Genomes and Genes
human enterovirus b
Summary: A species of ENTEROVIRUS infecting humans and containing 36 serotypes. It is comprised of all the echoviruses and a few coxsackieviruses, including all of those previously named coxsackievirus B.
- Yuan J, Zhang J, Wong B, Si X, Wong J, Yang D, et al. Inhibition of glycogen synthase kinase 3beta suppresses coxsackievirus-induced cytopathic effect and apoptosis via stabilization of beta-catenin. Cell Death Differ. 2005;12:1097-106 pubmed..Taken together, our results demonstrate that CVB3 infection stimulates GSK3beta activity via a tyrosine kinase-dependent mechanism, which contributes to CVB3-induced CPE and apoptosis through dysregulation of beta-catenin. ..
- Triantafilou K, Orthopoulos G, Vakakis E, Ahmed M, Golenbock D, Lepper P, et al. Human cardiac inflammatory responses triggered by Coxsackie B viruses are mainly Toll-like receptor (TLR) 8-dependent. Cell Microbiol. 2005;7:1117-26 pubmed..Here we report that the CBV-induced inflammatory response is mediated through TLR8 and to a lesser extent through TLR7. ..
- Cornell C, Kiosses W, Harkins S, Whitton J. Inhibition of protein trafficking by coxsackievirus b3: multiple viral proteins target a single organelle. J Virol. 2006;80:6637-47 pubmed..Thus, coxsackieviruses rely on the combined effects of several gene products that target a single cellular organelle to successfully block protein secretion during an infection. These findings have implications for viral pathogenesis. ..
- Dalwai A, Ahmad S, Pacsa A, Al Nakib W. Echovirus type 9 is an important cause of viral encephalitis among infants and young children in Kuwait. J Clin Virol. 2009;44:48-51 pubmed publisher..The role of enteroviruses in encephalitis is not fully established...
- Fuse K, Chan G, Liu Y, Gudgeon P, Husain M, Chen M, et al. Myeloid differentiation factor-88 plays a crucial role in the pathogenesis of Coxsackievirus B3-induced myocarditis and influences type I interferon production. Circulation. 2005;112:2276-85 pubmed..Absence of MyD88 confers host protection possibly through novel direct activation of IRF-3 and IFN-beta. ..
- Kramer M, Schulte B, Toonen L, de Bruijni M, Galama J, Adema G, et al. Echovirus infection causes rapid loss-of-function and cell death in human dendritic cells. Cell Microbiol. 2007;9:1507-18 pubmedCoxsackie B viruses (CVB) and Echoviruses (EV) form a single species; Human enterovirus B (HeV-B), within the genus Enterovirus. Although HeV-B infections are usually mild or asymptomatic, they can cause serious acute illnesses...
- Mirand A, Henquell C, Archimbaud C, Peigue Lafeuille H, Bailly J. Emergence of recent echovirus 30 lineages is marked by serial genetic recombination events. J Gen Virol. 2007;88:166-76 pubmed..The contribution of recombination to the evolution of E-30 is substantial. It is associated tightly with the emergence of new genetic lineages and certain recombinants have undergone epidemic spread. ..
- Oberste M, Maher K, Nix W, Michele S, Uddin M, Schnurr D, et al. Molecular identification of 13 new enterovirus types, EV79-88, EV97, and EV100-101, members of the species Human Enterovirus B. Virus Res. 2007;128:34-42 pubmed..17 enterovirus isolates from four countries were identified as members of 13 new types within the species Human Enterovirus B (HEV-B) by complete genome sequencing...
- Cornell C, Kiosses W, Harkins S, Whitton J. Coxsackievirus B3 proteins directionally complement each other to downregulate surface major histocompatibility complex class I. J Virol. 2007;81:6785-97 pubmed..Taken together, these effects may render CVB3-infected cells invisible to CD8(+) T cells and untouchable by many antiviral effector molecules. This has important implications for immune evasion by CVB3. ..
- Tam P. Coxsackievirus myocarditis: interplay between virus and host in the pathogenesis of heart disease. Viral Immunol. 2006;19:133-46 pubmed..Studies of T cell responsiveness and the development of autoimmunity at the molecular level are beginning to clarify the mechanisms through which CVB infection causes inflammatory heart disease. ..
