Viruses in Vietnamese patients presenting with community-acquired sepsis of unknown cause

Anh, NT; Hong, NTT; Nhu, LNT; Thanh, TT; Lau, C-Y; Limmathurotsakul, D; Deng, X; Rahman, M; Chau, NVV; van Doorn, HR; Thwaites, G; Delwart, E; Tan, LV; Southeast Asia Infectious Disease Clinical Research Network

Journal article

Viruses in Vietnamese patients presenting with community-acquired sepsis of unknown cause

Abstract:: Community-acquired (CA) sepsis is a major public health problem worldwide, yet the etiology remains unknown for >50% of the patients. Here we applied metagenomic next-generation sequencing (mNGS) to characterize the human virome in 492 clinical samples (384 sera, 92 pooled nasal and throat swabs, 10 stools, and 6 cerebrospinal fluid samples) from 386 patients (213 adults and 173 children) presenting with CA sepsis who were recruited from 6 hospitals across Vietnam between 2013 and 2015. Specific monoplex PCRs were used subsequently to confirm the presence of viral sequences detected by mNGS. We found sequences related to 47 viral species belonging to 21 families in 358 of 386 (93%) patients, including viruses known to cause human infections. After PCR confirmation, human viruses were found in 52 of 386 patients (13.4%); picornavirus (enteroviruses [n = 14], rhinovirus [n = 5], and parechovirus [n = 2]), hepatitis B virus (n = 10), cytomegalovirus (n = 9), Epstein-Barr virus (n = 5), and rotavirus A (n = 3) were the most common viruses detected. Recently discovered viruses were also found (gemycircularvirus [n = 5] and WU polyomavirus, Saffold virus, salivirus, cyclovirus-VN, and human pegivirus 2 [HPgV2] [n, 1 each]), adding to the growing literature about the geographic distribution of these novel viruses. Notably, sequences related to numerous viruses not previously reported in human tissues were also detected. To summarize, we identified 21 viral species known to be infectious to humans in 52 of 386 (13.4%) patients presenting with CA sepsis of unknown cause. The study, however, cannot directly impute sepsis causation to the viruses identified. The results highlight the fact that it remains a challenge to establish the causative agents in CA sepsis patients, especially in tropical settings such as Vietnam.

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

Anh, N. T., Hong, N. T. T., Nhu, L. N. T., Thanh, T. T., Lau, C.-Y., Limmathurotsakul, D., Deng, X., Rahman, M., Chau, N. V. V., van Doorn, H. R., Thwaites, G., Delwart, E., Tan, L. V., & Network, S. A. I. D. C. R. (2019). Viruses in Vietnamese patients presenting with community-acquired sepsis of unknown cause. Journal of Clinical Microbiology, 57(9).

MLA Style

Anh, NT, et al. “Viruses in Vietnamese Patients Presenting with Community-Acquired Sepsis of Unknown Cause.” Journal of Clinical Microbiology, vol. 57, no. 9, 2019.

Chicago Style

Anh, NT, NTT Hong, LNT Nhu, et al. 2019. “Viruses in Vietnamese Patients Presenting with Community-Acquired Sepsis of Unknown Cause.” Journal of Clinical Microbiology 57 (9).
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