title: Adenovirus species C is associated with chronic suppurative lung diseases in children.
abstract: BACKGROUND
  The role of human adenoviruses (HAdVs) in chronic respiratory disease pathogenesis is recognized. However, no studies have performed molecular sequencing of HAdVs from the lower airways of children with chronic endobronchial suppuration. We thus examined the major HAdV genotypes/species, and relationships to bacterial coinfection, in children with protracted bacterial bronchitis (PBB) and mild bronchiectasis (BE).
  
  
  METHODS
  Bronchoalveolar lavage (BAL) samples of 245 children with PBB or mild (cylindrical) BE were included in this prospective cohort study. HAdVs were genotyped (when possible) in those whose BAL had HAdV detected (HAdV(+)). Presence of bacterial infection (defined as ≥10(4) colony-forming units/mL) was compared between BAL HAdV(+) and HAdV negative (HAdV(-)) groups. Immune function tests were performed including blood lymphocyte subsets in a random subgroup.
  
  
  RESULTS
  Species C HAdVs were identified in 23 of 24 (96%) HAdV(+) children; 13 (57%) were HAdV-1 and 10 (43%) were HAdV-2. An HAdV(+) BAL was significantly associated with bacterial coinfection with Haemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumoniae (odds ratio [OR], 3.27; 95% confidence interval, 1.38-7.75; P = .007) and negatively associated with Staphylococcus aureus infection (P = .03). Young age was related to increased rates of HAdV(+). Blood CD16 and CD56 natural killer cells were significantly more likely to be elevated in those with HAdV (80%) compared with those without (56.1%) (P = .027).
  
  
  CONCLUSIONS
  HAdV-C is the major HAdV species detected in the lower airways of children with PBB and BE. Younger age appears to be an important risk factor for HAdV(+) of the lower airways and influences the likelihood of bacterial coinfection.
authors.affiliation: Queensland Children's Medical Research Institute, The University of Queensland Queensland Children's Respiratory Centre, Royal Children's Hospital.
authors.forename: Danielle F
authors.initials: DF
authors.lastname: Wurzel
authors.affiliation: Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Medical Research Institute, Sir Albert Sakzewski Virus Research Centre, Children's Health Queensland Hospital and Health Service, The University of Queensland, Herston.
authors.forename: Ian M
authors.initials: IM
authors.lastname: Mackay
authors.affiliation: Queensland Children's Medical Research Institute, The University of Queensland Queensland Children's Respiratory Centre, Royal Children's Hospital.
authors.forename: Julie M
authors.initials: JM
authors.lastname: Marchant
authors.affiliation: Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Medical Research Institute, Sir Albert Sakzewski Virus Research Centre, Children's Health Queensland Hospital and Health Service, The University of Queensland, Herston.
authors.forename: Claire Y T
authors.initials: CY
authors.lastname: Wang
authors.affiliation: Queensland Lung Transplant Service, Prince Charles Hospital.
authors.forename: Stephanie T
authors.initials: ST
authors.lastname: Yerkovich
authors.affiliation: School of Medicine, The University of Queensland, Brisbane.
authors.forename: John W
authors.initials: JW
authors.lastname: Upham
authors.affiliation: Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
authors.forename: Heidi C
authors.initials: HC
authors.lastname: Smith-Vaughan
authors.affiliation: Queensland Children's Respiratory Centre, Royal Children's Hospital Queensland Children's Medical Research Institute, Queensland University of Technology, Brisbane.
authors.forename: Helen L
authors.initials: HL
authors.lastname: Petsky
authors.affiliation: Queensland Children's Respiratory Centre, Royal Children's Hospital Queensland Children's Medical Research Institute, Queensland University of Technology, Brisbane Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
authors.forename: Anne B
authors.initials: AB
authors.lastname: Chang
mesh_terms: D000258:Adenovirus Infections, Human / Q000453:epidemiology / Q000821:virology*; D000260:Adenoviruses, Human / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D001990:Bronchiolitis, Viral / Q000453:epidemiology / Q000821:virology*; D001992:Bronchoalveolar Lavage Fluid / Q000821:virology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D060005:Genotyping Techniques; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies
keywords: bronchiectasis; children; protracted bacterial bronchitis; respiratory bacteria; respiratory viruses
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