Human adenoviruses (HAdV) are one of the most frequent causes of respiratory infections around the world, causing mild to severe disease. In Argentina, many studies focused on the association of HAdV ...respiratory infection with severe disease and fatal outcomes leading to the discovery in 1984 of a genomic variant 7h associated with high fatality. Although several molecular studies reported the presence of at least 4 HAdV species (B, C, D and E) in Argentina, few sequences were available in the databases. In this study, sequences from the hexon gene region were obtained from 141 patients as a first approach to assess the genetic diversity of HAdVs circulating in Buenos Aires, Argentina. Phylogenetic analysis of these sequences and others recovered from public databases confirmed the circulation of the four above-mentioned species represented by 11 genotypes, with predominance in species B and C and shifts in their proportion in the studied period (2000 to 2018). The variants detected in Argentina, for most of the genotypes, were similar to those already described in other countries. However, uncommon lineages belonging to genotypes C2, C5 and E4 were detected, which might indicate the circulation of local variants and will deserve further studies of whole-genome sequences.
Current diagnostic standards involve severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) detection in nasopharyngeal swabs (NPS), but saliva is an attractive and noninvasive option for ...diagnosis. The objectives were to determine the performance of saliva in comparison with NPS for detecting SARS‐CoV‐2 and to compare the optimized home brew reverse‐transcription polymerase chain reaction (RT‐PCR) with a commercial RT‐PCR. Paired NPS and saliva specimens were prospectively collected and tested by RT‐PCR from patients presenting at an emergency room with signs and symptoms compatible with coronavirus disease‐2019. A total of 348 samples from 174 patients were tested by RT‐PCR assays. Among 174 patients with symptoms, 63 (36%) were SARS‐CoV‐2 positive in NPS using the optimized home‐brew PCR. Of these 63 patients, 61 (98%) were also positive in saliva. An additional positive SARS‐CoV‐2 saliva was detected in a patient with pneumonia. Kappa Cohen's coefficient agreement between NPS and saliva was 0.96 (95% confidence interval CI, 0.90–0.99). Median Ct values in NPS versus saliva were 18.88 (interquartile range IQR, 15.60–23.58; range, 11.97–38.10) versus 26.10 (IQR, 22.75–30.06; range, 13.78–39.22), respectively (p < .0001). The optimized home‐brew RT‐PCR demonstrated higher analytical and clinical sensitivity compared with the commercial RT‐PCR assay. A high sensitivity (98%) and agreement (kappa 0.96) in saliva samples compared to NPS was demonstrated when using an optimized home‐brew PCR even when the viral load in saliva was lower than in NPS. This noninvasive sample is easy to collect, requires less consumable and avoids discomfort to patients. Importantly, self‐collection of saliva can diminish exposure to healthcare personnel.
To determine and compare the viral frequency, seasonality and clinical-demographic features in 2 groups of children (hospitalized versus outpatients) with acute respiratory infections.
A ...cross-sectional, descriptive study was performed from 2008 to 2010 in 620 children <6 years of age with acute respiratory infection. Respiratory samples were studied for classical respiratory viruses by immunofluorescence and for human rhinoviruses (HRV) by real-time reverse transcription polymerase chain reaction. Clinical and demographic data were recorded.
Viral detection by immunofluorescence was 48% in 434 inpatients and 37% in 186 outpatients. Viral diagnosis increased to 83% and 62%, respectively, when testing for HRV. HRV (41%) and respiratory syncytial virus (RSV) (27%) were most common viruses identified, followed by metapneumovirus (9%), influenza A and parainfluenza (3%), adenovirus and influenza B (2%). HRV frequency was significantly higher in hospitalized patients (47%) than in outpatients (27%) (P < 0.001). Coinfection was detected in 12% of hospitalized and 4% of outpatients (P < 0.031). HRV and adenovirus circulated throughout the entire year. RSV, influenza A and B predominated in winter, whereas metapneumovirus and parainfluenza predominated in spring. Of 362 patients with bronchiolitis, 84% had a virus identified; HRV (42%) and RSV (38%) were predominant. Of 77 patients with pneumonia, 84% had a virus detected with HRV (43%) and RSV (29%) predominating.
HRV were significant pathogens associated with bronchiolitis and pneumonia, especially in hospitalized patients. Both, HRV and coinfections, were risk factors for hospitalization. These findings support the importance of including HRV detection in children with acute respiratory infection.
The entire nucleotide sequence of the G gene of three human respiratory syncytial virus (HRSV) isolates (antigenic group B) has been determined. These three viruses (named BA viruses) were isolated ...in Buenos Aires in 1999 from specimens collected in different hospitals and at different dates. BA viruses have an exact duplication of 60 nucleotides in the G gene, starting after residue 791. This duplication is flanked by a repeat of four nucleotides (GUGU) and can fold into a relatively stable secondary structure. These features suggest a possible mechanism for the generation of a duplicated G segment. The predicted polypeptide is lengthened by 20 amino acids (residues 260-279) and this is reflected in the slower electrophoretic mobility of the G protein precursor of BA viruses compared with related viruses. The changes reported here expand the examples of drastic genetic alterations that can be introduced into the G protein sequence of HRSV while it replicates in its natural host.
