title: Clinical characteristics and molecular epidemiology of Enterovirus infection in infants <3 months in a referral paediatric hospital of Barcelona.
abstract: Enterovirus (EV) infection is common in infants, but the information with regard to the molecular epidemiology and the associations between types and clinical variables is very scarce. This study includes 195 children <3 months old with fever, attended from March 2010 to December 2012 in an emergency department of a tertiary paediatric hospital in whom EV infection was confirmed by real-time PCR in blood and/or cerebrospinal fluid. Clinical and epidemiological data was prospectively collected. In 152 (77.9 %) patients, EVs could be typed. The most common type was Echovirus-5 (E5; 32, 21.1 %), followed by Echovirus-11 (E11; 18, 11.8 %), Echovirus-21 and Echovirus-25 (E21, E25; 11 each one, 7.2 %) and Coxsackievirus-B4 (CVB4; 6, 6.6 %). The majority of types appeared in spring, but E5 and E25 were found mainly during summer (p < 0.01). E21 was associated with high-grade fever (p < 0.01); E5 with exanthema (p = 0.03) and CVB4 tended to cause meningitis more often than the other types (p = 0.07).
  
  
  CONCLUSIONS
  The most common EV types were Echovirus-5 and Echovirus-11. Some significant associations between types and epidemiologic and clinical findings were observed. What is Known-What is New • Enteroviruses cause a normally benign illness in young infants, except in some cases. • The molecular epidemiology of Enterovirus infection is not well known in European countries. • This study describes a large number of infants with Enterovirus infection and shows the seasonality of different types, and their associations with epidemiologic and clinical variables.
authors.affiliation: Paediatrics Department, Hospital Sant Joan de Déu (University of Barcelona), Passeig Sant Joan de Déu 2, 08940, Esplugues de Llobregat, Barcelona, Spain. droda@hsjdbcn.org.
authors.forename: Diana
authors.initials: D
authors.lastname: Rodà
authors.affiliation: Paediatrics Department, Hospital Sant Joan de Déu (University of Barcelona), Passeig Sant Joan de Déu 2, 08940, Esplugues de Llobregat, Barcelona, Spain. eperezm@hsjdbcn.org.
authors.forename: Esther
authors.initials: E
authors.lastname: Pérez-Martínez
authors.affiliation: Enterovirus Unit, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain. MCABRERIZO@isciii.es.
authors.forename: María
authors.initials: M
authors.lastname: Cabrerizo
authors.affiliation: Enterovirus Unit, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain. gtralle@isciii.es.
authors.forename: Gloria
authors.initials: G
authors.lastname: Trallero
authors.affiliation: Paediatrics Department, Hospital Sant Joan de Déu (University of Barcelona), Passeig Sant Joan de Déu 2, 08940, Esplugues de Llobregat, Barcelona, Spain. amartinez@hsjdbcn.org.
authors.forename: Aina
authors.initials: A
authors.lastname: Martínez-Planas
authors.affiliation: Emergency Department, Hospital Sant Joan de Déu (University of Barcelona), Barcelona, Spain. cluaces@hsjdbcn.org.
authors.forename: Carles
authors.initials: C
authors.lastname: Luaces
authors.affiliation: Paediatrics Department, Hospital Sant Joan de Déu (University of Barcelona), Passeig Sant Joan de Déu 2, 08940, Esplugues de Llobregat, Barcelona, Spain. juanjo@hsjdbcn.org.
authors.forename: Juan-José
authors.initials: JJ
authors.lastname: García-García
authors.affiliation: Molecular Microbiology Department, Hospital Sant Joan de Déu (University of Barcelona), Barcelona, Spain. cma@hsjdbcn.org.
authors.forename: Carmen
authors.initials: C
authors.lastname: Muñoz-Almagro
authors.affiliation: Paediatrics Department, Hospital Sant Joan de Déu (University of Barcelona), Passeig Sant Joan de Déu 2, 08940, Esplugues de Llobregat, Barcelona, Spain. claunes@hsjdbcn.org.
authors.forename: Cristian
authors.identifier: http://orcid.org/0000-0002-0913-9303
authors.initials: C
authors.lastname: Launes
mesh_terms: D004770:Enterovirus / Q000235:genetics / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000453:epidemiology*; D005260:Female; D005838:Genotype; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D017720:Molecular Epidemiology; D011446:Prospective Studies; D060888:Real-Time Polymerase Chain Reaction; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012703:Serotyping; D013030:Spain / Q000453:epidemiology
keywords: Children; Enterovirus; Meningitis; Molecular epidemiology; Type