Investigation of Respiratory Syncytial Virus Outbreak on an Adult Stem Cell Transplant Unit by Use of Whole-Genome Sequencing

Zhu, Yijun; Zembower, Teresa; Metzger, Kristen; Lei, Zhengdeng; Green, Stefan J.; Qi, Chao

doi:10.1128/jcm.00360-17

Cited by 17 publications

(12 citation statements)

References 32 publications

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“…In this study, we also observed that HRV/EV were associated with prolonged shedding and the most commonly found coinfections were PIV3 and HRV/EV. These results are consistent with previous findings that HRV/EV co-infection or different HRV species co-infection were associated with acute respiratory illness hospitalization and that prolonged viral shedding over the course of 30 days was more commonly associated with respiratory viruses [9,[20][21][22][23]. Because shedding of HRV can occur more than two weeks after infection [19], it could be interpreted that HRV was the most commonly found co-infection pathogen in this study.…”

Section: Quantitative Respiratory Virus Loadsupporting

confidence: 93%

Respiratory virus associated with surgery in children patients

et al. 2019

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Background Viral respiratory infection (VRI) is a common contraindication to elective surgery. Asymptomatic shedding among pediatric surgery patients (PSPs) could potentially lead to progression of symptomatic diseases and cause outbreaks of respiratory diseases. The aim of this study is to investigate the incidence of infection among mild symptomatic PSP group and asymptomatic PSP group after surgical procedure. Methods We collected the induced sputum from enrolled 1629 children (under 18 years of age) with no respiratory symptom prior to pediatric surgery between March 2017 and February 2019. We tested 16 different respiratory virus infections in post-surgery mild symptomatic PSP group and asymptomatic PSP group using a quantitative real-time reverse transcriptase polymerase chain reaction (qRT-PCR) assay panel. We analyzed symptom data and quantitative viral load to investigate the association between viruses, symptoms and viral quantity in qRT-PCR-positive PSPs. Results Out of 1629 children enrolled, a total of 204 respiratory viruses were present in 171 (10.50%) PSPs including 47 patients with mild symptoms and 124 with no symptoms after surgery. Commonly detected viruses were human rhino/enterovirus (HRV/EV, 42.19%), parainfluenza virus 3 (PIV3, 24.48%), coronavirus (CoV NL63, OC43, HKU1, 11.46%), and respiratory syncytial virus (RSV, 9.9%). PIV3 infection with a higher viral load was frequently found in PSPs presenting with mild symptoms, progressing to pneumonia with radiographic evidence after surgery. HRV/EV were the most commonly detected pathogens in both asymptomatic and mild symptomatic PSPs. CoV (OC43, HKU1) infections with a higher viral load were mostly observed in asymptomatic PSPs progressing to alveolar or interstitial infiltration. Conclusions Our study suggested that PIV3 is a new risk factor for VRI in PSPs. Employing a more comprehensive, sensitive and quantitative method should be considered for preoperative testing of respiratory viruses in order to guide optimal surgical timing.

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Section: Quantitative Respiratory Virus Loadsupporting

confidence: 93%

Respiratory virus associated with surgery in children patients

et al. 2019

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“…Applying WGS and phylogenetic analysis, they excluded the possibility of a single source-transmission with a turnaround time of 24 hour. 240 Phylogenetic analysis applied to WGS revealed to be essential to discriminate nosocomial outbreak strains from other strains isolated in the same setting but not related to the outbreak event, as recently demonstrated by Zhu et al 241 during an epidemiological investigation performed on respiratory syncytial virus-B strains circulating within a unit of hematology and stem cell transplant. Authors compared the routine sequencing of glycoprotein (G) gene to the WGS and concluded that phylogenetic analysis applied to single gene sequence was not able to identify the cluster outbreak and that at this aim WGS was essential.…”

