Enterovirus and Viral Gastroenteritis Unit, National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.
Euro Surveill. 2024 Oct;29(44). doi: 10.2807/1560-7917.ES.2024.29.44.2400221.
BackgroundIn 2023, a European alert was issued regarding an increase in severe enterovirus (EV) neonatal infections associated with echovirus 11 (E11) new lineage 1.AimTo analyse E11-positive cases between 2019 and 2023 to investigate whether the new lineage 1 circulated in Spain causing severe neonatal infections.MethodsEV-positive samples from hospitalised cases are sent for typing to the National Reference Enterovirus Laboratory. Available samples from 2022-23 were subjected to metagenomic next-generation sequencing.ResultsOf 1,288 samples genotyped, 103 were E11-positive (98 patients: 6 adults, 33 neonates, 89 children under 6 years; male to female ratio 1.9). E11 detection rate was similar before and after detection of the new lineage 1 in Spain in June 2022 (9.7% in 2019 vs 10.6% in 2023). The proportion of E11-infected ICU-admitted neonates in 2019-2022 (2/7) vs 2022-2023 (5/12) did not significantly differ (p = 0.65). In severe neonatal infections, 4/7 E11 strains were not linked to the new lineage 1. The three novel E11 recombinant genomes were associated with severe (n = 2) and non-severe (n = 1) cases from 2022-2023 and clustered outside the new lineage 1. Coinfecting pathogenic viruses were present in four of 10 E11-positive samples.ConclusionThe emergence of the new lineage 1 is not linked with an increase in incidence or severity of neonatal E11 infections in Spain. The detection of two novel E11 recombinants associated with severe disease warrants enhancing genomic and clinical surveillance.
背景
2023 年，欧洲发出警报称，与新型 1 谱系肠道病毒 11（E11）相关的严重新生儿感染有所增加。
目的
分析 2019 年至 2023 年期间 E11 阳性病例，以调查新型 1 谱系是否在西班牙传播并导致严重的新生儿感染。
方法
将住院患者的肠道病毒阳性样本送往国家参考肠道病毒实验室进行分型。对 2022-2023 年的可用样本进行宏基因组下一代测序。
结果
在 1288 个分型样本中，有 103 个为 E11 阳性（98 例患者：6 例成人，33 例新生儿，89 例<6 岁儿童；男女比例为 1.9）。在 2022 年 6 月西班牙发现新型 1 谱系前后，E11 的检出率相似（2019 年为 9.7%，2023 年为 10.6%）。2019-2022 年（2/7）与 2022-2023 年（5/12）入住 ICU 的 E11 感染新生儿的比例无显著差异（p=0.65）。在严重的新生儿感染中，7 株 E11 株中无 4 株与新型 1 谱系相关。2022-2023 年发现的 3 株新型 E11 重组基因组与严重（n=2）和非严重（n=1）病例相关，聚类在新型 1 谱系之外。在 10 个 E11 阳性样本中，有 4 个样本同时感染了致病性病毒。
结论
新型 1 谱系的出现与西班牙新生儿 E11 感染的发病率或严重程度增加无关。检测到与严重疾病相关的两个新型 E11 重组体需要加强基因组和临床监测。
