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Published on: September 10, 2021
Nonenteric Adenoviruses Associated with Gastroenteritis in Hospitalized Children
Maria Antonia De Francesco1, Giovanni Lorenzin1, Antonella Meini2
1Institute of Microbiology, Department of Molecular and Translational Medicine, University of Brescia-Spedali Civili, Brescia, Italy.
Insights
Human adenovirus (HAdV) infections were found in 7.1% of hospitalized children, primarily those under five. This highlights the need for broader diagnostic methods to detect diverse HAdV types causing gastroenteritis.
Area of Science:
- Virology
- Pediatric Infectious Diseases
- Molecular Diagnostics
Background:
- Gastroenteritis is a leading cause of death in children globally.
- Human adenovirus (HAdV) is a significant pathogen, but non-enteric types' role in gastroenteritis is under-recognized.
- Current diagnostic methods may not detect all relevant HAdV types.
Purpose of the Study:
- To determine the frequency of HAdV infections in hospitalized pediatric patients.
- To characterize the HAdV types and genetic diversity circulating in this population.
- To assess the clinical relevance of HAdV, including coinfections.
Main Methods:
- Collection and analysis of stool samples from pediatric patients over one year (Feb 2018-Jan 2019).
- Detection of HAdV using broad-range polymerase chain reaction (PCR).
- Genotyping via sequencing and phylogenetic analysis, alongside clinical data review.
Main Results:
- HAdV was detected in 7.1% (34/476) of stool samples.
- The majority (85.2%) of positive cases were in children under five years old.
- Two HAdV species (B and C) with three types were identified; species F was not detected. High genetic diversity was observed.
Conclusions:
- Adenovirus types beyond 40 and 41 may contribute to acute gastroenteritis in children.
- Coinfections with other pathogens were common (23.5%) among HAdV-positive patients.
- Development of molecular assays with broad reactivity is crucial for accurate and rapid HAdV diagnosis.
Abstract:
The object of this study was to investigate the frequency of human adenovirus (HAdV) infections in hospitalized pediatric patients. Stool samples were collected during a 1-year period (February 2018 to January 2019). HAdV was detected by a broad-range PCR and genotyped by sequencing and phylogenetic analysis. Demographic characteristics and detailed clinical information were analyzed for each patient. HAdV was detected in 7.1% of stool samples (34/476). Among these patients, 23.5% were coinfected with other enteric viral or bacterial pathogens. The majority (85.2%) of HAdV positives were detected in children of <5 years of age. Two HAdV species (B and C) with three types were identified in this study population. HAdV species F was not detected. Genetic analysis shows that the isolates circulating in our region present high diversity and do not exhibit clonal expansion. The presence of nonenteric HAdV in subjects with gastrointestinal symptoms and in immunocompromised patients has already been reported by different studies and underlines the need to develop routine molecular assays that have wide reactivity for most types of adenovirus in order to obtain an optimal tool for their rapid and accurate diagnosis. IMPORTANCE Gastroenteritis is the second leading cause of death among infants and children worldwide. Our study shows that adenovirus types other than 40 and 41 might be related to acute gastroenteritis. Therefore, a novel approach using diagnostic methods able to detect all adenovirus types is desirable in order to overcome the limitations of the current techniques.
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