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European Journal of Clinical Microbiology & Infectious Diseases

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Open Access 01-08-2020 | Adenovirus | Original Article

Viruses and atypical bacteria in the respiratory tract of immunocompromised and immunocompetent patients with airway infection

Authors: Maria Reckziegel, Claudia Weber-Osel, Renate Egerer, Bernd Gruhn, Florian Kubek, Mario Walther, Stefanie Wilhelm, Roland Zell, Andi Krumbholz

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 8/2020

Abstract

Respiratory tract infections (RTI) can take a serious course under immunosuppression. Data on the impact of the underlying pathogens are still controversial. Samples from the upper (n = 322) and lower RT (n = 169) were collected from 136 children and 355 adults; 225 among them have been immunocompromised patients. Exclusion criteria were presence of relevant cultivable microorganisms, C-reactive protein > 20 mg/dl, or procalcitonin > 2.0 ng/ml. Samples were tested by PCR for the presence of herpesviruses (HSV-1/-2; VZV; CMV; HHV6; EBV), adenoviruses, bocaviruses, entero-/rhinoviruses (HRV), parechoviruses, coronaviruses, influenza viruses (IV), parainfluenza viruses as well as for pneumoviruses (HMPV and RSV), and atypical bacteria (Mycoplasma pneumoniae, M.p.; Chlamydia pneumoniae, C.p.). Viral/bacterial genome equivalents were detected in more than two-thirds of specimens. Under immunosuppression, herpesviruses (EBV 30.9%/14.6%, p < 0.001; CMV 19.6%/7.9%, p < 0.001; HSV-1: 14.2%/7.1%, p = 0.012) were frequently observed, mainly through their reactivation in adults. Immunocompromised adults tended to present a higher RSV prevalence (6.4%/2.4%, p = 0.078). Immunocompetent patients were more frequently tested positive for IV (15.0%/5.8%, p = 0.001) and M.p. (6.4%/0.4%, p < 0.001), probably biased due to the influenza pandemic of 2009 and an M.p. epidemic in 2011. About 41.8% of samples were positive for a single pathogen, and among them EBV (19.9%) was most prevalent followed by HRV (18.2%) and IV (16.6%). HSV-2 and C.p. were not found. Marked seasonal effects were observed for HRV, IV, and RSV. Differences in pathogen prevalence were demonstrated between immunocompetent and immunocompromised patients. The exact contribution of some herpesviruses to the development of RTI remains unclear.

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Title: Viruses and atypical bacteria in the respiratory tract of immunocompromised and immunocompetent patients with airway infection
Authors: Maria Reckziegel
Claudia Weber-Osel
Renate Egerer
Bernd Gruhn
Florian Kubek
Mario Walther
Stefanie Wilhelm
Roland Zell
Andi Krumbholz
Publication date: 01-08-2020
Publisher: Springer Berlin Heidelberg
Keywords: Adenovirus
Chlamydophila Pneumoniae
Coronavirus
Published in: European Journal of Clinical Microbiology & Infectious Diseases / Issue 8/2020
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI: https://doi.org/10.1007/s10096-020-03878-9

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