Identificación etiológica de agentes virales de la encefalitis aguda en Guadalajara, México, 2011-2015 / Etiological identification of viral agents in acute encephalitis in Guadalajara, México, 2011-2015

Resumen Introducción. La encefalitis viral aguda se define como un proceso inflamatorio asociado a disfunción neurológica con desenlace fatal o daño grave permanente. En México no se han hecho estudios de identificación directa de los agentes etiológicos causales de la encefalitis viral aguda. Objetivo. Identificar mediante PCR en tiempo real los principales agentes virales causantes de encefalitis viral aguda en México. Materiales y métodos. Se obtuvo el líquido cefalorraquídeo de pacientes con sospecha de encefalitis viral que ingresaron al servicio de urgencias del Hospital Civil Fray Antonio Alcalde. Se extrajeron ácidos nucleicos para identificar los patógenos mediante PCR y PCR con transcripción inversa en tiempo real. Resultados. Se captaron un total de 66 pacientes entre el 2011 y el 2014. En 16 de los casos (24 %) se identificó el agente viral y se encontró que el principal agente causal fue el enterovirus, con ocho casos (50 %), seguido del virus del herpes simple (HSV: 37 %), con seis casos, y el citomegalovirus (CMV: 12,5 %), con dos casos. El promedio de edad fue de 25 años (0-70 años). Los casos positivos predominaron en los varones (63,3 %) y se estableció un predominio estacional en otoño (37,5 %). La mayoría de los pacientes presentó fiebre (48,4 %) o cefalea (36,3 %) y, en menor proporción, convulsiones, confusión y debilidad muscular (30,3 %) seguidas de desorientación (28,75 %) y apatía (25,7 %). En dos de los casos se observó el signo de Kerning (3 %) y en otros dos, el signo de Brudzinski (3 %). Conclusiones. La PCR en líquido cefalorraquídeo es una técnica de diagnóstico adecuada para la identificación de virus causales de encefalitis viral, lo cual permite prescribir los medicamentos específicos.

Abstract Introduction: Viral encephalitis is a well-known inflammatory process associated with neurological dysfunction that might derive into severe brain damage or a fatal outcome. In México there is no epidemiological data that describes the prevalence of viral agents responsible for acute encephalitis. Objective: To identify the main viral agents by real time PCR involved in acute encephalitis in Mexico. Materials and methods: We obtained cerebral spinal fluid (CSF) samples from all patients with suspected viral encephalitis admitted to the emergency service of the Hospital Civil de Guadalajara "Fray Antonio Alcalde". To identify pathogens, we performed nucleic acid extraction using real-time PCR and RT-PCR. Results: Sixty-six patients were diagnosed with acute encephalitis from 2011 to 2014. A definitive viral etiological diagnosis was established in 16 patients (24%); the main causative agents were enteroviruses in 50% of the 16 positive samples, followed by herpes simplex virus (37%) and cytomegaloviruses (12.5%). Patients with encephalitis were predominantly male (63.3%) and a seasonal predominance was observed during autumn (37.5%). The main clinical characteristics in the acute encephalitis phase were fever (48.45) and cephalea (36.3), followed by seizures, disorientation, and muscular weakness (30.3%). Kerning sign was present in two cases (3%) and other two cases presented Brudzinski's sign (3%). Conclusions: CSF PCR is a suitable diagnostic technique for the identification of viral encephalitis caused by viral infections that allows an appropriate antiviral therapeutic treatment.

Study on viral etiology of acute respiratory tract infections in children in Wuxi area during 2011-2014 / 中华传染病杂志

Objective To investigate the epidemiology of respiratory viruses in children from Wuxi area.Methods A total of 2 747 cases of children diagnosed with acute respiratory infection in Wuxi during 2011 —2014 were collected.Reverse transcription-polymerase chain reaction was used to detect nine kinds of respiratory viruses,including influenza virus A (Flu A),influenza virus B (Flu B),parainfluenza virus (PIV)Ⅰ-Ⅳ,adenovirus (ADV),respiratory sycytial virus (RSV),human metaneumovirus (hMPV), human bocavirus (HBov),human coronaviruses (hCov)and human rhinovirus (HRV).The categorical data were compared using chi square test.Results A total of 856 among the 2 747 samples were tested positive for respiratory virus nucleic acid,with the positive rate of 31 .16%.The viral distribution was uneven in different seasons,and the infection peaked in winter and spring.The virus detection rate was highest in age 1 to 2 year group (up to 40.18%),and followed by age 6 to 12 year group (32.63%).Flu A virus was the most frequently detected virus,accounting for 7.54% (207/2 747);followed by PIV, accounting for 6.95 % (191/2 747);and Flu B accounted for 4.22%(116/2 747).There were 84 cases of mixed infection of two or more kinds of respiratory viruses,with positive rate of 3.06% (84/2 747 ). Conclusions Our study suggests that Flu A is the most common pathogen in children with acute respiratory infections in Wuxi area during 2011 —2014;virus detection rate is highest in age 1 to 2 year group;and parainfluenza virus is almost detected throughout the year,while the rest of respiratory viruses are commonly seen in winter and spring.

