Respiratory syncytial virus genotypes and disease severity among children in hospital
a University of Liverpool: Department
of Medical Microbiology and Genito-Urinary Medicine, b Department of Child Health, c Department of Paediatrics, Southmead
Hospital, Bristol
Correspondence to: Professor C A Hart, Department of Medical Microbiology and Genito-Urinary Medicine, University of Liverpool, Liverpool L69 3BX.
Accepted 10 July 1997
OBJECTIVES
To determine the spectrum of N and G
genotypes of respiratory syncytial virus (RSV) causing respiratory
tract infection and whether particular genotypes are associated with
severity of infection.
PATIENTS AND METHODSNasopharyngeal aspirates
(NPAs) were obtained from 114 infants with acute respiratory tract
infection due to RSV over two seasons. Viral mRNA was extracted from
NPAs or cultured virus, reverse transcribed, and the cDNA amplified by
the polymerase chain reaction using primers directed to parts of the N
and G gene respectively. Amplicons were separately digested with four different restriction endonucleases for each gene. The fragments were
separated by agarose gel, electrophoresis, and the electrophoretic patterns used to assign the various genotypes. Disease severity was
assessed as very mild (upper respiratory tract signs only), mild
(coryza and signs of lower respiratory tract infection), moderate
(requiring nasogastric or intravenous fluids), and severe (requiring oxygen or ventilation).
RESULTSFive of the six known N genotypes were
detected, but NP4 and NP2 were found most frequently. There was no
association between N genotype and disease severity. Six G (SHL)
genotypes were detected. Significantly (p = 0.04) more of the infants
infected with the SHL2 genotype had severe or moderate disease.
CONCLUSIONSDuring the seasonal peaks of RSV
respiratory tract infection at least 10 different RSV genotypes
cocirculated. While there is no association between N genotypes and
disease severity, infection with the SHL2 G genotype appears to result
in moderate to severe disease.
© 1997 by Archives of Disease in Childhood
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