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1.
BMC Genomics ; 22(1): 11, 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33407096

RESUMO

BACKGROUND: The genus Ehrlichia consists of tick-borne obligatory intracellular bacteria that can cause deadly diseases of medical and agricultural importance. Ehrlichia sp. HF, isolated from Ixodes ovatus ticks in Japan [also referred to as I. ovatus Ehrlichia (IOE) agent], causes acute fatal infection in laboratory mice that resembles acute fatal human monocytic ehrlichiosis caused by Ehrlichia chaffeensis. As there is no small laboratory animal model to study fatal human ehrlichiosis, Ehrlichia sp. HF provides a needed disease model. However, the inability to culture Ehrlichia sp. HF and the lack of genomic information have been a barrier to advance this animal model. In addition, Ehrlichia sp. HF has several designations in the literature as it lacks a taxonomically recognized name. RESULTS: We stably cultured Ehrlichia sp. HF in canine histiocytic leukemia DH82 cells from the HF strain-infected mice, and determined its complete genome sequence. Ehrlichia sp. HF has a single double-stranded circular chromosome of 1,148,904 bp, which encodes 866 proteins with a similar metabolic potential as E. chaffeensis. Ehrlichia sp. HF encodes homologs of all virulence factors identified in E. chaffeensis, including 23 paralogs of P28/OMP-1 family outer membrane proteins, type IV secretion system apparatus and effector proteins, two-component systems, ankyrin-repeat proteins, and tandem repeat proteins. Ehrlichia sp. HF is a novel species in the genus Ehrlichia, as demonstrated through whole genome comparisons with six representative Ehrlichia species, subspecies, and strains, using average nucleotide identity, digital DNA-DNA hybridization, and core genome alignment sequence identity. CONCLUSIONS: The genome of Ehrlichia sp. HF encodes all known virulence factors found in E. chaffeensis, substantiating it as a model Ehrlichia species to study fatal human ehrlichiosis. Comparisons between Ehrlichia sp. HF and E. chaffeensis will enable identification of in vivo virulence factors that are related to host specificity, disease severity, and host inflammatory responses. We propose to name Ehrlichia sp. HF as Ehrlichia japonica sp. nov. (type strain HF), to denote the geographic region where this bacterium was initially isolated.


Assuntos
Ehrlichia chaffeensis , Ehrlichiose , Ixodes , Animais , Cães , Ehrlichia chaffeensis/genética , Ehrlichiose/veterinária , Genoma Bacteriano , Japão , Camundongos
2.
Sci Transl Med ; 9(403)2017 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-28814544

RESUMO

Early detection and intervention are likely to be the most effective means for reducing morbidity and mortality of human cancer. However, development of methods for noninvasive detection of early-stage tumors has remained a challenge. We have developed an approach called targeted error correction sequencing (TEC-Seq) that allows ultrasensitive direct evaluation of sequence changes in circulating cell-free DNA using massively parallel sequencing. We have used this approach to examine 58 cancer-related genes encompassing 81 kb. Analysis of plasma from 44 healthy individuals identified genomic changes related to clonal hematopoiesis in 16% of asymptomatic individuals but no alterations in driver genes related to solid cancers. Evaluation of 200 patients with colorectal, breast, lung, or ovarian cancer detected somatic mutations in the plasma of 71, 59, 59, and 68%, respectively, of patients with stage I or II disease. Analyses of mutations in the circulation revealed high concordance with alterations in the tumors of these patients. In patients with resectable colorectal cancers, higher amounts of preoperative circulating tumor DNA were associated with disease recurrence and decreased overall survival. These analyses provide a broadly applicable approach for noninvasive detection of early-stage tumors that may be useful for screening and management of patients with cancer.


Assuntos
DNA Tumoral Circulante/metabolismo , Detecção Precoce de Câncer/métodos , Neoplasias/diagnóstico , Neoplasias/patologia , Células Sanguíneas/metabolismo , Estudos de Casos e Controles , Ácidos Nucleicos Livres/sangue , DNA Tumoral Circulante/sangue , Progressão da Doença , Feminino , Genes Neoplásicos , Humanos , Mutação/genética , Estadiamento de Neoplasias , Neoplasias/sangue , Neoplasias/genética , Cuidados Pré-Operatórios , Análise de Sequência de DNA , Resultado do Tratamento
3.
Microb Biotechnol ; 10(4): 933-957, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28585301

