title: Phylogenetic characterization of enterovirus 68 strains in patients with respiratory syndromes in Italy.
abstract: Enterovirus 68 (EV-D68) was associated with mild to severe respiratory infections. In the last 4 years, circulation of different EV-D68 strains has been documented worldwide. In this study, the phylogenetic characterization of nine EV-D68 strains identified in patients in the 2010-2012 period and 12 additional EV-D68 Italian strains previously identified in 2008 in Italy was described. From January 2010 to December 2012, a total of 889 respiratory specimens from 588 patients stayed or visited at the Fondazione IRCCS Policlinico San Matteo were positive for HRV or HEV. Extracted nucleic acids were amplified by one-step RT-PCR with primer specific for VP1 region of EV-D68 and purified positive PCR products were directly sequenced. Overall, 9/3736 (0.24%) patients were EV-D68 positive. Of these, 7/9 (77.8%) were pediatric and two (22.2%) were adults. Five out of seven (71.4%) pediatric patients had lower respiratory tract infection with oxygen saturation <94%. Four cases were detected from August through October 2010, while five other cases from September through December 2012. The Italian EV-D68 strains in 2008 belonged to clade A (n = 5) and clade C (n = 7). In 2010 all the Italian strains belonged to clade A (n = 4) and in 2012, four Italian strains belonged to clade B and one to clade A. In conclusion, we provide additional evidence supporting a role of EV-D68 in severe respiratory infection in pediatric patients. In addition, all the three EV-D68 clades circulating worldwide were identified in Italy in a 5-year period of time.
authors.affiliation: Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Piralla
authors.forename: Alessia
authors.initials: A
authors.lastname: Girello
authors.forename: Michela
authors.initials: M
authors.lastname: Grignani
authors.forename: Monica
authors.initials: M
authors.lastname: Gozalo-Margüello
authors.forename: Antonietta
authors.initials: A
authors.lastname: Marchi
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Marseglia
authors.forename: Fausto
authors.initials: F
authors.lastname: Baldanti
mesh_terms: D000293:Adolescent; D000328:Adult; D036022:Capsid Proteins / Q000235:genetics; D002648:Child; D004770:Enterovirus / Q000235:genetics*; D004769:Enterovirus Infections / Q000821:virology*; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D007558:Italy; D008297:Male; D008875:Middle Aged; D058889:Molecular Typing; D010802:Phylogeny; D012141:Respiratory Tract Infections / Q000821:virology*; D012689:Sequence Homology, Nucleic Acid
chemical_list: D036022:Capsid Proteins
keywords: Italian strains; VP1 sequences; enterovirus 68; respiratory infection