- Lukashev A, Lashkevich V, Ivanova O, Koroleva G, Hinkkanen A, Ilonen J. Recombination in circulating Human enterovirus B: independent evolution of structural and non-structural genome regions. J Gen Virol. 2005;86:3281-90 pubmedThe complete nucleotide sequences of eight Human enterovirus B (HEV-B) strains were determined, representing five serotypes, E6, E7, E11, CVB3 and CVB5, which were isolated in the former Soviet Union between 1998 and 2002...
- Si X, McManus B, Zhang J, Yuan J, Cheung C, Esfandiarei M, et al. Pyrrolidine dithiocarbamate reduces coxsackievirus B3 replication through inhibition of the ubiquitin-proteasome pathway. J Virol. 2005;79:8014-23 pubmed..Cheung, A. Suarez, B. M. McManus, and D. Yang, Am. J. Pathol. 163:381-385, 2003), results in this study suggest a strong antiviral effect of PDTC on coxsackievirus, likely through inhibition of the ubiquitin-proteasome pathway. ..
- Barral P, Morrison J, Drahos J, Gupta P, Sarkar D, Fisher P, et al. MDA-5 is cleaved in poliovirus-infected cells. J Virol. 2007;81:3677-84 pubmed..Poliovirus-induced cleavage of MDA-5 may be a mechanism to antagonize production of type I interferon in response to viral infection. ..
- Kemball C, Harkins S, Whitton J. Enumeration and functional evaluation of virus-specific CD4+ and CD8+ T cells in lymphoid and peripheral sites of coxsackievirus B3 infection. J Virol. 2008;82:4331-42 pubmed publisher..Finally, our findings have implications for the biological significance of cross-priming, a process thought by some to be important for the induction of antiviral CD8(+) T-cell responses...
- Brunel D, Leveque N, Jacques J, Renois F, Motte J, Andreoletti L. Clinical and virological features of an aseptic meningitis outbreak in North-Eastern France, 2005. J Clin Virol. 2008;42:225-8 pubmed publisher..Enteroviruses (EVs) are considered as a major viral etiological cause of aseptic meningitis in children...
- Lanke K, van der Schaar H, Belov G, Feng Q, Duijsings D, Jackson C, et al. GBF1, a guanine nucleotide exchange factor for Arf, is crucial for coxsackievirus B3 RNA replication. J Virol. 2009;83:11940-9 pubmed publisher..In conclusion, this study identifies a critical role for GBF1 in CVB3 RNA replication, but the importance of the 3A-GBF1 interaction requires further study. ..
- Cabrerizo M, Echevarria J, González I, de Miguel T, Trallero G. Molecular epidemiological study of HEV-B enteroviruses involved in the increase in meningitis cases occurred in Spain during 2006. J Med Virol. 2008;80:1018-24 pubmed publisher..Direct molecular typing of clinical samples also allows rapid identification of the serotypes involved in an epidemic alert and phylogenetic analysis in the 3'-VP1 region is useful to study viral epidemiology. ..
- Feuer R, Pagarigan R, Harkins S, Liu F, Hunziker I, Whitton J. Coxsackievirus targets proliferating neuronal progenitor cells in the neonatal CNS. J Neurosci. 2005;25:2434-44 pubmed..These data lead us to propose a model of CVB infection of the developing CNS, which may explain the neurodevelopmental defects that result from fetal infection. ..
- Palacios G, Casas I, Cisterna D, Trallero G, Tenorio A, Freire C. Molecular epidemiology of echovirus 30: temporal circulation and prevalence of single lineages. J Virol. 2002;76:4940-9 pubmed..This pattern of evolution is clearly different from that of other enteroviruses. A single lineage at a time appears to be circulating worldwide. This behavior may be related to the epidemic activity of EV30. ..
- Bahri O, Rezig D, Nejma Oueslati B, Yahia A, Sassi J, Hogga N, et al. Enteroviruses in Tunisia: virological surveillance over 12 years (1992-2003). J Med Microbiol. 2005;54:63-9 pubmed..This study is the first report of the epidemiology of NPEV in Tunisia. These viruses are associated with various diseases and epidemiological data may help to clarify their impact on human health. ..
- Norder H, Bjerregaard L, Magnius L. Open reading frame sequence of an Asian enterovirus 73 strain reveals that the prototype from California is recombinant. J Gen Virol. 2002;83:1721-8 pubmed..the complete open reading frame of 2776/82, its non-structural region was found to be divergent from all human enterovirus B (HEV-B) strains, including CA55-1988, indicating that one or other strain was recombinant...
