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Adenovirus species C is associated with chronic suppurative lung diseases in children
Danielle F Wurzel1, Ian M Mackay2, Julie M Marchant1
1Queensland Children's Medical Research Institute, The University of Queensland Queensland Children's Respiratory Centre, Royal Children's Hospital.
Insights
Human adenoviruses (HAdVs) species C, particularly HAdV-1 and HAdV-2, are common in children with chronic respiratory conditions. HAdV detection in the lower airways is linked to specific bacterial infections and younger age.
Area of Science:
- Pediatric Pulmonology
- Virology
- Infectious Diseases
Background:
- Human adenoviruses (HAdVs) are implicated in chronic respiratory diseases.
- Limited data exists on HAdV molecular sequencing in the lower airways of children with chronic endobronchial suppuration.
- This study investigates HAdV genotypes and their association with bacterial coinfections in children with protracted bacterial bronchitis (PBB) and mild bronchiectasis (BE).
Purpose of the Study:
- To identify major human adenovirus (HAdV) genotypes and species in the lower airways of children with PBB and mild bronchiectasis.
- To explore the relationship between HAdV detection and bacterial coinfections in these pediatric populations.
- To assess the influence of age and immune factors on HAdV presence and coinfection patterns.
Main Methods:
- A prospective cohort study included 245 children with PBB or mild bronchiectasis.
- Bronchoalveolar lavage (BAL) samples were analyzed for HAdV detection and genotyping.
- Bacterial infection presence was compared between HAdV-positive and HAdV-negative groups; immune function tests were also conducted.
Main Results:
- Species C HAdVs (HAdV-1 and HAdV-2) were identified in 96% of HAdV-positive children.
- HAdV detection was significantly associated with bacterial coinfection (Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae) and negatively associated with Staphylococcus aureus.
- Younger age correlated with increased HAdV detection, and elevated natural killer cells (CD16/CD56) were more common in HAdV-positive children.
Conclusions:
- Human Adenovirus C (HAdV-C) is the predominant species found in the lower airways of children with PBB and BE.
- Younger age is a significant risk factor for lower airway HAdV detection and influences bacterial coinfection likelihood.
- Findings highlight the role of HAdV-C in pediatric chronic airway diseases and associated coinfections.
Background:
The role of human adenoviruses (HAdVs) in chronic respiratory disease pathogenesis is recognized. However, no studies have performed molecular sequencing of HAdVs from the lower airways of children with chronic endobronchial suppuration. We thus examined the major HAdV genotypes/species, and relationships to bacterial coinfection, in children with protracted bacterial bronchitis (PBB) and mild bronchiectasis (BE).
Methods:
Bronchoalveolar lavage (BAL) samples of 245 children with PBB or mild (cylindrical) BE were included in this prospective cohort study. HAdVs were genotyped (when possible) in those whose BAL had HAdV detected (HAdV(+)). Presence of bacterial infection (defined as ≥10(4) colony-forming units/mL) was compared between BAL HAdV(+) and HAdV negative (HAdV(-)) groups. Immune function tests were performed including blood lymphocyte subsets in a random subgroup.
Results:
Species C HAdVs were identified in 23 of 24 (96%) HAdV(+) children; 13 (57%) were HAdV-1 and 10 (43%) were HAdV-2. An HAdV(+) BAL was significantly associated with bacterial coinfection with Haemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumoniae (odds ratio [OR], 3.27; 95% confidence interval, 1.38-7.75; P = .007) and negatively associated with Staphylococcus aureus infection (P = .03). Young age was related to increased rates of HAdV(+). Blood CD16 and CD56 natural killer cells were significantly more likely to be elevated in those with HAdV (80%) compared with those without (56.1%) (P = .027).
Conclusions:
HAdV-C is the major HAdV species detected in the lower airways of children with PBB and BE. Younger age appears to be an important risk factor for HAdV(+) of the lower airways and influences the likelihood of bacterial coinfection.
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