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2005-2014 年爱尔兰嗜神经肠道病毒的血清流行病学和系统进化特征。

Seroepidemiological and phylogenetic characterization of neurotropic enteroviruses in Ireland, 2005-2014.

机构信息

National Virus Reference Laboratory, University College Dublin, Belfield, Dublin, Ireland.

Health Protection Surveillance Centre, Dublin, Ireland.

出版信息

J Med Virol. 2017 Sep;89(9):1550-1558. doi: 10.1002/jmv.24765. Epub 2017 Jun 6.

Abstract

Enteroviruses (EVs) are associated with a broad spectrum of clinical presentation, including aseptic meningitis (AM), encephalitis, hand, foot and mouth disease, acute flaccid paralysis, and acute flaccid myelitis. Epidemics occur sporadically and are associated with increased cases of AM in children. The present study describes the seroepidemiological analysis of circulating EVs in Ireland from 2005 to 2014 and phylogenetic characterization of echovirus 30 (E-30), enterovirus A71 (EV-A71), and enterovirus D68 (EV-D68). EV VP1 genotyping was applied to viral isolates and clinical samples, including cerebrospinal fluid (CSF), and those isolates that remained untypeable by neutralising anti-sera. An increase in AM cases from 2010 to 2014 was associated with an E-30 genogroup variant VII and sequences clustered phylogenetically with those detected in AM outbreaks in France and Italy. EV-D68 viral RNA was not detected in CSF samples and no neurological involvement was reported. Three EV-A71 positive CSF samples were identified in patients presenting with AM. A phylogenetic analysis of respiratory-associated EV-D68 and EV-A71 cases in circulation was performed to determine baseline epidemiological data. EV-D68 segregated with clades B and B(1) and EV-A71 clustered as subgenogroup C2. The EV VP1 genotyping method was more sensitive than neutralising anti-sera methods by virus culture and importantly demonstrated concordance between EV genotypes in faecal and CSF samples which should facilitate EV screening by less invasive sampling approaches in AM presentations.

摘要

肠道病毒(EVs)与广泛的临床症状相关,包括无菌性脑膜炎(AM)、脑炎、手足口病、急性弛缓性麻痹和急性弛缓性脊髓炎。这些疾病呈散发性流行,与儿童 AM 病例增加有关。本研究描述了 2005 年至 2014 年期间爱尔兰循环肠道病毒的血清流行病学分析,以及对柯萨奇病毒 30 型(E-30)、肠道病毒 A71 型(EV-A71)和肠道病毒 D68 型(EV-D68)的系统发育特征分析。肠道病毒 VP1 基因分型应用于病毒分离株和临床样本,包括脑脊液(CSF),以及那些无法通过中和抗血清鉴定的分离株。2010 年至 2014 年 AM 病例的增加与 E-30 基因组变异 VII 有关,序列与法国和意大利 AM 爆发中检测到的序列聚类。CSF 样本中未检测到 EV-D68 病毒 RNA,也未报告神经系统受累。在出现 AM 的患者中鉴定出 3 例 EV-A71 阳性 CSF 样本。对循环中与呼吸道相关的 EV-D68 和 EV-A71 病例进行了系统发育分析,以确定基线流行病学数据。EV-D68 与分支 B 和 B(1)聚类,EV-A71 聚类为亚组 C2。肠道病毒 VP1 基因分型方法比病毒培养的中和抗血清方法更敏感,重要的是,在粪便和 CSF 样本中证明了肠道病毒基因型之间的一致性,这应该有助于在 AM 发作时通过侵袭性较小的采样方法进行肠道病毒筛查。

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