1. A(H1N1)pdm09 hemagglutinin D222G and D222N variants are frequently harbored by patients requiring extracorporeal membrane oxygenation and advanced respiratory assistance for severe A(H1N1)pdm09 infection
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Giovanni Di Perri, Tiziano Allice, Maria Grazia Milia, Rosario Urbino, Maria Stella, Valeria Ghisetti, Andrea Calcagno, T. Ruggiero, Francesco Giuseppe De Rosa, Elisa Burdino, Francesco Cerutti, Marco Ranieri, Nicole Pagani, Gabriella Gregori, Ruggiero, T., De Rosa, F., Cerutti, F., Pagani, N., Allice, T., Stella, M.L., Milia, M.G., Calcagno, A., Burdino, E., Gregori, G., Urbino, R., Di Perri, G., Ranieri, M.V., and Ghisetti, V.
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Male ,Pandemic H1N1 Influenza ,Epidemiology ,receptor binding ,retrospective study ,medicine.medical_treatment ,Hemagglutinin Glycoproteins, Influenza Virus ,virus strain, A(H1N1)pdm09 viru ,Disease ,intensive care unit ,Influenza virus A H1N1 ,Influenza A Virus, H1N1 Subtype ,Mutant Protein ,Retrospective Studie ,Virulence Factor ,Part 5 ,genetic variability ,genetic polymorphism ,hemagglutinin D222G and D222N variants, Adult ,A(H1N1)pdm09 viru ,Respiratory system ,Young adult ,respiratory distre ,APACHE ,influenza A (H1N1) ,Aged, 80 and over ,Respiratory Distress Syndrome ,virus mutation ,article ,upper respiratory tract ,Middle Aged ,aged ,Exact test ,female ,Infectious Diseases ,Italy ,priority journal ,outpatient ,Original Article ,disease severity ,ECMO ,influenza ,extracorporeal membrane oxygenation and influenza ,amino acid substitution ,Human ,Adult ,drug dose increase ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Critical Care ,Virulence Factors ,oseltamivir, adult ,Molecular Sequence Data ,Mutation, Missense ,A(H1N1)pdm09 virus ,hemagglutinin D222G and D222N variants ,virus shedding ,Virus ,lower respiratory tract ,Young Adult ,critically ill patient ,Extracorporeal Membrane Oxygenation ,Internal medicine ,Intensive care ,Influenza, Human ,medicine ,Extracorporeal membrane oxygenation ,Humans ,controlled study ,influenza A(H1N1)pdm09 infection ,Hemagglutinin Glycoproteins, Influenza Viru ,outcome assessment ,Retrospective Studies ,virus detection ,Polymorphism, Genetic ,extracorporeal oxygenation ,business.industry ,Intensive Care ,Respiratory Distress Syndrome, Adult ,Public Health, Environmental and Occupational Health ,nucleotide sequence ,Retrospective cohort study ,Sequence Analysis, DNA ,Influenza virus A H1N1 pdm09 ,Influenza virus hemagglutinin ,major clinical study ,Hemagglutinin D222G and D222N variants ,Surgery ,unindexed sequence ,randomized controlled trial ,Mutant Proteins ,business - Abstract
Background In patients with A(H1N1)pdm09 infection, severe lung involvement requiring admission to intensive care units (ICU) has been reported. Mutations at the hemagglutinin (HA) receptor binding site (RBS) have been associated with increased virulence and disease severity, representing a potential marker of critical illness. Objectives To assess the contribution of HA-RBS variability in critically ill patients, A(H1N1)pdm09 virus from adult patients with severe infection admitted to ICU for extracorporeal membrane oxygenation support (ECMO) during influenza season 2009–2011 in Piemonte (4·2 million inhabitants), northwestern Italy, was studied. Patients and methods We retrospectively analyzed HA-RBS polymorphisms in ICU patients and compared with those from randomly selected inpatients with mild A(H1N1)pdm09 disease and outpatients with influenza from the local surveillance program. Results By HA-RBS direct sequencing of respiratory specimens, D222G and D222N viral variants were identified in a higher proportion in ICU patients (n = 8/24, 33·3%) than in patients with mild disease (n = 2/34, 6%) or in outpatients (n = 0/44) (Fisher's exact test P
- Published
- 2013
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