RESUMO

Neorickettsia helminthoeca, a type species of the genus Neorickettsia, is an endosymbiont of digenetic trematodes of veterinary importance. Upon ingestion of salmonid fish parasitized with infected trematodes, canids develop salmon poisoning disease (SPD), an acute febrile illness that is particularly severe and often fatal in dogs without adequate treatment. We determined and analysed the complete genome sequence of N. helminthoeca: a single small circular chromosome of 884 232 bp encoding 774 potential proteins. N. helminthoeca is unable to synthesize lipopolysaccharides and most amino acids, but is capable of synthesizing vitamins, cofactors, nucleotides and bacterioferritin. N. helminthoeca is, however, distinct from majority of the family Anaplasmataceae to which it belongs, as it encodes nearly all enzymes required for peptidoglycan biosynthesis, suggesting its structural hardiness and inflammatory potential. Using sera from dogs that were experimentally infected by feeding with parasitized fish or naturally infected in southern California, Western blot analysis revealed that among five predicted N. helminthoeca outer membrane proteins, P51 and strain-variable surface antigen were uniformly recognized. Our finding will help understanding pathogenesis, prevalence of N. helminthoeca infection among trematodes, canids and potentially other animals in nature to develop effective SPD diagnostic and preventive measures. Recent progresses in large-scale genome sequencing have been uncovering broad distribution of Neorickettsia spp., the comparative genomics will facilitate understanding of biology and the natural history of these elusive environmental bacteria.


Assuntos
Infecções por Anaplasmataceae/veterinária , Antígenos de Bactérias/genética , Antígenos de Superfície/genética , Doenças do Cão/microbiologia , Genoma Bacteriano , Neorickettsia/genética , Sequenciamento Completo do Genoma , Infecções por Anaplasmataceae/microbiologia , Animais , Anticorpos Antibacterianos/sangue , Western Blotting , Cães , Redes e Vias Metabólicas/genética , Neorickettsia/isolamento & purificação
4.
Genome Announc ; 5(14)2017 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-28385830

RESUMO

We report here paired isogenic Burkholderia pseudomallei genomes obtained from three patients receiving intravenous meropenem for melioidosis treatment, with post-meropenem isolates developing decreased susceptibility. Two genomes were finished, and four were drafted to improved high-quality standard. These genomes will be used to identify meropenem resistance mechanisms in B. pseudomallei.

5.
Sci Rep ; 6: 35284, 2016 10 18.
Artigo em Inglês | MEDLINE | ID: mdl-27752055

RESUMO

Babesia microti, a tick-transmitted, intraerythrocytic protozoan parasite circulating mainly among small mammals, is the primary cause of human babesiosis. While most cases are transmitted by Ixodes ticks, the disease may also be transmitted through blood transfusion and perinatally. A comprehensive analysis of genome composition, genetic diversity, and gene expression profiling of seven B. microti isolates revealed that genetic variation in isolates from the Northeast United States is almost exclusively associated with genes encoding the surface proteome and secretome of the parasite. Furthermore, we found that polymorphism is restricted to a small number of genes, which are highly expressed during infection. In order to identify pathogen-encoded factors involved in host-parasite interactions, we screened a proteome array comprised of 174 B. microti proteins, including several predicted members of the parasite secretome. Using this immuno-proteomic approach we identified several novel antigens that trigger strong host immune responses during the onset of infection. The genomic and immunological data presented herein provide the first insights into the determinants of B. microti interaction with its mammalian hosts and their relevance for understanding the selective pressures acting on parasite evolution.


Assuntos
Babesia microti/patogenicidade , Babesiose/genética , Polimorfismo Genético , Proteômica , Animais , Babesia microti/genética , Babesiose/parasitologia , Babesiose/transmissão , Regulação da Expressão Gênica , Genoma de Protozoário , Genômica , Interações Hospedeiro-Parasita/genética , Humanos , Ixodes/genética , Ixodes/parasitologia , Análise em Microsséries , New England
6.
PLoS One ; 10(11): e0141906, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26536348

