Microsatellite analysis of HSV-1 isolates: from oropharynx reactivation toward lung infection in patients undergoing mechanical ventilation.
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.
Deback
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C
UPMC Univ. Paris 06, ER1 DETIV, F-75013 Paris, France. claire.deback@psl.aphp.fr
Luyt
C E
CE
Lespinats
S
S
Depienne
C
C
Boutolleau
D
D
Chastre
J
J
Agut
H
H
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
D004279:DNA, Viral