Segregation of Virulent Influenza A(H1N1) Variants in the Lower Respiratory Tract of Critically Ill Patients during the 2010–2011 Seasonal Epidemic 英文参考文献.docVIP

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Segregation of Virulent Influenza A(H1N1) Variants in the Lower Respiratory Tract of Critically Ill Patients during the 2010–2011 Seasonal Epidemic 英文参考文献.doc

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Segregation of Virulent Influenza A(H1N1) Variants in the Lower Respiratory Tract of Critically Ill Patients during the 2010–2011 Seasonal Epidemic 英文参考文献

SegregationofVirulentInfluenzaA(H1N1)Variantsin theLowerRespiratoryTractofCriticallyIllPatients duringthe2010–2011SeasonalEpidemic AntonioPiralla1,ElenaPariani2,FrancescaRovida1,GiuliaCampanini1,AlbaMuzzi3,VincenzoEmmi4, GiorgioA.Iotti5,AntonioPesenti6,PierGiulioConaldi7,AlessandroZanetti2,FaustoBaldanti1*and the SevereInfluenzaATaskForce 1Struttura Semplice Virologia Molecolare, Struttura Complessa Virologia e Microbiologia, Fondazione Istituto Ricovero e Cura a Carattere Scientifico Policlinico San Matteo,Pavia,Italy, 2DipartimentodiSanita` Pubblica-Microbiologia-Virologia,Universita` degliStudidiMilano,Milan,Italy, 3StrutturaComplessaDirezioneMedicadi Presidio,FondazioneIstitutoRicoveroeCuraaCarattereScientificoPoliclinicoSan Matteo,Pavia, Italy, 4Struttura Complessa AnestesiaeRianimazioneI,Fondazione IstitutoRicoveroeCuraaCarattereScientificoPoliclinicoSanMatteo,Pavia,Italy,5StrutturaComplessaAnestesiaeRianimazioneII,FondazioneIstitutoRicoveroeCuraa CarattereScientificoPoliclinicoSanMatteo,Pavia,Italy,6StrutturaComplessaAnestesiaeRianimazione,AziendaOspedalieraSanGerardo,Monza,Italy,7Laboratoriodi PatologiaClinica,MicrobiologiaeVirologiaIstitutoMediterraneoperiTrapiantieTerapieadAltaSpecializzazione,Palermo,Italy Abstract Background: Since its appearance in 2009, the pandemic influenza A(H1N1) virus circulated worldwide causing several severeinfections. Methods: Respiratory samples from patients with 2009 influenza A(H1N1) and acute respiratory distress attending 24 intensivecareunits(ICUs)aswellasfrompatientswithlowerrespiratorytractinfectionsnotrequiringICUadmissionand communityupperrespiratorytractinfectionsintheLombardyregion(10millioninhabitants)ofItalyduringthe2010–2011 winter-springseason,wereanalyzed. Results:InpatientswithsevereILI,theviralloadwashigherinbronchoalveolarlavage(BAL)withrespecttonasalswab(NS), (p,0.001) suggesting a higher virus replication in the lower respiratory tract. Four distinct virus clusters (referred to as clus