- Rossmann M, He Y, Kuhn R. Picornavirus-receptor interactions. Trends Microbiol. 2002;10:324-31 pubmed..Binding into the canyon destabilizes the virus and thus initiates the uncoating process. By contrast, non-IgSF molecules, when used by picornaviruses as receptors, bind outside the canyon and do not cause viral instability. ..
- Kishimoto C, Kurokawa M, Ochiai H. Antibody-mediated immune enhancement in coxsackievirus B3 myocarditis. J Mol Cell Cardiol. 2002;34:1227-38 pubmed..By another virus rechallenge in Experiment III, enhanced infection of CB3 was not observed in vivo. These findings suggest that antibody-mediated immune enhancement might be involved in the pathogenesis of CB3 myocarditis. ..
- Luo H, Zhang J, Dastvan F, Yanagawa B, Reidy M, Zhang H, et al. Ubiquitin-dependent proteolysis of cyclin D1 is associated with coxsackievirus-induced cell growth arrest. J Virol. 2003;77:1-9 pubmed
- Oberste M, Peñaranda S, Pallansch M. RNA recombination plays a major role in genomic change during circulation of coxsackie B viruses. J Virol. 2004;78:2948-55 pubmed..These results suggest that recombination is a frequent event during enterovirus evolution but that there are genetic restrictions that may influence recombinational compatibility. ..
- Huber S, Ramsingh A. Coxsackievirus-induced pancreatitis. Viral Immunol. 2004;17:358-69 pubmed
- Shen Y, Xu W, Chu Y, Wang Y, Liu Q, Xiong S. Coxsackievirus group B type 3 infection upregulates expression of monocyte chemoattractant protein 1 in cardiac myocytes, which leads to enhanced migration of mononuclear cells in viral myocarditis. J Virol. 2004;78:12548-56 pubmed..In conclusion, our results indicate that CVB3 infection stimulates the expression of MCP-1 in myocardial cells, which subsequently leads to migration of mononuclear cells in viral myocarditis. ..
- Lindberg A, Andersson P, Savolainen C, Mulders M, Hovi T. Evolution of the genome of Human enterovirus B: incongruence between phylogenies of the VP1 and 3CD regions indicates frequent recombination within the species. J Gen Virol. 2003;84:1223-35 pubmed..Phylogenetic analysis revealed that sequences of Human enterovirus B (HEV-B) were segregated in the 3CD region into three distinct clusters without the VP1-associated serotype/..
- Cunningham K, Chapman N, Carson S. Caspase-3 activation and ERK phosphorylation during CVB3 infection of cells: influence of the coxsackievirus and adenovirus receptor and engineered variants. Virus Res. 2003;92:179-86 pubmed..These results show that ERK phosphorylation precedes caspase-3 activation, both occur late in the infection, and both are influenced by the presence of CAR. ..
- Whitton J. Immunopathology during coxsackievirus infection. Springer Semin Immunopathol. 2002;24:201-13 pubmed
- Rezig D, Ben Yahia A, Ben Abdallah H, Bahri O, Triki H. Molecular characterization of coxsackievirus B5 isolates. J Med Virol. 2004;72:268-74 pubmed..It gives a first approach on the molecular epidemiology of these viruses, which have a particular importance in human health. ..
- Wang J, Tsai H, Huang S, Kuo P, Kiang D, Liu C. Laboratory diagnosis and genetic analysis of an echovirus 30-associated outbreak of aseptic meningitis in Taiwan in 2001. J Clin Microbiol. 2002;40:4439-44 pubmed..1 to 25.2%, suggesting that this outbreak was caused by a new variant strain of E30 introduced into Taiwan in 2000 that resulted in the widespread aseptic meningitis epidemic in 2001...
- Esfandiarei M, Luo H, Yanagawa B, Suarez A, Dabiri D, Zhang J, et al. Protein kinase B/Akt regulates coxsackievirus B3 replication through a mechanism which is not caspase dependent. J Virol. 2004;78:4289-98 pubmed..Taken together, these data illustrate a new and imperative role for Akt in CVB3 infection in HeLa cells and show that the PI3K/Akt signaling is beneficial to CVB3 replication. ..
