Human Metapneumovirus and Community-Acquired Respiratory Illness in Children

摘要: To the Editor: Stockton et al. have reported detection of human metapneumovirus (HMPV) by using reverse transcriptase-polymerase chain reaction (PCR) in patients with influenzalike illness (1). These authors examined specimens submitted from patients, mainly adults, during winter 2000–01 and identified HMPV 2.2% who had tested negative for influenza virus respiratory syncytial (HRSV). Although several papers been published on infection children (2–4), real impact this health pediatric population remains to be determined. The data we obtained present study support epidemiologic findings J. (1) reinforce notion that is a pathogen associated community-acquired acute tract (ARTI). We investigated occurrence 80%) affected lower tract. Of these children, 379 were hospitalized 186 discharged without admission. Hospital Donostia belongs public system main referral hospital 9,500 <3 years age. More than 97% hospitalizations our region occur hospital. Nasopharyngeal aspirates processed cell culture rapid shell vial techniques MDCK, A-549, LLC-MK2 lines. RNA was then extracted original samples phenol-chloroform (TRIzol LS Reagent, Invitrogen Corp., Carlsbad, U.K.) converted into cDNA random primers M-MuLV transcriptase (USB Cleveland, OH). Nested PCR performed detect HRSV, influenza, parainfluenza viruses as previously described (5,6). remaining frozen at –80°C until subsequent use. We all studied viruses, well 100 randomly selected positive one or more viruses. 5 µL stored derived F gene under conditions (7). product (450 bp) HMPV-positive sequenced an ABI PRISM 3100 Genetic Analyzer (Applied Biosystems, Foster City, CA). In 411 (72.7%) 565 studied, least initially detected. HRSV found 313 (55.4%) 44 (7.8%), 36 (6.4%), adenovirus 32 (5.7%); 14 mixed infections 154 result, 147 (95.5%), result six (4.1%). No detected any Four required hospitalization: 7-month-old boy pulmonary bronchodysplasia, rhinitis, fever 38.4°C (patient 1); 20-month-old girl previous obstructive disease insufficiency along generalized hypoventilation, crackles, wheezing, radiologic images air entrapment requiring bronchodilator administration 2); 16-month-old febrile syndrome, basal crackles auscultation, perihilar infiltrates 3); 11-month-old pneumonia upper left lobe 4). two 5) 9-month-old 6), both symptoms clear chest, did not require hospitalization. In outcome favorable. Analysis amplified sequences showed clusters HMPV. first composed 1, 3, 4, 6 (GenBank accession nos. {"type":"entrez-nucleotide","attrs":{"text":"AY152846","term_id":"25527934"}}AY152846, {"type":"entrez-nucleotide","attrs":{"text":"AY152851","term_id":"25528052"}}AY152851, {"type":"entrez-nucleotide","attrs":{"text":"AY152850","term_id":"25528033"}}AY152850, {"type":"entrez-nucleotide","attrs":{"text":"AY152847","term_id":"25527963"}}AY152847, respectively), second 2 {"type":"entrez-nucleotide","attrs":{"text":"AY152849","term_id":"25528014"}}AY152849 {"type":"entrez-nucleotide","attrs":{"text":"AY152848","term_id":"25527988"}}AY152848). similarity among nucleotide same cluster >95% oscillated 86% 88% when compared those different cluster. During season, observed circulation clusters. When Spain recently North America (7), isolate CAN97-83 no. {"type":"entrez-nucleotide","attrs":{"text":"AY145296","term_id":"24429881"}}AY145296), isolates CAN98-73 CAN98-79 {"type":"entrez-nucleotide-range","attrs":{"text":"AY145287-AY145293","start_term":"AY145287","end_term":"AY145293","start_term_id":"24429863","end_term_id":"24429875"}}AY145287-AY145293), connecting Canadian characterized groups Our results suggest Spain, other places world (2,7), major exist. severity episodes varied mild severe hospitalization 2–6 days. Overall, (2,8), clinical picture provoked indistinguishable fact also suggests coinfection infrequent. study, consecutive seasons southern Europe, allow us estimate incidence moderate caused low considerably greater. Despite results, think new warrants surveillance. appears capable provoking infections, its role still poorly understood.