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Original Research: Chest Infections |

Emergence of Community-Acquired Adenovirus Type 55 as a Cause of Community-Onset PneumoniaHuman Adenovirus Type 55 Pneumonia

Bin Cao, MD; Guo-Hong Huang, MD; Zeng-Hui Pu, MD; Jiu-Xin Qu, MD; Xiao-Min Yu, MD; Zhen Zhu, MD; Jian-Ping Dong, MD; Yan Gao, MD; Yong-Xiang Zhang, MD; Xiao-Hui Li, MD; Jian-Hua Liu, MD; Hong Wang, MD; Qian Xu, MD; Hui Li, MD; Wenbo Xu, MD; Chen Wang, MD, FCCP
Author and Funding Information

From the Department of Infectious Diseases and Clinical Microbiology (Drs Cao, Qu, Yu, H. Li, and C. Wang), and Department of Respiratory and Critical Care Medicine (Dr C. Wang), Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing; the National Institute for Viral Disease Control and Prevention (Drs Huang, Zhu, and W. Xu), Chinese Center for Disease Control and Prevention, Beijing; YanTai Yu Huang-Ding Hospital (Dr Pu), Yan Tai, Shan Dong Province; Lu-He Hospital (Dr X-H. Li) and Beijing Friendship Hospital (Dr H. Wang), Capital Medical University, Beijing; Beijing Hai-Dian Hospital (Dr Dong), Beijing; Peking University People’s Hospital (Dr Gao), Beijing; Beijing Da-Xing Hospital (Dr Zhang), Beijing; Beijing Huai Rou Hospital (Dr Liu), Beijing; China-Japan Friendship Hospital (Dr Q. Xu), Ministry of Health, Beijing; Institute of Respiratory Medicine (Dr C. Wang), Beijing Hospital, Ministry of Health, Beijing; Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders (Dr C. Wang), Beijing; and Xinjiang Medical University (Dr Huang), Urumuqi, China.

Correspondence to: Chen Wang, MD, FCCP, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University and Beijing Hospital, Ministry of Health, Gong Ti S Rd, No. 8, Beijing, 100020, China; e-mail: cyh-birm@263.net


Drs. Cao, Huang, and Pu contributed equally to this article.

Funding/Support: This work was supported by the Beijing Science and Technology Project [Grant D101100049810002], the National Natural Science Foundation of China [Grants 81070005/H0104, 81030032/H19, and 81271840], China’s Key Technologies Research and Development Program of the National Ministry of Science [Grants 2013ZX10004-202 and 2012ZX10004201-003], and the Program for New Century Excellent Talents in University [Grant NCET-09-0006].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;145(1):79-86. doi:10.1378/chest.13-1186
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Background:  Since 2008, severe cases of emerging human adenovirus (HAdV) type 55 (HAdV-55) were reported sporadically in China. But no comparative studies had been conducted to discern the differences in epidemiologic and clinical abnormalities between HAdV-55 and other types (HAdV-7, HAdV-3, HAdV-14, HAdV-50, and HAdV-C).

Methods:  A multicenter surveillance study for adult and adolescent community-acquired pneumonia (CAP) was conducted prospectively in Beijing and Yan Tai between November 2010 and April 2012. A standardized data form was used to record clinical information. The viral DNA extracted from the clinical samples or adenovirus viral isolates was sequenced.

Results:  Among 969 cases, 48 (5%) were identified as adenovirus pneumonia. Six branches were clustered: HAdV-55 in 21, HAdV-7 in 11, HAdV-3 in nine, HAdV-14 in four, HAdV-50 in two, and HAdV-C in one. Most HAdV-55 cases were identified during February and March. All the hypervariable regions of the hexon genes of the 21 HAdV-55 strains were completely identical. Patients who had HAdV-55 were about 10 years older (P = .027) and had higher pneumonia severity index scores (P = .030) compared with those with other types (HAdV-7, HAdV-3, HAdV-14, HAdV-50, and HAdV-C). Systemic BP was also higher among patients in the HAdV-55 group (P = .006). Unilateral or bilateral consolidations were the most common radiologic findings in both patients with HAdV-55 and those with other types (57.9% vs 36%). More than one-half of the patients were admitted to hospital; oxygen therapy was given to 29.2% of the 48 patients, and two needed mechanical ventilation.

Conclusions:  HAdV-55 has established itself as a major pneumonia pathogen in the Chinese population, and further surveillance and monitoring of this agent as a cause of CAP is warranted.

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