An intertypic recombinant adenovirus with a serotype 3-like hexon gene and a serotype 16-like fiber (99% identical to that of the prototype strain of human adenovirus 16 HAdV-16, Ch79) was isolated ...in Argentina from an infant admitted to the hospital with acute respiratory disease. Consistent with the results of molecular characterization, strain Arg827/04 was designated H3-F16.
To determine clinical and virologic characteristics of pandemic (H1N1) 2009 in Buenos Aires, Argentina, we conducted real-time reverse transcription-PCR on samples from patients with influenza-like ...illness, June 11-30, 2009. Of 513 patients tested, 54% were positive for influenza virus subtype H1N1. Infection rate was lowest for patients >or=60 years of age.
Las infecciones respiratorias agudas producen una importante morbimortalidad y comúnmente son causadas por virus. En Argentina, los programas de vigilancia epidemiológica se basan en la detección de ...antígenos virales por inmunofluorescencia (IF), aunque es bien conocido que los métodos moleculares son más sensibles. El panel respiratorio (PR) FilmArray (PR-FilmArray) es un equipo comercial automatizado de PCR múltiples que detecta 17 virus respiratorios y 3 bacterias, en un sistema cerrado que requiere 5min de procesamiento y una 1h de instrumentación. Se evaluó un total de 315 muestras respiratorias de niños menores de 6 años con infecciones respiratorias agudas por IF para 8 virus respiratorios y por RT-PCR para rinovirus. Posteriormente, estas muestras se estudiaron con el PR-FilmArray. La frecuencia de positividad al considerar los 9 virus estudiados por IF y RT-PCR fue del 75%; por PR-FilmArray fue del 92%. El porcentaje de acuerdo positivo entre ambas metodologías fue del 70,5% y el de acuerdo negativo fue del 99,6% (intervalo de confianza 95%: 65,5-75,1 y 99,2-99,8, respectivamente). El PR-FilmArray permitió obtener un mayor diagnóstico positivo (97%) y detectó otros virus, como los coronavirus NL63, 229E, OC43 y HKU1 (10%) y los bocavirus (18%). Además, permitió identificar coinfecciones múltiples (39%) con 2, 3, 4 y hasta 5 virus. Actualmente, la IF continúa siendo el método más utilizado en los países latinoamericanos para el diagnóstico de virus respiratorios por su bajo costo, por su capacidad para procesar un alto número de muestras simultáneamente y porque los resultados de los virus más frecuentes están disponibles en 5h. Sin embargo, la futura incorporación de métodos moleculares aumentaría notablemente la capacidad diagnóstica.
Acute respiratory infections, which are commonly caused by viruses, are an important cause of morbidity and mortality in children. In Argentina, national surveillance programs for the detection of respiratory viruses are usually performed by using immunofluorescence (IF) assays, although it is well known that molecular methods are more sensitive. An automated multiplex PCR device, the FilmArray-Respiratory Panel (FilmArray-RP), can detect 17 viral and 3 bacterial pathogens in a closed system that requires only 5min of hands-on time and 1h of instrumentation time. A total of 315 respiratory samples from children under 6 years of age suffering from acute respiratory infections, were studied by IF for 8 respiratory viruses and by RT-PCR for rhinoviruses. Later, these samples were tested by the FilmArray-RP. The positivity frequency obtained for the 9 viruses tested was 75% by IF/RT-PCR and 92% by the FilmArray-RP. The positive and negative percent agreement between both methods was 70.5% whereas the negative percent agreement was 99.6% (95% confidence interval:65.5-75.1 and 99.2-99.8 respectively). The FilmArray-RP allowed a higher positive diagnosis (97%) and detected other viruses such as coronavirus NL63, 229E, OC43, HKU1 (10%) and bocavirus (18%). In addition, this method identified multiple coinfections (39%) with 2, 3, 4 and up to 5 different viruses. At present, IF is still the most frequently used method in most Latin American countries for respiratory viruses diagnosis due to its low cost, its capability to process a high number of samples simultaneously and the fast determination of results for the most frequent viruses, which are available within 5h. However, the coming incorporation of molecular methods in routine procedures will significantly increase the diagnostic yield of these infections.
The genetic and antigenic variability of human respiratory syncytial virus (HRSV) strains isolated in Buenos Aires from 1995 to 2001 was evaluated by partial nucleotide sequencing of the G gene and ...enzyme-linked immunosorbent assay analysis with anti-G monoclonal antibodies. Phylogenetic analyses showed that 37 group A strains clustered into five genotypes, whereas 20 group B strains clustered into three genotypes. Group A showed more genetic variability than group B. A close correlation between genotypes and antigenic patterns was observed. Changes detected in the G protein of viruses from both groups included (i) amino acid substitutions and(ii) differences in protein length due to either changes in stop codon usage or sequence duplications. Three B strains from 1999 exhibited a duplication of 20 amino acids, while one B strain from 2001 had 2 amino acids duplicated. The comparison among Argentinean HRSV strains and viruses isolated in other geographical areas during different epidemics is discussed.
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