Genotype prevalence and risk factors for severe clinical adenovirus infection, united states 2004-2006

被引:163
作者
Gray, Gregory C.
McCarthy, Troy
Lebeck, Mark G.
Schnurr, David P.
Russell, Kevin L.
Kajon, Adriana E.
Landry, Marie L.
Leland, Diane S.
Storch, Gregory A.
Ginocchio, Christine C.
Robinson, Christine C.
Demmler, Gail J.
Saubolle, Michael A.
Kehl, Sue C.
Selvarangan, Rangaraj
Miller, Melissa B.
Chappell, James D.
Zerr, Danielle M.
Kiska, Deanna L.
Halstead, Diane C.
Capuano, Ana W.
Setterquist, Sharon F.
Chorazy, Margaret L.
Dawson, Jeffrey D.
Erdman, Dean D.
机构
[1] Univ Iowa, Coll Publ Hlth, Dept Epidemiol, Ctr Emerging Infect Dis, Iowa City, IA 52242 USA
[2] Univ Iowa, Coll Publ Hlth, Dept Biostat, Iowa City, IA 52242 USA
[3] Calif Dept Hlth Serv, Richmond, CA USA
[4] Naval Hlth Res Ctr, Navy Resp Dis Lab, San Diego, CA USA
[5] Lovelace Resp Res Inst, Albuquerque, NM USA
[6] Yale New Haven Med Ctr, Dept Lab Med, Clin Virol Lab, New Haven, CT 06504 USA
[7] Yale Univ, New Haven, CT USA
[8] Indiana Univ, Sch Med, Indianapolis, IN 46204 USA
[9] Clarian Hlth Partners, Indianapolis, IN USA
[10] St Louis Childrens Hosp, St Louis, MO 63178 USA
[11] Childrens Mercy Hosp, Dept Pathol & Lab Med, Kansas City, MO 64108 USA
[12] N Shore Univ Hosp, Manhasset, NY USA
[13] N Shore Long Isl Jewish Hlth Syst Labs, Manhasset, NY USA
[14] SUNY Upstate Med Univ, Dept Clin Pathol, Syracuse, NY USA
[15] Childrens Hosp, Dept Pathol, Denver, CO 80218 USA
[16] Baylor Coll Med, Dept Pediat, Houston, TX 77030 USA
[17] Texas Childrens Hosp, Diagnost Virol Lab, Houston, TX 77030 USA
[18] Lab Sci Arizona Sonora Quest Labs, Tempe, AZ USA
[19] Med Coll Wisconsin, Dept Pathol, Milwaukee, WI 53226 USA
[20] Univ N Carolina, Dept Pathol & Lab Med, Chapel Hill, NC USA
[21] Vanderbilt Univ, Sch Med, Dept Pathol, Nashville, TN 37212 USA
[22] Vanderbilt Univ, Sch Med, Dept Pediat, Nashville, TN 37212 USA
[23] Univ Washington, Dept Pediat, Seattle, WA 98195 USA
[24] Childrens Hosp & Med Ctr, Seattle, WA 98105 USA
[25] Baptist Med Ctr, Infect Dis Labs, Jacksonville, FL USA
[26] Ctr Dis Control & Prevent, Atlanta, GA USA
关键词
D O I
10.1086/522188
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. Recently, epidemiological and clinical data have revealed important changes with regard to clinical adenovirus infection, including alterations in antigenic presentation, geographical distribution, and virulence of the virus. Methods. In an effort to better understand the epidemiology of clinical adenovirus infection in the United States, we adopted a new molecular adenovirus typing technique to study clinical adenovirus isolates collected from 22 medical facilities over a 25- month period during 2004 - 2006. A hexon gene sequence typing method was used to characterize 2237 clinical adenovirus- positive specimens, comparing their sequences with those of the 51 currently recognized prototype human adenovirus strains. In a blinded comparison, this method performed well and was much faster than the classic serologic typing method. Results. Among civilians, the most prevalent adenovirus types were types 3 ( prevalence, 34.6%), 2 ( 24.3%), 1 ( 17.7%), and 5 ( 5.3%). Among military trainees, the most prevalent types were types 4 ( prevalence, 92.8%), 3 ( 2.6%), and 21 ( 2.4%). Conclusions. For both populations, we observed a statistically significant increasing trend of adenovirus type 21 detection over time. Among adenovirus isolates recovered from specimens from civilians, 50% were associated with hospitalization, 19.6% with a chronic disease condition, 11% with a bone marrow or solid organ transplantation, 7.4% with intensive care unit stay, and 4.2% with a cancer diagnosis. Multivariable risk factor modeling for adenovirus disease severity found that age ! 7 years ( odds ratio [ OR], 3.2; 95% confidence interval [ CI], 1.4 - 7.4), chronic disease ( OR, 3.6; 95% CI, 2.6 - 5.1), recent transplantation ( OR, 2.7; 95% CI, 1.3 - 5.2), and adenovirus type 5 ( OR, 2.7; 95% CI, 1.5 - 4.7) or type 21 infection ( OR, 7.6; 95% CI, 2.6 - 22.3) increased the risk of severe disease.
引用
收藏
页码:1120 / 1131
页数:12
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