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

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S54 Abstracts / Journal of Clinical Virology 82S (2016) S1–S142
Abstract no: 127
Presentation at ESCV 2016: Poster 66
Microbiological evaluation of respiratory tract
infections in pilgrims returning from countries
affected by Middle East respiratory syndrome
coronavirus (MERS-CoV)
S. Burrel ∗, S. Jaureguiberry , E. Caumes ,
A. Aubry , H. Agut , D. Boutolleau
1 Sorbonne Université, UPMC Univ Paris 06, CR7,
CIMI-Paris, INSERM U1135, and AP-HP, Hôpitaux
Universitaires La Pitié-Salpêtrière – Charles Foix,
Service de Virologie, Paris, France
2 Sorbonne Université, UPMC Univ Paris 06, CR7,
CIMI-Paris, INSERM U1135, and AP-HP, Hôpitaux
Universitaires La Pitié-Salpêtrière – Charles Foix,
Service de Maladies Infectieuses et Médecine
Tropicale, Paris, France
3 Sorbonne Université, UPMC Univ Paris 06, CR7,
CIMI-Paris, INSERM U1135, and AP-HP, Hôpitaux
Universitaires La Pitié-Salpêtrière - Charles Foix,
Service de Bactériologie-Hygiène, Paris, France
Since September 2012, the World Health Organization (WHO)
has been notified of 1728 laboratory-confirmed cases of infection
with Middle East respiratory syndrome coronavirus (MERS-CoV),
including at least 624 related deaths (disease outbreak news of
April 26, 2016). Although MERS-CoV appears to be transmitted
through respiratory droplets between humans with close contact,
dromedary camels are likely to be a zoonotic source of MERS-CoV
infection in humans. Early detection of MERS-CoV infection among
international travelers exposed to camels or healthcare facilities
in the Middle East remains essential. All travelers returning from
MERS-CoV-affected areas to Paris (France) are given particular
attention and those with fever and/or respiratory symptoms are
referred to a dedicated infectious disease unit as the Infectious Dis-
ease Department of La Pitié-Salpêtrière University Hospital in Paris.
The aim of this study was to investigate the microbiological eti-
ologies of respiratory tract infections (RTI) among these specific
travellers from the beginning of the 2015 Hajj and Umrah pilgrim-
age period (September 2015) to April 2016.
Upon admission, patients were isolated and nasopharyngeal
swabs, sputum samples and, for persons on ventilators, bron-
choalveolar lavage specimens were collected by trained nurses.
We examined which etiological respiratory pathogens were iden-
tified during screening for MERS-CoV in symptomatic travellers
returning to Paris during September 2015 to April 2016 period,
from MERS-CoV endemic regions (published WHO bulletins).
Firstly, samples were screened with a specific MERS-CoV real-
time reverse transcription PCR targeting region upstream of the
E gene (upE), as recommended by WHO. The second step of
the etiologic diagnosis entailed an investigation for other respi-
ratory viruses (influenza A/B viruses, respiratory syncytial virus,
metapneumovirus, rhinovirus-enterovirus, parainfluenza viruses,
other human coronaviruses) using Respiratory MWS r-gene® kits
(bioMérieux) and for bacteria using standardized culture proce-
dures.
A total of 31 symptomatic travellersmainly returning fromSaudi
Arabia (mean age 63.1 years, range 21–92 years; 58% male) were
included during the study period and overall 48 respiratory clinical
specimens were collected. None of the tested specimens were pos-
itive for MERS-CoV. Since a negative result should not absolutely
rule out the possibility of MERS-CoV infection, notably if speci-
men is collected late or very early in the illness, some patients
were screened twice. The vast majority of viral RTI, sometimes
associatedwith bacteria superinfection, in these pilgrims returning
home, were due to seasonal influenza A viruses (29%), rhinoviruses
(23%), and other coronaviruses (7%) distinct from the MERS-CoV.
Four patients were presenting acute lobar pneumonia, none were
formally diagnosed. However, all were cured with antibiotics, as
the presentation suggested pneumococcal infection. One case of Q
fever, another known zoonosis transmitted by dromedary camels,
and one case of Legionnella pneumophilia- associated disease were
diagnosed among tested pilgrims.
Continuous surveillance should be implemented to ensure the
timely detection of possible imported cases of MERS-CoV and their
immediate isolation in order to avoid secondary cases. However,
clinicians should be aware that influenza viruses and rhinoviruses
are the most commonly identified pathogens in returning pilgrims
with acute RTI.
Abstract no: 136
Presentation at ESCV 2016: Poster 67
Determination of genotype distribution and the
various polymorphisms in cytomegalovirus
(CMV) strains
Saliha Gökc¸ e Alagöz ∗, Tekin Karslıgil ,
Mehmet Ozaslan
1 Gaziantep University Faculty of Science Biology
Department, Turkey
2 Gaziantep University Faculty of Medicine
Microbiology Department, Turkey
Keywords: Genotyping; CMV; Phylogenetic analysis
Human cytomegalovirus has different genotypes, by determin-
ing these genotypes in different disease groups, the association of
one and more than one infections can be found. In genotyping,
frequently seen genetic polymorphisms gB (UL55) and gH (UL75)
performed in envelope’s glycoprotein. In our study phylogenetic
analysis of 50 CMV (+) patient’s gB and gH gene regions were done.
In this study DNA sequence analysis performed and the result was
evaluated by MEGA 6.0 program. According to phylogenetic anal-
ysis the results were; 48–50 patient gene region were amplified,
23 (%48) of these patients were gB1, 8 (%16) were gB2, 11 (32%)
were gB3 genotype and one patient was gB4. According to UL 75
(gH) gene region the patients ´genotype was observed as; 6 (%12)
were gH1 and 44 (%88) were gH, while in five of patients gB2/3 mix
genotype was found According to gene regions, gB1 and
gH2 were reported in more ratios.
According to sequence analysis results more polymorphismwas
observed. In the polymorphisms, the peptide change which belong
to gB region frequently seen in gp166 while gH region is observed
in general. We found S51Stop, K56E and T57H polymorphisms in all
of the our patient’s gH region, which is not found in the previous
studies. The reason behind not finding S51Stop, K56E and T57H
polymorphisms in previous studying is these polymorphisms are
Table 1
Genotype (n/%)
Gene region Patients’
numbers
(n)
1 2 3 4 2/3
UL55 (gB) 50 23 (%46) 8 (%16) 11 (%22) 1 (%2) 5 (%10)
UL75 (gH) 50 6 (%12) 44 (%88) – – –