Journal of Clinical Virology - Volume 82 - Supplement 1 - September 2016

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Abstracts / Journal of Clinical Virology 82S (2016) S1–S142 S125
Conclusion: Based on testing results, and in contrast with the
2014–2015 influenza season, the circulation of EV-D68 in South-
eastern Spain (Valencian Community) in cases of severe respiratory
disease during the 2015–2016 season was almost absent. Further
studies are needed to determine if these low detection rates have
also decreased in other geographical regions.
Abstract no: 321
Presentation at ESCV 2016: Poster 210
Genetic variability of human
metapneumovirus A strain circulating in
Catalonia during the 2014–2015 and 2015–2016
seasons: A 180-nucleotide G gene duplication
reported
María Pi˜nana∗, Jorgina Vila, Laura Gimferrer,
María Valls, Cristina Andrés, Javier Ramón,
María Gema Codina, María del Carmen Martín,
Francisco Fuentes, Rosario Saiz, Pilar Alcubilla,
Carlos Rodrigo, Tomàs Pumarola, Andrés Antón
Hospital Universitari Vall d’Hebron, Vall d’Hebron
Research Institute, Universitat Autònoma de
Barcelona, Barcelona, Spain
Background: Human Metapneumovirus (HMPV) causes respi-
ratory tract infections (RTI) in children. HMPV is an enveloped
single-stranded negative-sense RNA virus. It usually shows a
seasonality pattern, mainly in spring and winter months. Fusion
(F) and glycosylate (G) proteins, the two major envelope proteins
of the virus, evolve by selective immune pressure. HMPV is divided
into two genotypes (HMPV-A and -B), into 4 subgenotypes (A1, A2,
B1 and B2), and also into two lineages (A2a and A2b). The aimof this
study was to describe the molecular epidemiology and diversity of
HMPV, and the clinical features related to infection, in paediatric
population attended at a tertiary university hospital in Barcelona
from 2014 to 2016.
Material and methods: Respiratory specimens from paediatric
patients with suspicion of RTI attended at Emergency Care Unit
or outpatient departments, or admitted to Hospital Universitari
Vall d’Hebron (Barcelona, Spain) were collected fromOctober 2014
(week 40) to May 2016 (week 20) for virological diagnosis. All
samples were laboratory-confirmed for HMPV by immunofluores-
cence or by real-time multiplex RT-PCR assays. Both complete G
and partial F coding sequences fromHMPV viruses were sequenced
to perform phylogenetic analyses and molecular characterisations
with MEGA v5.2. Clinical and epidemiological features of HMPV
infected caseswere retrospectively reviewed frommedical records.
Results: A total of 6658 specimens from4488 paediatric patients
were collected, of which 128 (2%) samples from 121 (3%) patients
were laboratory-confirmed for HMPV. Based on phylogenetic anal-
ysis of G or F sequences, 59 (49%) viruses belonged to HMPV-A
and 54 (45%) to HMPV-B genotypes; the remaining 8 viruses (6%)
could not be sequenced. Weekly distribution of HMPV detections
showed a higher circulation from February to April. Although both
HMPV genotypes simultaneously co-circulated, HMPV-B was pre-
dominant in the 2014–2015 season while HMPV-A was in the
2015–2016 season. Regarding the HMPV-A phylogenetic analysis,
52 (88%) belonged to A2b lineage and 7 (12%) to A2a. In addi-
tion, molecular characterisation of A2b sequences revealed that 9
sequences (2014–2015, 2; 2015–2016, 7) had a 180-nucleotide (60
amino acids) duplication in the G protein.
Overall, HMPV caused lower respiratory tract infections (LRTI)
in 74% of children, more frequently for genotypes A2b (87%) and B2
(81%). 85% of patients required hospitalisation (median: 8.3 days).
Childrenwith B1 LRTIs, comparedwith other genotypes, had longer
hospital stays (median: 8.8 days) and longer supplementary oxygen
requirements (median: 4.6 days), but one requiredmechanical ven-
tilation (MV). 6 children with A2b LRTI and 3 with B2 LRTI required
MV. No fatal cases due to HPMV infection were reported. Most chil-
dren with A2b with 180-nt duplication had LRTI (67%), who all
required hospitalization (3 with supplementary oxygen, and one
with MV).
Conclusions: Recent and valuable data on regards on seasona-
lity, genetic diversity and clinical features of circulating HMPV in
Catalonia (Spain) is reported. A 180-nucleotide duplication within
HMPV G protein is first described here to our knowledge. The fact
that the number of viruses with this 180-nt duplication increased
during the last season suggests that it may become predominant in
the future. In addition, further studies are needed to know if this
variant causes different disease severity.
Abstract no: 325
Presentation at ESCV 2016: Poster 211
Respiratory viruses in patients with acute
respiratory infections in the pediatric and
adults intensive care units
Imran Saglik ∗, R. Can Sarınoglu , D. Mutlu ,
M. Cengiz Dursun Oygur
A. Ramazanoglu , D. Colak
1 Akdeniz University Faculty of Medicine,
Department of Medical Microbiology, Antalya,
Turkey
2 Akdeniz University Faculty of Medicine,
Department of Anesthesiology and Reanimation,
Antalya, Turkey
3 Akdeniz University Faculty of Medicine,
Department of Pediatri, Antalya, Turkey
Background: Severe Acute Respiratory Infections (ARI) that
requires intensive care unit (ICU) admission is associated with high
morbidity and mortality. Patients with severe ARI admitted to the
ICU, are usuallymonitored a standard approach consisting of bacte-
rial culture and testing. The importance of viruses in severe ARI has
been apparent with new viral detection techniques in recent years.
The aim of this study was to investigate the prevalance of respira-
tory viruses in patients with severe ARI who required admission to
a medical ICU during the 2015–2016 winter season.
Methods: Between September 2015 and April 2016, nasopha-
ryngeal swab samples were collected from 70 children (36 female
and 34male) and 18 adults (6 female and 12male) with ARI in Pedi-
atric and Adult Intensive Care Units of Akdeniz University Hospital.
Samples were investigated by multiplex PCR (Verigene Respiratory
PathogensFlex Test; RP Flex; Nanosphere, Northbrook) for Adenovi-
rus, Metapneumovirus, Influenza (INF) A, (subtype AH1 and AH3),
INF B, Parainfluenza 1,2,3 and 4, Rhinovirus, RSV A and B, Bordetella
sp.
Results: The median age was 1 year (range: 1 day–84 year) of
the patients. Positive samples were found between October 2015
andMarch 2016 andmost frequently positivity rates were detected
in January (50%), February (73.7%) and March (50%). The chronic
diseases were common in the positive patients (51.3%) such as car-
diac diseases, chronic pulmonary disease, diabetes mellitus. About
47.7% of patientswere positive for at least one viral pathogen. Single
viral pathogen occurred in 73.8%, viral coinfections were found in
26.2% of positive patients. Influenza viruseswere themost common