引起的，随后逐渐感染下呼吸道。
