Genetic diversity of avian paramyxoviruses isolated from wild birds and domestic poultry in Taiwan between 2009 and 2020.

Avian paramyxoviruses (APMVs) belonging to the subfamily Avulavirinae within the family Paramyxoviridae. APMVs consist of twenty-two known species and are constantly isolated from a wide variety of avian species around the world. In this study, the APMV isolates obtained from wild birds and domestic poultry during 2009-2020 in Taiwan were genetically characterized by phylogenetic analysis of their complete fusion protein gene or full-length genome. As a result, 57 APMV isolates belonging to seven different species were obtained during this period and subsequently identified as APMV-1 (n=17), APMV-2 (n=1), APMV-4 (n=25), APMV-6 (n=8), APMV-12 (n=2), APMV-21 (n=2) and APMV-22 (n=2). Sanger sequencing was performed to provide 22 full-length genome sequences and 35 complete fusion protein gene sequences for the APMV isolates. Phylogenetic analysis showed that the recovered viruses were closely related to Eurasian strains, except five class I APMV-1 and four APMV-4 isolates were related to North America strains. Our findings provided more evidence for the intercontinental transmission of APMVs between Eurasia and North America by wild birds. In addition, according to the criteria of the classification system based on complete fusion protein gene sequences, three novel genotypes within APMV-2, APMV-12, and APMV-22 were identified. Together, this investigation provided a broader perspective on the genetic diversity, evolution, and distribution of APMVs in multiple avian host species sampled in Taiwan.

Phylogenetic analysis of avian paramyxoviruses 1 isolated in Taiwan from 2010 to 2018 and evidence for their intercontinental dispersal by migratory birds.

Avian paramyxovirus 1 (APMV-1), synonymous with Newcastle disease virus (NDV), is a worldwide viral agent that infects various avian species and responsible for outbreaks of Newcastle disease. In this study, 40 APMV-1 isolates collected from poultry, migratory birds, and resident birds during 2010-2018 in Taiwan were characterized genetically. Our phylogenetic analysis of complete fusion protein gene of the APMV-1 isolates revealed that 39 of the 40 Taiwanese isolates were closely related to APMV-1 of class I genotype 1 or class II genotypes I, VI or VII, and one isolate belonged to a group that can be classified as a novel genotype 2 within class I. The fusion protein gene sequences of a branch (former 1d) nested within class I sub-genotype 1.2 were closely related to those isolated from wild birds in North America. Viruses placed in class II sub-genotype VI.2.1.1.2.1 and sub-genotype VI.2.1.1.2.2 were the dominant pigeon paramyxovirus 1 (PPMV-1) circulating in the last decade in Taiwan. All the Newcastle disease outbreak-associated isolates belonged to class II sub-genotype VII.1.1, which was mainly responsible for the present epizootic of Newcastle disease in Taiwan. We conclude that at least five sub/genotypes of APMV-1 circulate in multiple avian host species in Taiwan. One genetically divergent group of APMV-1 should be considered as a novel genotype within class I. Migratory birds may play an important role in intercontinental spread of lentogenic APMV-1 between Eurasia and North America.

Urological manifestations of BK polyomavirus in renal transplant recipients.

OBJECTIVES: BK polyomavirus (BKV) disease in renal transplant recipients has become an increasingly problematic clinical entity. Complications of BKV disease lead to chronic allograft nephropathy and ultimately loss in greater than 50% of cases. We reviewed our experience with BKV disease over a 5-year period. PATIENTS AND METHODS: We performed 155 cadaveric and 168 live-related transplants between January 2000 and June 2005. During this period, seven patients had biopsy-confirmed BKV disease, which compromised the renal function of six cadaveric and one live-related renal transplant recipients. BKV was suspected as a potential cause of renal function deterioration after eliminating other possibilities. BKV was then confirmed by detecting viral DNA in urine samples by polymerase chain reaction (PCR) and visualizing viral particles in allograft biopsies by electron microscopy. RESULTS: The deterioration of allograft function in five renal transplant recipients was due to polyomavirus-associated nephropathy and two due to ureteric stenosis. Upon confirmation of BKV, overall immunosuppression was reduced or modified with follow-up of 5 to 44 months. However, additional rescue therapies were used to stabilize allograft function including ciprofloxacin, intravenous immunoglobulin, and leflunomide. One patient died and another lost his allograft due to non-compliance and reverted to hemodialysis, but renal function in the remaining five allografts has remained stable at higher serum creatinine levels. CONCLUSIONS: The management of BKV disease in renal transplant recipients is not yet clearly defined. However, early recognition of urological sequelae and modification of immunosuppressive therapy are essential to ensure adequate long-term function of these allografts.

Terminal loop cutaneous ureterostomy in renal transplantation: an under utilized urinary diversion technique.

PURPOSE: We evaluated the effectiveness of terminal loop cutaneous ureterostomy as a means of urinary drainage in kidney transplant recipients during a 20-year period. MATERIALS AND METHODS: Five cadaveric and 2 living related patients underwent kidney transplantation with terminal loop cutaneous ureterostomy between 1984 and 2004. These patients had no usable bladder or they were not suitable candidates for intermittent catheterization. RESULTS: Followup was 20 months to 17 years. One patient underwent stomal revision 5 months after renal transplantation. Current serum creatinine 4 years later was 166 mumol/l. The remaining 6 patients had no evidence of ureteral obstruction and rarely had bacteriuria or urinary tract infections. Four patients had a functioning allograft with normal serum creatinine. One patient died with a normally functioning allograft and the remaining patient lost his graft due to chronic rejection. No patient in this series lost the graft due to a urological cause. Overall outcomes included excellent allograft function with minimal infection or stomal stenotic complications. CONCLUSIONS: Terminal loop cutaneous ureterostomy is a simple, safe and alternative means of urinary diversion in patients with renal transplant and a defunctionalized lower urinary tract.

Primary small cell carcinoma of the ureter.

Primary small cell carcinoma of the ureter is a rare clinico-pathological entity. We present a report of primary ureteric small cell carcinoma and pathological correlates.