- Stuart A, McKee T, Williams P, Harley C, Shen S, Stuart D, et al. Determination of the structure of a decay accelerating factor-binding clinical isolate of echovirus 11 allows mapping of mutants with altered receptor requirements for infection. J Virol. 2002;76:7694-704 pubmed..We suggest that a DAF-binding site is located at the fivefold axes of the virion, while the binding site for a distinct but as yet unidentified receptor is located within the canyon surrounding the virion fivefold axes. ..
- Opavsky M, Martino T, Rabinovitch M, Penninger J, Richardson C, Petric M, et al. Enhanced ERK-1/2 activation in mice susceptible to coxsackievirus-induced myocarditis. J Clin Invest. 2002;109:1561-9 pubmed..In contrast, significantly less ERK-1/2 activation is found in the hearts of myocarditis-resistant C57BL/6 mice. Therefore, the ERK-1/2 response to CVB3 infection may contribute to differential host susceptibility to viral myocarditis. ..
- Bailly J, Brosson D, Archimbaud C, Chambon M, Henquell C, Peigue Lafeuille H. Genetic diversity of echovirus 30 during a meningitis outbreak, demonstrated by direct molecular typing from cerebrospinal fluid. J Med Virol. 2002;68:558-67 pubmed..The apparent displacement observed between virus variants did not result from a selective advantage caused by antigenic variation. ..
- Luo H, Zhang J, Cheung C, Suarez A, McManus B, Yang D. Proteasome inhibition reduces coxsackievirus B3 replication in murine cardiomyocytes. Am J Pathol. 2003;163:381-5 pubmed..Thus, proteasome inhibition may represent a novel therapeutic approach against myocarditis. ..
- Oberste M, Maher K, Pallansch M. Evidence for frequent recombination within species human enterovirus B based on complete genomic sequences of all thirty-seven serotypes. J Virol. 2004;78:855-67 pubmedThe species Human enterovirus B (HEV-B) in the family Picornaviridae consists of coxsackievirus A9; coxsackieviruses B1 to B6; echoviruses 1 to 7, 9, 11 to 21, 24 to 27, and 29 to 33; and enteroviruses 69 and 73...
- Thoelen I, Moës E, Lemey P, Mostmans S, Wollants E, Lindberg A, et al. Analysis of the serotype and genotype correlation of VP1 and the 5' noncoding region in an epidemiological survey of the human enterovirus B species. J Clin Microbiol. 2004;42:963-71 pubmed..g., primer choice), provided some background knowledge on the local spectrum of enteroviruses already exists. ..
- Triantafilou K, Triantafilou M. Coxsackievirus B4-induced cytokine production in pancreatic cells is mediated through toll-like receptor 4. J Virol. 2004;78:11313-20 pubmed..Here we demonstrate that CBV4 triggers cytokine production through a TLR4-dependent pathway. This interaction seems to be independent of virus attachment and cell entry. ..
- Wessels E, Duijsings D, Notebaart R, Melchers W, van Kuppeveld F. A proline-rich region in the coxsackievirus 3A protein is required for the protein to inhibit endoplasmic reticulum-to-golgi transport. J Virol. 2005;79:5163-73 pubmed..The functional relevance of the proline-rich region is discussed in light of the proposed structural model of 3A. ..
- Oprisan G, Combiescu M, Guillot S, Caro V, Combiescu A, Delpeyroux F, et al. Natural genetic recombination between co-circulating heterotypic enteroviruses. J Gen Virol. 2002;83:2193-200 pubmed..Our results suggest that such genetic recombinations between different echovirus serotypes are possible when multiple epidemic strains are circulating simultaneously...
- Merkle I, van Ooij M, van Kuppeveld F, Glaudemans D, Galama J, Henke A, et al. Biological significance of a human enterovirus B-specific RNA element in the 3' nontranslated region. J Virol. 2002;76:9900-9 pubmed..However, the heart tissue from mice infected with the recombinant virus showed only slight signs of myocarditis. These results suggest that the enterovirus B-like-specific Z domain plays a role in coxsackievirus-induced pathogenesis. ..
- Charrel R, Bernit E, Zandotti C, de Lamballerie X. An approach based on RFLP assay to investigate outbreaks of enteroviral meningitis. J Clin Virol. 2004;29:54-8 pubmed..During the last two decades, echovirus type 30 (E-30) has revealed to be one of the most prevalent enteroviruses at the origin of epidemics of EV meningitis...
