The authors were interested in the transmission of adenoviruses among patients in a tertiary paediatric hospital. They developed a target-enriched adenovirus whole-genome sequencing (WGS) assay for clinical samples and retrospectively sequenced 107 adenovirus-positive residual diagnostic samples, including viraemias (>5×10^4 copies/mL), from 37 patients. Adenovirus sequences could be recovered from 105 of the 107 samples. Full genome sequences were recovered from all 20 non-species C samples and from 36 of 85 species C viruses, with partial genome sequences recovered from the rest. Phylogenetic analyses suggested that three of the genotype A31 cases were linked and demonstrated a previously unsuspected epidemiologic link to an A31 infection first detected on the same ward 4 years previously. In nine of the samples from a patient who died, the authors also identified a mixed genotype adenovirus infection. Therefore adenovirus WGS from clinical samples is possible and can be used to identify nosocomial transmission with greater resolution than conventional genotyping.
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