Prevalência de conjuntivite adenoviral em clínica oftalmológica no município de Viçosa (MG) / Prevalence of adenoviral conjunctivitis at the ophthalmologic clinic on municipality of Viçosa/MG

Objetivo: Avaliar a prevalência de Adenovírus como agente etiológico da conjuntivite, em clínica médica oftalmológica especializada, em Viçosa, Minas Gerais, Brasil. Métodos: Amostras da secreção conjuntival de 91 pacientes clinicamente diagnosticados com conjuntivite foram submetidos à reação em cadeia da polimerase (PCR), utilizando primers degenerados para a região codificadora do gene da proteína estrutural II. Posteriormente as amostras positivas foram submetidas a sequenciamento e genotipagem. Resultados: A análise dos resultados de PCR revelou prevalência de 36,3% de Adenovírus. Não havendo distinção entre os sexos e com maior prevalência na faixa etária de 26 a 65 anos com 60,60% dos casos positivos. O sequenciamento dos casos positivos por Adenovírus revelaram a presença dos sorotipos 3, 4, 7, 8 e 34 circulante na região. Conclusão: No município de Viçosa, dois em cada cinco casos de conjuntivite são de etiologia adenoviral.

Objective: The aim of this study was to evaluate the prevalence of Adenovirus as a etiologic agent of conjunctivitis on a ophthalmic clinic in Viçosa, Minas Gerais, Brazil. Methods: Samples of conjunctival secretion from 91 patients clinically diagnosed with conjunctivitis were subjected to polymerase chain reaction (PCR) using degenerate primers targeted to the gene encoding the structural protein II. Positive samples were subsequently subjected to sequencing and genotyping. Results: PCR results showed 36.3% prevalence of Adenovirus. No differences between the sexes and was found to be higher in the age group 26-65 years with 60.60% of the positive cases. Sequencing of positive cases showed the presence of Adenovirus serotypes 3, 4, 7, 8, and 34 circulating in the region. Conclusion: In Viçosa two in five cases of conjunctivitis has Adenovirus as etiologic agent.

Human endogenous retroviruses and tumors / 白血病·淋巴瘤

Viral etiology of tumor has been studied for a century.Seven human tumor viruses were identified over the past half century.The complexity and regularity of the pathogenic mechanisms of human tumor viruses have been elucidated preliminarily.Human genome sequencing indicated that 8 ％ of human genes were composed of human endogenous retroviruses (HERVs).Owing to the findings that adult T-cell leukemia virus (HTLV) can cause human adult T-cell leukemia and animal exogenous and HERVs can induce tumors and malignant diseases,the relationship between HERVs and human tumors has attracted much attention receutly.Here this article discusses the association of the expression of HERVs with leukemia and solid tumors progression,which may be an important aspect of tumor virology.

Características epidemiológicas e influência da coinfecção por vírus respiratórios na gravidade da bronquiolite aguda em lactentes / Epidemiological surveillance and influence of co-infection by respiratory virusesin the severity of acute bronchiolitis in infants

Porto Alegre e comparar a gravidade da doença entre pacientes com um ou mais agentes virais.Métodos: um estudo transversal, realizado entre setembro de 2009 e setembro de 2010, incluiu lactentes de até 12 meses de idade com diagnóstico de bronquiolite viral aguda, que estavam internados nas unidades pediátricas do Hospital São Lucas da PUCRS e haviam iniciado com sintomas de vias aéreas inferiores até 72 horas antes da inclusão. A pesquisa de vírus respiratórios foi realizada em amostras de secreção nasofaríngea, por imunofluorescência direta.Resultados: foram coletadas 71 amostras de um total de 73 pacientes, cuja média de idade foi de 3,3 meses. Do total das amostras coletadas, 61,97% (44/71) foram positivas para vírus. Destas, 70,46% (31/44) foram positivas para apenas um vírus e 29,54% (13/44) para dois ou mais vírus. O vírus sincicial respiratório foi o mais comum (86,36%), seguido pelo influenza (27,27%). Utilizando os desfechos tempo de internação e tempo de uso de oxigênio, não foi observada associação entre presença de coinfecção e gravidade da bronquiolite.Conclusões: o estudo demonstrou uma positividade geral elevada para vírus, com a predominância do vírus sincicial respiratório. Foi demonstrado também um alto índice de coinfecção viral. Não houve efeito adicional, pela presença de mais de um tipo de vírus, na gravidade da bronquiolite. Não se pode excluir a possibilidade de que a combinação com outros vírus, não identificados neste estudo, possa influenciar a gravidade da bronquiolite viral aguda.

