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Medical Academy named after S.I. Georgievsky of Vernadsky CFU

PHYLOGENETIC DISORDERS OF RESPIRATORY SYSTEM REPRESENTED BY :DHRUV MANGAL195 b (LA-2)SUPERVISOR: ANNA ZHUKOVA

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Слайд 1Medical Academy named after S.I. Georgievsky of Vernadsky CFU

Medical Academy named after S.I. Georgievsky of Vernadsky CFU

Слайд 2PHYLOGENETIC DISORDERS OF RESPIRATORY SYSTEM


REPRESENTED BY :
DHRUV MANGAL
195 b (LA-2)
SUPERVISOR:


ANNA ZHUKOVA

PHYLOGENETIC DISORDERS OF RESPIRATORY SYSTEM REPRESENTED BY :DHRUV MANGAL195 b (LA-2)SUPERVISOR: ANNA ZHUKOVA

Слайд 3Respiratory syncytial virus (RSV) is a major cause of lower

respiratory tract infection in young children in both the community

and hospital setting.


Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infection in young children in

Слайд 4Respiratory syncytial virus (RSV) is an important cause of bronchiolitis

and pneumonia in infants and young children [1]. Globally, it

is estimated that RSV causes over 30 million new acute lower respiratory tract infection (LRTI) episodes annually, resulting in more than 3.4 million hospital admissions and199,000 deaths in children younger than 5 years of age [1]. One-third of RSV-related deaths occur in the first year of life, with 96 % of these deaths occurring in low-resource countries

BACKGROUND OF RSV

Respiratory syncytial virus (RSV) is an important cause of bronchiolitis and pneumonia in infants and young children

Слайд 5A commercial multiplex PCR assay (Seeplex RV7, Seegene, Seoul, South

Korea) was used to screen for 7 respiratory viruses (Influenza

A, Influenza B, Metapneumovirus, RSV A/B, Rhinovirus A, Parainfluenza 1/2/3, Adenovirus) on nasopharyngeal aspirate or bronchoalveolar lavage specimens. Bacterial and viral co-pathogens were identified on blood, tracheal aspirate or urine specimens obtained at the discretion of the attending clinicians.

Laboratory diagnosis of RSV

A commercial multiplex PCR assay (Seeplex RV7, Seegene, Seoul, South Korea) was used to screen for 7

Слайд 6Two-hundred and twenty-six children with PCR-confirmed RSV acute lower respiratory

tract infection were identified during the study period, January to

October 2012. Figure 1 shows the monthly distribution of community-acquired and nosocomial acute respiratory tract infection associated with RSV. Case detection peaked in May.

RESULTS OF RSV

Two-hundred and twenty-six children with PCR-confirmed RSV acute lower respiratory tract infection were identified during the study

Слайд 7The median duration of symptoms preceding hospitalisation was 2 days

(IQR: 1–4 days). As shown in Table 3, the commonest

presenting symptoms were cough 196 (86.7 %), difficulty in breathing (tight chest) 115 (50.9 %) and fever 91 (41.6 %). Wheezing was present in 20 (8.8 %) of the cases. With regards to the management of the patients, 170 (75.2 %) cases received supplemental oxygen, 89 (39.4 %) were admitted either in the intensive care or high care units while 59 (26.1 %) required assisted ventilation by continuous positive airway pressure (CPAP) or mechanical ventilation.

Clinical characteristics, management and outcome

The median duration of symptoms preceding hospitalisation was 2 days (IQR: 1–4 days). As shown in Table

Слайд 8RSV A and RSV B accounted for 181 (80.1 %)

and 45 (19.9 %) of the infections, respectively. There were

no mixed infections with both A and B groups. The prevalent genotypes were NA1 (n = 127, 70.1 %), ON1 (n = 45, 24.9 %) and NA2 (n = 9, 5.0 %) for groupA, while the only circulating RSV B genotype was BA4. Age, gender, need for assisted ventilation, HIV status and presence of co-pathogens were not associated with the RSV genotypes.

Genotype distribution and pattern of RSV infection

RSV A and RSV B accounted for 181 (80.1 %) and 45 (19.9 %) of the infections,

Слайд 9Monthly distribution of community-acquired and nosocomial acute lower respiratory tract

infection associated with RSV

Monthly distribution of community-acquired and nosocomial acute lower respiratory tract infection associated with RSV

Слайд 10Factors significantly associated with nosocomial infection on univariate analysis included

age 6 months or older and pre-existing conditions. However, on

multivariate analysis age 6 months or older was the only factor independently associated with nosocomial infection with RSV (Table 6). The odds of nosocomial infection was 3.35 times higher in infants and children aged 6 months or older, compared to younger infants (adjusted OR = 3.35 (1.20–9.36); p = 0.02).