- Tracy S, Gauntt C. Group B coxsackievirus virulence. Curr Top Microbiol Immunol. 2008;323:49-63 pubmed..It is not known how highly virulent CVB strains may arise but evidence suggests such strains are not the norm. ..
- Belguith K, Hassen A, Bouslama L, Khira S, Aouni M. Enterovirus circulation in wastewater and behavior of some serotypes during sewage treatment in Monastir, Tunisia. J Environ Health. 2007;69:52-6 pubmed..Isolation of serotypes varied according to the step of wastewater treatment. Poliovirus 1 and Echovirus 6 were the most resistant serotypes. ..
- Smets K, Keymeulen A, Wollants E, Lagrou K, Van Ranst M, Padalko E. Detection of enteroviral RNA on Guthrie card dried blood of a neonate with fatal Coxsackie B3 myocarditis on day 17. J Clin Virol. 2008;42:207-10 pubmed publisher..This is the first report on the detection of enteroviral RNA in Guthrie card dried blood using reverse-transcriptase PCR. Materials and methods used are described in detail. ..
- Wang Z, Hua Y, Zhang X, Wang Y, Shi X, Li M. [Effect of resveratrol on myocardial fibrosis in mice with chronic viral myocarditis]. Zhongguo Dang Dai Er Ke Za Zhi. 2009;11:291-5 pubmed..05), while PINP concentrations increased significantly (P<0.05). Resveratrol can inhibit hyperplasia of myocardial collagen in the mouse model of chronic VMC, acting as an effective anti-fibrotic agent in the myocardium. ..
- Shaw A, Reid S, Knowles N, Hutchings G, Wilsden G, Brocchi E, et al. Sequence analysis of the 5' untranslated region of swine vesicular disease virus reveals block deletions between the end of the internal ribosomal entry site and the initiation codon. J Gen Virol. 2005;86:2753-61 pubmed..Further work is required to define the significance of these deletions and to assess whether they impact on the pathogenesis of SVD. ..
- Bendig J, Earl P. The Lim Benyesh-Melnick antiserum pools for serotyping human enterovirus cell culture isolates--still useful, but may fail to identify current strains of echovirus 18. J Virol Methods. 2005;127:96-9 pubmed..Of 15 coxsackievirus A16 isolates only nine were typable by neutralisation. Neutralisation with the LBM pools remains a useful second line method of serotyping human enteroviruses despite difficulties with at least two serotypes. ..
- Yang C, Li H, Jiang J, Hsu C, Wang Y, Lai M, et al. Enterovirus type 71 2A protease functions as a transcriptional activator in yeast. J Biomed Sci. 2010;17:65 pubmed publisher..Interestingly, this acidic region of poliovirus 2A protease is critical for viral RNA replication. The transcriptional activity of the EV71 or Coxsackie virus B3 2A protease should play a role in viral replication and/or pathogenesis. ..
- Wang J, Asher D, Chan M, Kurt Jones E, Finberg R. Cutting Edge: Antibody-mediated TLR7-dependent recognition of viral RNA. J Immunol. 2007;178:3363-7 pubmed..These data define a pathway by which intracellular TLR7 senses viral RNA and indicate a role for TLRs in association with Abs in sustaining virus-specific responses. ..
- Seko Y. Effect of the angiotensin II receptor blocker olmesartan on the development of murine acute myocarditis caused by coxsackievirus B3. Clin Sci (Lond). 2006;110:379-86 pubmed..The findings suggest that olmesartan prevents myocardial damage and may improve the prognosis of patients with acute myocarditis; however, further investigations are needed before clinical use. ..
- Dorta Contreras A, Lewczuk P, Padilla Docal B, Noris García E, Coifiu Fanego R, Sanchez Martinez C, et al. sICAM-1 intrathecal synthesis and release during the acute phase in children suffering from Coxsackie A9 and S. pneumoniae meningoencephalitis. Arq Neuropsiquiatr. 2008;66:504-8 pubmed..An important role of sICAM-1 in the transmigration of different cell types into CSF during CNS inflammation in children with S. pneumoniae and Coxsackie A9 meningoencephalitis may be suggested. ..