Aims: To evaluate the epidemiologic characteristics and to compare the seriousness of the infection between one or more than one viral agents in infants hospitalized with acute viral bronchiolitis.Methods: A cross-sectional study conducted between September 2009 and September 2010 included infants up to 12 months of age diagnosed with acute viral bronchiolitis, who were admitted to the pediatric units of the Hospital São Lucas da PUCRS and had started with lower airways symptoms to 72 hours before inclusion. Testing for respiratory viruses was performed on nasopharyngeal specimens by direct immunofluorescence.Results: Seventy one samples were collected from a total of 73 patients, whose mean age was 3.3 months. Of the total samples collected, 61,97% (44/71) were positive for virus. Of these, 70,46% (31/44) were positive for one virus and 29,54% (13/44) for two or more viruses. Respiratory syncytial virus was the most common (86,36%), followed by parainfluenza (27,27%). Using the outcomes length of hospital stay and time of use of oxygen, there was no association between the presence of coinfection and severity of bronchiolitis.Conclusions: The study demonstrated a high overall positivity for viruses, with the predominance of respiratory syncytial virus. A high rate of viral coinfection was also showed. There was no additional effect of the presence of more than one type of virus on the severity of bronchiolitis. We can not exclude the possibility that the combination with other viruses, unidentified in this study, may influence the severity of acute viral bronchiolitis.

Etiology analysis of 165 infant patients with viral pneumonia / 中国基层医药

Objective To comprehend etiology and clinical manifestation changes of infant pneumonia in this locality.Methods Indirect immunofluorescence (IIF) assay was applied in children with acute pneumonia to detect serum 11 kinds of viruses[respiratory syncytial virus (RSV),adenovirus (ADV),influenza virus (IFV-A+B),parain fluenza virus(PIV14) ,coxsackie B,virus(CB1V),Coxsackie A7 virus (CA7V) ,ECHO virus]specific antibody IgM,according to the serum virus-specific IgM positive,C-reactive protein(CRP)<8mg/L and no other pathogenic infection and laboratory evidence for the conditions of 436 cases detected in children with pneumonia.Results Detected a total 125 cases of antibody-positive,the positive detection rate is 37.99%.Of which 103 cases of single virus infection .accounting for 82.4% ,22 cases of mixed infection,accounting for 17.6%.RSV infection on top of the list followed by the rest of IFV,ADV and PIV.Infants of different ages,different seasons of the different types of virus susceptibility.Conclusion Pneumonia in infants were caused by pathogenic bacteria in addition to the virus of a wide range,and the incidence of age,the peak seasons and the clinical manifestations were vary.From an early stage of infection pathogen detection,clearing pathogen type,making the correct diagnosis of pneumonia in the treatment of infants had an important guiding significance.

Dynamic Etiological Observation of Different Areas in Children with Viral Pneumonia / 实用儿科临床杂志

Objective To investigate the prevalent characteristics of children with viral pneumonia in different areas and years.Methods The viral antigen of cells of nasopharyngeal secretions was detected by the method of alkaline phosphatasea anti-alkalinephhosphatase in viral pneumonia children in different areas and years.Results Among 627cases , there were 290 positive cases and 14 cases were infected by 2 viral strains. Three hundred and four positive viral strains,71 cases (23.35%) were RS virus infection, 47 cases (15.46%) were AD virus infection, 74 cases (24.34%) were FLU-A virus infection,50 cases (16.44%) were FLU-B virus infection, 47 cases (15.46%) were PIV1,3 virus infection, and 15 cases (4.93%) were PIV2 virus infection. But in different areas, the kind of the viral strain of the highest infection rate was different. The viral detection rate in autumn and winter was the highest and in summer was the lowest. Conclusions FLU-A virus is the main etiological agent of children viral pneumonia,but the main etiological agent in different areas is different. In autumn and winter, the viral infection rate is high. The chance of viral infection of lower respiratory tract of big children is reduced.