Factors associated with nosocomial RSV infection

Factors significantly associated with nosocomial infection on univariate analysis included age 6 months or older and pre-existing

Слайд 11In order to evaluate the circulation of the different human

rhinovirus (HRV) species and genotypes in Italian children with radiographically

confirmed community-acquired pneumonia (CAP), a nasopharyngeal swab was obtained from 643 children admitted to hospital because of CAP during five consecutive winter and early spring seasons (2007-2012). Real-time reverse transcriptase polymerase chain reaction (RT-PCR) was used to identify HRV, and the HRV-positive samples were used for sequencing analysis and to reconstruct the phylogenetic tree

HUMAN RHINOVIRUS

In order to evaluate the circulation of the different human rhinovirus (HRV) species and genotypes in Italian

Слайд 12The study was carried out in Pediatric Clinic 1 of

the Department of Pathophysiology and Transplantation of the University of

Milan during five consecutive years. The enrolment occurred between November 1 and April 30 in the years 2007-2008, 2008-2009, 2009-2010 and 2011-2011 and between November 1 and June 30 in 2011-2012. It was approved by the Institutional Review Board of the Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy. The written informed consent of a parent or legal guardian was required, and the older children were asked to give their assent.

Study population and samples

The study was carried out in Pediatric Clinic 1 of the Department of Pathophysiology and Transplantation of

Слайд 13Viral nucleic acids were extracted from the nasopharyngeal swabs using

a Nuclisens EasyMAG automated extraction system (Biomeriéux, Craponne, France), and

the extracts were tested for respiratory viruses using the RVP Fast assay (Luminex Molecular Diagnostics Inc., Toronto, Canada) in accordance with the manufacturer’s instructions. The RVP Fast assay consists of a single multiplex polymerase chain reaction (PCR) with labelled primers, followed by the single-step hybridization of the PCR products with the fluorescent bead array and incubation with reporter reagents.

Nucleic acid extraction and real-time reverse transcriptase polymerase chain reaction (RT-PCR)

Viral nucleic acids were extracted from the nasopharyngeal swabs using a Nuclisens EasyMAG automated extraction system (Biomeriéux,

Слайд 14The hypervariable part of the 5' NCR (non-coding region), the

entire VP4 gene and the 5' terminus of the VP2

gene in the HRV-positive samples were amplified by means of a RT-PCR as previously described [6,14]. The PCR products were purified using the Wizard SV Gel and PCR Clean-Up System (Promega, Milan, Italy), and then sequenced in both directions using the same forward and reverse primers as those used in the PCR. The nucleotide sequences were obtained by means of automated DNA sequencing using an ABI PRISM 3730 genetic analyser (Applied Biosystems, Foster City, CA)

Sequencing analysis, phylogeny and classification

The hypervariable part of the 5' NCR (non-coding region), the entire VP4 gene and the 5' terminus

Слайд 15The HRV sequences showed marked genetic diversity. The HRV-C sequences

were the most heterogenous, with an intra-species nucleotide p-distance of

0.25, which was greater than the p-distance within HRV-A (0.20) or HRV-B (0.21). Nucleotide variability was 37% between HRV-A and HRV-B, 37.3% between HRV-A and HRV-C, and 39.9% between HRV-B and HRV-C. Figure 2 shows the phylogenetic tree constructed on the basis of the VP4/VP2 region of the 151 sequences from this study and the references sequences.


The HRV sequences showed marked genetic diversity. The HRV-C sequences were the most heterogenous, with an intra-species

Слайд 16Pasteurella multocida is a leading cause of respiratory diseases in

many host species. To understand the genetic characteristics of P.

multocida strains isolated from different host species, we sequenced the genomic DNA of P. multocida isolated from pigs and analyzed the genetic characteristics of strains from avian species, bovine species, pigs, and rabbits using whole genome sequence (WGS) data. Our results found that a capsular: lipopolysaccharide (LPS): multilocus sequence typing (MLST) genotype A: L1: ST129 (43.75%) was predominant in avian P. multocida; while genotypes B: L2: ST122 (60.00%) and A: L3: ST79 (30.00%) were predominate in bovine P. multocida; genotype D: L6: ST50 (37.50%) in porcine P.

Pasteurellamultocida

Pasteurella multocida is a leading cause of respiratory diseases in many host species. To understand the genetic

Слайд 17A total of 47 P. multocida strains were selected for

whole genome sequencing in this study (Table 1). Most of

these strains were isolated from pigs with respiratory disorders in China (Peng et al., 2018), with the exception of strain HN04, which is a capsular type B isolate from a swine haemorrhagic septicaemia case. The capsular types and LPS genotypes of these 47 P. multocida isolates were determined through PCR assays, as described previously

multocida

A total of 47 P. multocida strains were selected for whole genome sequencing in this study (Table

Слайд 18he phylogenetic relationship between P. multocida strains from different host

species was predicted by analyzing the whole-genome single nucleotide polymorphisms

(WG-SNPs) as well as the set of SNPs present in all single-copy core genes across genomes (CG-SNPs). The WG-SNPs were identified by comparing each of the WGSs against the reference P. multocida ATCC 43137 genome sequence (GenBank accession NO. CP008918) using MAFFT (version 7.222) software (Katoh and Standley, 2013).


he phylogenetic relationship between P. multocida strains from different host species was predicted by analyzing the whole-genome

Слайд 20Whole genome sequencing yielded approximately 796.25~1823.87 Mbp raw data for

the 47 porcine P. multocida isolates. The data filter strategy

produced approximately 701.86~1589.23 Mb clean data for assembly. Sequences assembled using SPAdes v3.9.0 (Bankevich et al., 2012) generated approximately 18~66 contigs for the 47 porcine P. multocida isolates, with an average of 25 contigs for each strain.

Results

Whole genome sequencing yielded approximately 796.25~1823.87 Mbp raw data for the 47 porcine P. multocida isolates. The

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