title: Microsatellite analysis of HSV-1 isolates: from oropharynx reactivation toward lung infection in patients undergoing mechanical ventilation.
abstract: BACKGROUND
  According to recent reports, herpes simplex virus type 1 (HSV-1) induces bronchopneumonitis (BPn) in immunocompetent patients undergoing prolonged mechanical ventilation (MV), whose respiratory functions deteriorate with a poor outcome. HSV-1 BPn is associated with HSV symptomatic or symptomless reactivation in the oropharynx.
  
  
  OBJECTIVE
  We sought to systematically and genetically characterize HSV-1 strains isolated from immunocompetent patients receiving prolonged MV and to characterize the genetic relationship of strains sequentially isolated from oropharyngeal samples (OPS) and broncho-alveolar liquids (BAL) to determine the natural course of HSV BPn.
  
  
  METHODS
  In this molecular epidemiological study, microsatellite technology was used to determine genetic relationships between 211 HSV-1 strains isolated from OPS and/or BAL from 106 patients receiving MV.
  
  
  RESULTS
  Microsatellite haplotypes of HSV-1 strains sequentially isolated from the same individual were identical, and HSV-1 isolates from the lung were genetically indistinguishable from strains isolated from the oral cavity. Each patient was characterized by their own HSV-1 microsatellite haplotype, and no nosocomial transmission of strains between patients was observed.
  
  
  CONCLUSIONS
  Our results demonstrate that, in patients who receive MV, the HSV-1 pulmonary infection results from the reactivation of genetically related HSV-1 in the oropharynx, which progressively infects the lower respiratory tract.
authors.affiliation: UPMC Univ. Paris 06, ER1 DETIV, F-75013 Paris, France. claire.deback@psl.aphp.fr
authors.forename: C
authors.initials: C
authors.lastname: Deback
authors.forename: C E
authors.initials: CE
authors.lastname: Luyt
authors.forename: S
authors.initials: S
authors.lastname: Lespinats
authors.forename: C
authors.initials: C
authors.lastname: Depienne
authors.forename: D
authors.initials: D
authors.lastname: Boutolleau
authors.forename: J
authors.initials: J
authors.lastname: Chastre
authors.forename: H
authors.initials: H
authors.lastname: Agut
mesh_terms: D000328:Adult; D001996:Bronchopneumonia / Q000821:virology*; D016000:Cluster Analysis; D004279:DNA, Viral / Q000235:genetics*; D006239:Haplotypes; D018259:Herpesvirus 1, Human / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008168:Lung / Q000821:virology*; D018895:Microsatellite Repeats; D017720:Molecular Epidemiology; D009960:Oropharynx / Q000821:virology*; D012121:Respiration, Artificial / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D004279:DNA, Viral