Abstract:
INTRODUCTION:Most human parechovirus (HPeV, family Picornaviridae) infections are asymptomatic but may cause gastroenteritis in children. New reports show that HPeVs can be associated with severe central nervous system symptoms and sepsis-like syndromes in infants. The clinical significance of HPeVs in Hungary has not been investigated before. AIM:The aim of this study was to detect genotype HPeV in faecal samples of children and analysis of the clinical symptoms. METHOD:For the detection and genotyping of HPeV strains, reverse transcription-polymerase chain reaction and sequencing methods were used from faecal samples of children with gastroenteritis divided into three groups: group A) hospitalised children younger than 10 years (n = 75); group B) 0-12 months infants (n = 237) and group C) children less than 18 years of age with sepsis-like/neurological symptoms (n = 105) were tested. RESULTS:Three HPeV positive samples (3/75, 4%) were found in group A, two of them belong to the HPeV type 1, the third was non-typeable. All positive samples were from infants of 7 to 11 months of age. In group B, HPeV was detected in 6.8% (16/237) of the samples. Five were HPeV1, six were HPeV3 and five were non-typeable. While most of the infants with HPeV1 (4/5) did not require hospitalisation, 83% of the HPeV3 infected infants (5/6) did. Five (4.8%) HPeV strains detected from children less than 18 years of age with sepsis-like/neurological symptoms (group C) belonged to HPeV1 (three) and HPeV3 (two). All positive samples were from hospitalised infants less than 2 months of age. CONCLUSION:HPeV1 infections are less severe in infants than HPeV3 infections. The leading symptom of HPeV1 was diarrhoea, although in infants less than 1-2 months neurological symptoms (somnolence, lassitude) were also present. HPeV3 infections were more common among newborns. The main symptoms of severe HPeV3 infection are: gastroenteritis (7/8), fever ≥38 °C (6/7), loss of appetite (6/7), rash (4/7), somnolence/lassitude (3/7), sepsis-like syndrome (3/7) and respiratory symptoms (2/7). Orv Hetil. 2019; 160(10): 386-395. :Absztrakt: Bevezetés: A humán parechovírus (HPeV, Picornaviridae víruscsalád) okozta fertőzések többsége tünetmentes, de gyermekeknél hasmenéssel járhatnak. Újabb megfigyelés, hogy a HPeV-ok a csecsemők körében súlyos, központi idegrendszeri megbetegedést és szepszisszerű kórképet is okozhatnak. A HPeV-ok szerepe a hazai klinikumban nem ismert. Célkitűzés: A HPeV-ok kimutatása, meghatározása gyermekektől származó székletmintákból és a klinikai tünetek elemzése. Módszer: A HPeV-ok kimutatása és tipizálása a reverz transzkripció–polimeráz-láncreakció és a szekvenálás módszereivel történt három betegcsoportban: A) 10 év alatti kórházban kezelt, n = 75; B) 1 év alatti, n = 237; és C) szisztémás/idegrendszeri tüneteket is mutató hasmenéses gyermekek (<18 év), n = 105 székletmintáiból. Eredmények: Az A csoportban 4% (3/75) volt a HPeV-pozitív minták aránya (két HPeV1, egy nem tipizálható HPeV), mind gastroenteralis tüneteket mutató csecsemőkből (7–11 hónapos). A B csoportban a HPeV-fertőzések aránya 6,8% (16/237) volt, melyek közül öt HPeV1, hat HPeV3 és öt nem tipizálható HPeV volt. E csoportban a HPeV1-fertőzések többsége (4/5) nem igényelt kórházi ellátást, míg a HPeV3-fertőzéses esetek 83%-a (5/6) igényelte azt. A szisztémás/idegrendszeri tüneteket is mutató betegekből (C csoport) azonosított HPeV-pozitív minták (4,8%) két genotípusba tartoztak (három HPeV1 és két HPeV3), és mind kórházban kezelt fiatal (≤2 hónapos) csecsemőktől származtak. Következtetés: A HPeV1-fertőzések általában enyhébb lefolyásúak, és ritkábban igényelnek kórházi ellátást. A HPeV1-fertőzés vezető tünete a hasmenés, azonban 1–2 hónapos csecsemőknél idegrendszeri érintettség (aluszékonyság, bágyadtság) is tapasztalható volt. Az újszülöttek körében a HPeV3-megbetegedések gyakoribbak. A súlyos HPeV3-fertőzésre jellemzőek a gastroenteralis tünetek (7/8), a ≥38 °C-os láz (6/7), az étvágytalanság (6/7), az exanthema (4/7), az aluszékonyság/bágyadtság (3/7), a szepszisszerű állapot (3/7) és a légzőszervi tünetek (2/7). Orv Hetil. 2019; 160(10): 386–395.
journal_name
Orv Hetiljournal_title
Orvosi hetilapauthors
Boros Á,Hamarics Z,Fenyvesi H,Liptai Z,Nyul Z,Pankovics P,Reuter Gdoi
10.1556/650.2019.31304subject
Has Abstractpub_date
2019-03-01 00:00:00pages
386-395issue
10eissn
0030-6002issn
1788-6120journal_volume
160pub_type
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