RESUMO

Peripheral T cell lymphoma (PTCL) is a heterogeneous malignancy with poor response to current therapeutic strategies and incompletely characterized genetics. We conducted whole exome sequencing of matched PTCL and non-malignant samples from 12 patients, spanning 8 subtypes, to identify potential oncogenic mutations in PTCL. Analysis of the mutations identified using computational algorithms, CHASM, PolyPhen2, PROVEAN, and MutationAssessor to predict the impact of these mutations on protein function and PTCL tumorigenesis, revealed 104 somatic mutations that were selected as high impact by all four algorithms. Our analysis identified recurrent somatic missense or nonsense mutations in 70 genes, 9 of which contained mutations predicted significant by all 4 algorithms: ATM, RUNX1T1, WDR17, NTRK3, TP53, TRMT12, CACNA2D1, INTS8, and KCNH8. We observed somatic mutations in ATM (ataxia telangiectasia-mutated) in 5 out of the 12 samples and mutations in the common gamma chain (γc) signaling pathway (JAK3, IL2RG, STAT5B) in 3 samples, all of which also harbored mutations in ATM. Our findings contribute insights into the genetics of PTCL and suggest a relationship between γc signaling and ATM in T cell malignancy.


Assuntos
Proteínas Mutadas de Ataxia Telangiectasia/genética , Cadeias gama de Imunoglobulina/genética , Linfoma de Células T Periférico/genética , Mutação/genética , Proteínas Supressoras de Tumor/genética , Algoritmos , Exoma/genética , Feminino , Citometria de Fluxo , Humanos , Masculino
7.
PLoS One ; 10(2): e0116254, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25695510

RESUMO

Macrolide resistance, emerging in Streptococcus pneumoniae and other Gram-positive bacteria, is increasingly due to efflux pumps encoded by mef/mel(msr) operons found on discrete mobile genetic elements. The regulation of mef/mel(msr) in these elements is not well understood. We identified the mef(E)/mel transcriptional start, localized the mef(E)/mel promoter, and demonstrated attenuation of transcription as a mechanism of regulation of macrolide-inducible mef-mediated macrolide resistance in S. pneumoniae. The mef(E)/mel transcriptional start site was a guanine 327 bp upstream of mef(E). Consensus pneumococcal promoter -10 (5'-TATACT-3') and -35 (5'-TTGAAC-3') boxes separated by 17 bp were identified 7 bp upstream of the start site. Analysis of the predicted secondary structure of the 327 5' region identified four pairs of inverted repeats R1-R8 predicted to fold into stem-loops, a small leader peptide [MTASMRLR, (Mef(E)L)] required for macrolide induction and a Rho-independent transcription terminator. RNA-seq analyses provided confirmation of transcriptional attenuation. In addition, expression of mef(E)L was also influenced by mef(E)L-dependent mRNA stability. The regulatory region 5' of mef(E) was highly conserved in other mef/mel(msr)-containing elements including Tn1207.1 and the 5612IQ complex in pneumococci and Tn1207.3 in Group A streptococci, indicating a regulatory mechanism common to a wide variety of Gram-positive bacteria containing mef/mel(msr) elements.


Assuntos
Antibacterianos/farmacologia , Bactérias Gram-Positivas/efeitos dos fármacos , Macrolídeos/farmacologia , Streptococcus pneumoniae/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Streptococcus pyogenes/efeitos dos fármacos
8.
BMC Genomics ; 15: 738, 2014 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-25168586

RESUMO

BACKGROUND: Halyomorpha halys (Stål) (Insecta:Hemiptera;Pentatomidae), commonly known as the Brown Marmorated Stink Bug (BMSB), is an invasive pest of the mid-Atlantic region of the United States, causing economically important damage to a wide range of crops. Native to Asia, BMSB was first observed in Allentown, PA, USA, in 1996, and this pest is now well-established throughout the US mid-Atlantic region and beyond. In addition to the serious threat BMSB poses to agriculture, BMSB has become a nuisance to homeowners, invading home gardens and congregating in large numbers in human-made structures, including homes, to overwinter. Despite its significance as an agricultural pest with limited control options, only 100 bp of BMSB sequence data was available in public databases when this project began. RESULTS: Transcriptome sequencing was undertaken to provide a molecular resource to the research community to inform the development of pest control strategies and to provide molecular data for population genetics studies of BMSB. Using normalized, strand-specific libraries, we sequenced pools of all BMSB life stages on the Illumina HiSeq. Trinity was used to assemble 200,000 putative transcripts in >100,000 components. A novel bioinformatic method that analyzed the strand-specificity of the data reduced this to 53,071 putative transcripts from 18,573 components. By integrating multiple other data types, we narrowed this further to 13,211 representative transcripts. CONCLUSIONS: Bacterial endosymbiont genes were identified in this dataset, some of which have a copy number consistent with being lateral gene transfers between endosymbiont genomes and Hemiptera, including ankyrin-repeat related proteins, lysozyme, and mannanase. Such genes and endosymbionts may provide novel targets for BMSB-specific biocontrol. This study demonstrates the utility of strand-specific sequencing in generating shotgun transcriptomes and that rapid sequencing shotgun transcriptomes is possible without the need for extensive inbreeding to generate homozygous lines. Such sequencing can provide a rapid response to pest invasions similar to that already described for disease epidemiology.