- Zhao Y, Zhang H, Liu H, Sun H, Huang X, Yang Z, et al. Complete Genome Sequence of Human Echovirus 20 Strain 812/YN/CHN/2010, Associated with Severe Hand-Foot-and-Mouth Disease. Genome Announc. 2017;5: pubmed publisherHuman echovirus 20 (E-20) belongs to the Human enterovirus B (HEV-B) species and is often detected in nonpolio enterovirus cases of acute flaccid paralysis...
- Faustini A, Fano V, Muscillo M, Zaniratti S, La Rosa G, Tribuzi L, et al. An outbreak of aseptic meningitis due to echovirus 30 associated with attending school and swimming in pools. Int J Infect Dis. 2006;10:291-7 pubmed..3; 95% CI = 1.1-62.6 versus other pools). The epidemic curve appears to suggest a person-to-person transmission. The epidemic occurred by person-to-person transmission in a number of classrooms and at swimming pool X. ..
- Chanzy S, Mselati J, Jourdain G, Chabernaud J. [Group B coxsackie virus infection with fatal myocarditis in the neonate after early discharge from maternity unit]. Arch Pediatr. 2005;12:618-9 pubmed
- Zhong Q, Yang Z, Liu Y, Deng H, Xiao H, Shi L, et al. Antiviral activity of Arbidol against Coxsackie virus B5 in vitro and in vivo. Arch Virol. 2009;154:601-7 pubmed publisher..Our results demonstrate that in vitro and in vivo infection with CVB(5) can be effectively treated by Arbidol. ..
- Castro C, Oliveira D, Macedo O, Lima M, Santana M, Wanzeller A, et al. Echovirus 30 associated with cases of aseptic meningitis in state of Pará, Northern Brazil. Mem Inst Oswaldo Cruz. 2009;104:444-50 pubmed..1999). This study described the first molecular characterization of Echo 30 in Brazil and this will certainly contribute to future molecular analyses involving strains detected in other regions of Brazil. ..
- Kim K, Tracy S, Tapprich W, Bailey J, Lee C, Kim K, et al. 5'-Terminal deletions occur in coxsackievirus B3 during replication in murine hearts and cardiac myocyte cultures and correlate with encapsidation of negative-strand viral RNA. J Virol. 2005;79:7024-41 pubmed..These studies describe a naturally occurring genomic alteration to an enteroviral genome associated with long-term viral persistence. ..
- Dhole T, Ayyagari A, Chowdhary R, Shakya A, Shrivastav N, Datta T, et al. Non-polio enteroviruses in acute flaccid paralysis children of India: vital assessment before polio eradication. J Paediatr Child Health. 2009;45:409-13 pubmed publisher..Wild polio cases declined because of intensive oral polio vaccine immunization. As we approach global eradication of poliovirus (PV), NPEV causing acute flaccid paralysis (AFP) are equal cause of concern...
- Loeffelbein F, Schlensak C, Beyersdorf F, Dittrich S. Successful interventional closure of a patent foramen ovale in a pediatric patient supported with a biventricular assist device. Interact Cardiovasc Thorac Surg. 2007;6:778-9 pubmed..The diagnosis of a PFO may be missed under ECMO-treatment. Interventional closure of a PFO can successfully be performed even if the patient is supported with a BVAD. ..
- Brilot F, Geenen V. [Role of viral infections in the pathogenesis of type 1 diabetes]. Rev Med Liege. 2005;60:297-302 pubmed..CVB4-induced thymic dysfunction would contribute in close association with the peripheral "bystander" effect to the destruction of insulin-secreting islet beta cells and to the development of type 1 diabetes. ..
- Roberts B, Cech I. Association of type 2 diabetes mellitus and seroprevalence for cytomegalovirus. South Med J. 2005;98:686-92 pubmed..No other viruses tested in this study, either coxsackie B viruses or parvovirus, showed a significant association with type 2 diabetes. ..
- Kottaridi C, Bolanaki E, Mamuris Z, Stathopoulos C, Markoulatos P. Molecular phylogeny of VP1, 2A, and 2B genes of echovirus isolates: epidemiological linkage and observations on genetic variation. Arch Virol. 2006;151:1117-32 pubmed..Sequence analysis of the adjacent 2A and 2B genes provided a different pattern of phylogenetic relationships and strong evidence of epidemiological linkage of most of the clinical isolates. ..