Clinical and molecular characterization of rhinoviruses A, B, and C in adult patients with pneumonia
Section snippets
Background
Human rhinovirus (HRV) is a leading cause of the common cold [1]. However, the scope of HRV research recently widened to include lower respiratory tract infections. Several experimental studies suggested that HRV could function as a lower respiratory tract pathogen [2], [3], and clinical studies reported that HRV was detected in 18–26% of pediatric patients with community-acquired pneumonia (CAP) [4], [5], [6] and in 2–17% of adult patients with CAP [7], [8], [9], [10]. In recent studies, we
Objectives
In the present study we determined the clinical and molecular characteristics of HRVs in adult patients with pneumonia, and compared the severities and outcomes of pneumonia in patients with HRV-A, HRV-B, and HRV-C.
Study design
This study was performed at Asan Medical Center, a 2700-bed tertiary care affiliated teaching hospital in Seoul, Republic of Korea. Consecutive patients whose respiratory specimens tested positive for HRV by polymerase chain reaction (PCR) were identified between June 2012 and May 2013. HRV genotyping and real-time reverse-transcriptase (RT) PCR for HRV quantification were performed on all HRV-positive respiratory specimens. Investigators subsequently reviewed medical records and chest
Results
During the study period, 392 adult patients had HRVs in their respiratory specimens. Of these, 210 admitted patients (53.6%) were tested by PCR for pneumonia. Of these, 13 were excluded from analysis because their specimens were unavailable for genotyping or were negative in repeated PCR testing, and another 32 were excluded because their specimens could not be typed as a result of poor sequence quality (average QV < 10) or low sequence resolution. Finally, a total of 165 adult admitted patients
Discussion
In this study, each HRV species exhibited certain characteristic features. HRV-A was the most common species and HRV-B was more frequently associated with hospital acquisition, neutropenia, and fever. In addition, the HRV-B species harbored a lower viral load in respiratory specimens than the other HRV species. Although patients with a respiratory viral load of ≥104 copies/ml were more commonly encountered in the HRV-C species, HRV-C was not associated with more severe clinical manifestations or
Conflict of interest
A conflicting interest exists when professional judgement concerning a primary interest (such as patient’s welfare or the validity of research) may be influenced by the secondary interest (such as financial gain or personal rivary). It may arise for the authors when they have financial interest that may influence their results or those of others. Examples of potential conflict of interest include employment, consultancies, stock ownership, honoraria, paid expert testimony, patent
Funding
None to reportinterpretation of the
Competing interests
None to report
Ethics approval
The study was approved by the Institutional Review Board of the Asan Medical Center.
Author Contributions
Conception and design: S. H. C., S. H. C., and H. S. Acquisition of data: S. H. C., T. K., S. H. C., and H. S. Analysis and interpretation: S. H. C., S. B. H., S. H. K., J. W. H., K. H. D., S. O. L., S. H. C., and H. S. Drafting the manuscript: S. H. C. and S. H. C. Critical revision of the manuscript for intellectual content: M. N. K., C. M. L., Y. S. K., Y. K., and J. H. W. Final approval: all authors.
Acknowledgement
This study was supported by grant 2014–389 from the Asan Institute of Life Sciences, Seoul, South Korea.
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These authors contributed equally to this study.