title: Emergence of community-acquired adenovirus type 55 as a cause of community-onset pneumonia.
abstract: 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.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing.
authors.forename: Bin
authors.initials: B
authors.lastname: Cao
authors.affiliation: National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing; Xinjiang Medical University, Urumuqi, China.
authors.forename: Guo-Hong
authors.initials: GH
authors.lastname: Huang
authors.affiliation: YanTai Yu Huang-Ding Hospital, Yan Tai, Shan Dong Province.
authors.forename: Zeng-Hui
authors.initials: ZH
authors.lastname: Pu
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing.
authors.forename: Jiu-Xin
authors.initials: JX
authors.lastname: Qu
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing.
authors.forename: Xiao-Min
authors.initials: XM
authors.lastname: Yu
authors.affiliation: National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: Beijing Hai-Dian Hospital, Beijing.
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Dong
authors.affiliation: Peking University People's Hospital, Beijing.
authors.forename: Yan
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Beijing Da-Xing Hospital, Beijing.
authors.forename: Yong-Xiang
authors.initials: YX
authors.lastname: Zhang
authors.affiliation: Lu-He Hospital, Capital Medical University, Beijing.
authors.forename: Xiao-Hui
authors.initials: XH
authors.lastname: Li
authors.affiliation: Beijing Huai Rou Hospital, Beijing.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Liu
authors.affiliation: Beijing Friendship Hospital, Capital Medical University, Beijing.
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
authors.affiliation: China-Japan Friendship Hospital, Ministry of Health, Beijing.
authors.forename: Qian
authors.initials: Q
authors.lastname: Xu
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing.
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.affiliation: National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing.
authors.forename: Wenbo
authors.initials: W
authors.lastname: Xu
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing; Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing; Institute of Respiratory Medicine, Beijing Hospital, Ministry of Health, Beijing; Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing. Electronic address: cyh-birm@263.net.
authors.forename: Chen
authors.initials: C
authors.lastname: Wang
mesh_terms: D000258:Adenovirus Infections, Human / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D000260:Adenoviruses, Human / Q000235:genetics / Q000302:isolation & purification*; D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011024:Pneumonia, Viral / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D004279:DNA, Viral