Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.
Paediatric Hospitalisation Unit, Department of Paediatrics, Hospital Universitari Maternoinfantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
J Clin Virol. 2019 Jan;110:29-35. doi: 10.1016/j.jcv.2018.11.004. Epub 2018 Nov 30.
Enterovirus (EV) infections are usually asymptomatic or mild, but symptomatic infections can evolve to severe complications. Outbreaks of EV-A71 and EV-D68 have been recently reported worldwide, sometimes related to severe clinical outcomes.
To describe EV genetic diversity and the clinical outcomes from paediatric patients attended at a tertiary university hospital in Barcelona (Catalonia, Spain) from 2014 to 2017.
Specimens were collected from paediatric (<17 years old) cases with suspicion of respiratory tract infection or EV infection. EV laboratory-confirmation was performed by specific real-time multiplex RT-PCR assay. Partial viral VP1 protein was sequenced for genetic characterisation by phylogenetic analyses.
A total of 376 (7%) from 5703 cases were EV laboratory-confirmed. Phylogenetic analyses of VP1 (210; 81%) sequences distinguished up to 27 different EV types distributed within EV-A (82; 40%), EV-B (90; 42%), EV-C (5; 2%), and EV-D (33; 15%), in addition to 50 (19%) rhinoviruses. The most predominant were EV-A71 (37; 45%) and EV-D68 (32; 99%). EV-A71 was highly related to neurological complications (25/39, 63%), of which 20/39 were rhombencephalitis, and most EV-D68 (28/32, 88%) were associated with lower respiratory tract infections (LRTI), and exceptionally one (3%) with acute flaccid paralysis.
EV-A71 and EV-D68 were the most detected EV in respiratory specimens. EV-A71 was highly related to neurological disease and EV-D68 was often associated with LRTI. However, both potential relatedness to neurological diseases makes the monitoring of EV circulation obligatory.
肠病毒（EV）感染通常无症状或症状轻微，但有症状的感染可能会发展为严重并发症。最近，全世界都有 EV-A71 和 EV-D68 的爆发，有时与严重的临床结局有关。
描述 2014 年至 2017 年期间在西班牙巴塞罗那（加泰罗尼亚）一家三级大学医院就诊的儿科患者中 EV 的遗传多样性和临床结局。
从疑似呼吸道感染或 EV 感染的儿科（<17 岁）患者中采集标本。通过特定的实时多重 RT-PCR 检测进行 EV 实验室确认。通过系统发育分析对病毒 VP1 蛋白的部分序列进行遗传特征分析。
在 5703 例病例中，共有 376 例（7%）通过实验室确认为 EV。对 VP1（210 例；81%）序列的系统发育分析区分了 27 种不同的 EV 类型，分布在 EV-A（82 种；40%）、EV-B（90 种；42%）、EV-C（5 种；2%）和 EV-D（33 种；15%）中，此外还有 50 种（19%）鼻病毒。最主要的是 EV-A71（37 例；45%）和 EV-D68（32 例；99%）。EV-A71 与神经系统并发症高度相关（25/39，63%），其中 20/39 为脑脊髓炎，大多数 EV-D68（28/32，88%）与下呼吸道感染（LRTI）有关，极少数（3%）与急性弛缓性麻痹有关。
EV-A71 和 EV-D68 是呼吸道标本中检测到的最主要的 EV。EV-A71 与神经系统疾病高度相关，EV-D68 常与 LRTI 相关。然而，两者都与神经系统疾病有关，这使得对 EV 循环的监测成为必要。
