Faculty of Medicine, Department of Microbiology, Kuwait University, Safat, Kuwait.
J Med Virol. 2018 Jun;90(6):1033-1039. doi: 10.1002/jmv.25059. Epub 2018 Feb 28.
Human adenovirus (HAdV) infection can result in a severe respiratory disease. The aim of this study was to identify HAdV types detected in patients hospitalized for severe respiratory illness. The study population consisted of 743 patients with severe respiratory disease admitted to four major hospitals in Kuwait between January 2013 and December 2016. Respiratory specimens were retrospectively screened for 20 respiratory viruses by real-time PCR. The HAdV hexon gene was amplified and directly sequenced, and HAdV types were identified by performing Bayesian phylogenetic analysis. HAdV DNA was detected in 27 (3.6%) patients, with peaks in November and March. Most patients were infants and young children suffering from pneumonia or acute bronchiolitis. The detected HAdV types were C1, C2, C5, B3, and B7. Clusters of HAdV C1, C2, and C5 were observed with high posterior probability. All patients infected with HAdV C5 and 50% of patients infected with HAdV C2 or B7 were admitted to the intensive care unit (ICU). Co-infection with other viruses was detected in 44.4% of patients. The most common co-infecting virus was rhinovirus (HRV). HAdV/HRV co-infection was detected in two children who presumably developed disseminated HAdV infection and died. This is the first report describing the circulation of HAdV types associated with severe outcomes in Kuwait. These findings highlight the need for a national surveillance system to monitor changes in predominant HAdV types and increased numbers of severe respiratory infections.
人类腺病毒（HAdV）感染可导致严重的呼吸道疾病。本研究旨在鉴定在因严重呼吸道疾病住院的患者中检测到的 HAdV 型别。研究人群由 2013 年 1 月至 2016 年 12 月期间在科威特四家主要医院因严重呼吸道疾病住院的 743 例患者组成。通过实时 PCR 对呼吸道标本进行了 20 种呼吸道病毒的回顾性筛查。扩增 HAdV 衣壳基因并直接测序，通过贝叶斯系统发育分析鉴定 HAdV 型别。在 27 例（3.6%）患者中检测到 HAdV DNA，发病高峰在 11 月和 3 月。大多数患者为患有肺炎或急性细支气管炎的婴儿和幼儿。检测到的 HAdV 型别为 C1、C2、C5、B3 和 B7。观察到 HAdV C1、C2 和 C5 的聚类具有高后验概率。所有感染 HAdV C5 的患者和 50%感染 HAdV C2 或 B7 的患者均入住重症监护病房（ICU）。在 44.4%的患者中检测到合并其他病毒感染。最常见的合并感染病毒是鼻病毒（HRV）。在两名可能发生弥漫性 HAdV 感染并死亡的患儿中检测到 HAdV/HRV 合并感染。这是首次在科威特报告与严重结局相关的 HAdV 型别的流行情况。这些发现强调需要建立国家监测系统，以监测主要 HAdV 型别变化和严重呼吸道感染数量增加的情况。