Section: Phylogenetic Analysis Of Whole-genome Sequencing For Viralmentioning

confidence: 85%

“…Authors compared the routine sequencing of glycoprotein (G) gene to the WGS and concluded that phylogenetic analysis applied to single gene sequence was not able to identify the cluster outbreak and that at this aim WGS was essential. 241 Recently phylogenetic analysis was used to investigate the measles outbreak of nosocomial origin occurred in Milan, Italy between March and August 2017. This study by phylogenetic inference demonstrated the occurrence of three nosocomial clusters within an emergency department initially notified as unrelated cases, suggesting the importance of measles vaccination especially for the healthcare workers.…”

Section: Phylogenetic Analysis Of Whole-genome Sequencing For Viralmentioning

confidence: 99%

The phylogenetic approach for viral infectious disease evolution and epidemiology: An updating review

Ciccozzi

Lai

Zehender

et al. 2019

Journal of Medical Virology

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In the last decade, the phylogenetic approach is recurrent in molecular evolutionary analysis. On 12 May, 2019, about 2 296 213 papers are found, but typing “phylogeny” or “epidemiology AND phylogeny” only 199 804 and 20 133 are retrieved, respectively. Molecular epidemiology in infectious diseases is widely used to define the source of infection as so as the ancestral relationships of individuals sampled from a population. Coalescent theory and phylogeographic analysis have had scientific application in several, recent pandemic events, and nosocomial outbreaks. Hepatitis viruses and immunodeficiency virus (human immunodeficiency virus) have been largely studied. Phylogenetic analysis has been recently applied on Polyomaviruses so as in the more recent outbreaks due to different arboviruses type as Zika and chikungunya viruses discovering the source of infection and the geographic spread. Data on sequences isolated by the microorganism are essential to apply the phylogenetic tools and research in the field of infectious disease phylodinamics is growing up. There is the need to apply molecular phylogenetic and evolutionary methods in areas out of infectious diseases, as translational genomics and personalized medicine. Lastly, the application of these tools in vaccine strategy so as in antibiotic and antiviral researchers are encouraged.

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“…Molecular characterization of RSV strains, for instance by whole genome sequencing [37] or characterization of RSV G-Protein [16,38], has been used to investigate nosocomial RSV outbreaks. We were able to collect and examine selected outbreak strains by G-Protein gene sequencing.…”

Section: Discussionmentioning

confidence: 99%

Molecular characteristics and successful management of a respiratory syncytial virus outbreak among pediatric patients with hemato-oncological disease

Baier

Haid

Beilken

et al. 2018

Antimicrob Resist Infect Control

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BackgroundRespiratory syncytial virus (RSV) is responsible for upper and lower respiratory tract infection in adults and children. Especially immunocompromised patients are at high risk for a severe course of infection, and mortality is increased. Moreover RSV can spread in healthcare settings and can cause outbreaks. Herein we demonstrate the successful control and characteristics of a RSV outbreak that included 8 patients in our Department of Pediatric Hematology and Oncology.MethodsWe performed an epidemiologic investigation and a molecular analysis of the outbreak strains. Moreover we present the outbreak control bundle and our concept for RSV screening in the winter season.ResultsRSV A and B strains caused the outbreak. RSV B strains affected 3 patients, 2 of whom were co-infected with RSV A. Exactly this RSV A strain was detected in another 5 patients. Our multimodal infection control bundle including prophylactic RSV screening was able to rapidly stop the outbreak.ConclusionAn infection control bundle in RSV outbreaks should address all potential transmission pathways. In pediatric settings the restriction of social activities might have a temporal negative impact on quality of life but helps to limit transmission opportunities. Molecular analysis allows better understanding of RSV outbreaks and, if done in a timely manner, might be helpful for guidance of infection control measures.

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Investigation of Respiratory Syncytial Virus Outbreak on an Adult Stem Cell Transplant Unit by Use of Whole-Genome Sequencing

Cited by 17 publications

References 32 publications

Respiratory virus associated with surgery in children patients

Respiratory virus associated with surgery in children patients

The phylogenetic approach for viral infectious disease evolution and epidemiology: An updating review

Molecular characteristics and successful management of a respiratory syncytial virus outbreak among pediatric patients with hemato-oncological disease

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