Viral pathogens associated with acute respiratory illness in hospitalized adults and elderly from Zagreb, Croatia, 2016 to 2018

Abstract

Aims: To investigate the viral etiology of acute respiratory infection (ARI) in hospitalized adults and elderly patients in Croatia, compare the prevalence of detected viruses, and to determine clinical characteristics and seasonal occurrence of investigated infections.Methods: From January 2016 to June 2018, a total of 182 adult patients presented with symptoms of ARI and admitted to the hospital were tested for 15 respiratory viruses by multiplex reverse-transcription polymerase chain reaction. Clinical data were collected by retrospective analysis of the patient's chart. Results:A virus was identified in 106 (58.5%) of the patients. The most commonly detected virus was influenza virus (41.5%), followed by respiratory syncytial virus (13.8%), human metapneumovirus (13.0%), parainfluenza viruses (12.2%), rhinoviruses (11.4%), adenovirus and coronaviruses with equal frequencies (3.3%), and enterovirus (1.6%). The serum level of C-reactive protein and white blood cell count were significantly lower in patients with respiratory viruses identified when compared with those in whom no virus was detected (P < 0.001 and P = 0.007, respectively). There were no differences in clinical symptoms according to the type of the detected virus, except for more frequent illness exposure recall for influenza infection (P = 0.010). Influenza, parainfluenza, and pneumoviruses were detected mostly in winter months, while rhinoviruses in autumn and spring.Conclusions: In addition to influenza, pneumoviruses, rhinoviruses, and parainfluenza viruses play an important role in etiology of ARIs in adults. Fast and accurate laboratory diagnosis for respiratory viruses in routine practice is needed for clinicians optimally manage patients with ARI and potentially avoid the unnecessary use of antimicrobial drugs. K E Y W O R D S human metapneumovirus, influenza, multiplex reverse-transcription polymerase chain reaction, respiratory syncytial virus J Med Virol. 2019;91:1202-1209. wileyonlinelibrary.com/journal/jmv 1202 |

Human adenovirus type 26 uses sialic acid–bearing glycans as a primary cell entry receptor

“…As pathogens, human adenoviruses (HAdVs) have been isolated from severe infections in both immunocompromised and healthy individuals ( 1 ). Some adenoviruses have been associated with acute infection of the eye ( 2 ), respiratory ( 3 ), and gastrointestinal tract ( 1 ). In rare cases, infections prove fatal, as observed in a recent neonatal infection of species D adenovirus type 56 (HAdV-D56) ( 4 ), among adult patients in New Jersey with HAdV-B7d ( 5 ) and infamously with HAdV-E4, where large epidemics of adenovirus infection have been seen in military recruits ( 6 ).…”

The Emerging Role of Rhinoviruses in Lower Respiratory Tract Infections in Children – Clinical and Molecular Epidemiological Study From Croatia, 2017–2019

“…Introduction of sensitive and technically simple molecular detection assays, especially multiplex PCR, enabled affordable RV detection in line with other common respiratory viruses in clinical samples. Together with coronaviruses, RVs are indeed responsible for majority of upper respiratory tract infection (URTI), but also for substantial rate of LRTIs in all age groups (Lauinger et al, 2013; Zhao et al, 2018, Čivljak et al, 2019). Many studies showed that RV is one of the leading causes of pneumonia, bronchiolitis and other form of severe respiratory disease (Zhao et al, 2018), standing side by side with respiratory syncytial virus (RSV) in children and influenza in elderly (Esposito et al, 2013; Ning et al, 2017; Čivljak et al, 2019).…”

An Outbreak of Human Parainfluenza Virus 3 (Phylogenetic Subcluster C5) Infection among Adults at a Residential Care Facility for the Disabled in Croatia, 2018

“…Sequences from this study are shown in bold and are indicated with their strain identification number, followed by the accession number. stood [4,24]. HPIV3 is an important causative agent of ARI that can be complicated with pneumonia, especially in immunocompromised and elderly individuals.…”

“…Infections caused by HPIV may be sporadic, although outbreaks are frequent. Seasonal variations in the occurrence of HPIV infections are generally seen when serotype-specific rates of infection are analyzed, which are highly dependent on the region [3][4][5]. More specifically, the seasonal infection patterns observed in the northern hemisphere, in countries with temperate climate, are basically absent in tropical and subtropical regions, where there is little variation in infection rates during the year [3,6].…”