Assuntos
Perfilação da Expressão Gênica/métodos , Heterópteros/genética , Proteínas de Insetos/genética , Análise de Sequência de RNA/métodos , Animais , Bactérias/genética , Proteínas de Bactérias/genética , Biologia Computacional/métodos , Feminino , Transferência Genética Horizontal , Heterópteros/microbiologia , Espécies Introduzidas , Masculino , Dados de Sequência Molecular , Filogenia , Simbiose
9.
Genome Announc ; 2(2)2014 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-24675855

RESUMO

Full-length or nearly full-length RNA genome sequences for 98 rhinovirus (RV) A isolates (from the Enterovirus genus of the Picornaviridae family), representing 43 different genotypes, were resolved as part of ongoing studies to define RV genetic diversity and its potential link to respiratory disease.

10.
Genome Announc ; 2(2)2014 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-24675857

RESUMO

Nearly full-length RNA genome sequences for 39 rhinovirus B isolates (RV-B), representing 13 different genotypes, were resolved as part of ongoing studies at the University of Wisconsin that attempt to link rhinovirus (RV) diversity and respiratory disease in infants.

11.
Genome Announc ; 2(2)2014 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-24675858

RESUMO

Human rhinovirus (RV) isolates from the RV-C species are recently discovered infectious agents that are closely linked to asthma and wheezing etiologies in infants. Clinical study samples collected at the University of Wisconsin-Madison describe 41 nearly complete genome sequences representing 21 RV-C genotypes.

12.
Microbiome ; 2(1): 6, 2014 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-24558975

RESUMO

BACKGROUND: To take advantage of affordable high-throughput next-generation sequencing technologies to characterize microbial community composition often requires the development of improved methods to overcome technical limitations inherent to the sequencing platforms. Sequencing low sequence diversity libraries such as 16S rRNA amplicons has been problematic on the Illumina MiSeq platform and often generates sequences of suboptimal quality. RESULTS: Here we present an improved dual-indexing amplification and sequencing approach to assess the composition of microbial communities from clinical samples using the V3-V4 region of the 16S rRNA gene on the Illumina MiSeq platform. We introduced a 0 to 7 bp "heterogeneity spacer" to the index sequence that allows an equal proportion of samples to be sequenced out of phase. CONCLUSIONS: Our approach yields high quality sequence data from 16S rRNA gene amplicons using both 250 bp and 300 bp paired-end MiSeq protocols and provides a flexible and cost-effective sequencing option.

13.
Genome Announc ; 2(1)2014 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-24459263

RESUMO

We report the draft genome sequence of Mortierella alpina isolate CDC-B6842. M. alpina is a nonpathogenic member of the Mucoromycotina subphylum of fungi that is an important model for understanding the molecular mechanisms of lipid production and metabolism.

14.
PLoS One ; 8(12): e80597, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24324615

RESUMO

We developed an RNA-Seq-based method to simultaneously capture prokaryotic and eukaryotic expression profiles of cells infected with intracellular bacteria. As proof of principle, this method was applied to Chlamydia trachomatis-infected epithelial cell monolayers in vitro, successfully obtaining transcriptomes of both C. trachomatis and the host cells at 1 and 24 hours post-infection. Chlamydiae are obligate intracellular bacterial pathogens that cause a range of mammalian diseases. In humans chlamydiae are responsible for the most common sexually transmitted bacterial infections and trachoma (infectious blindness). Disease arises by adverse host inflammatory reactions that induce tissue damage & scarring. However, little is known about the mechanisms underlying these outcomes. Chlamydia are genetically intractable as replication outside of the host cell is not yet possible and there are no practical tools for routine genetic manipulation, making genome-scale approaches critical. The early timeframe of infection is poorly understood and the host transcriptional response to chlamydial infection is not well defined. Our simultaneous RNA-Seq method was applied to a simplified in vitro model of chlamydial infection. We discovered a possible chlamydial strategy for early iron acquisition, putative immune dampening effects of chlamydial infection on the host cell, and present a hypothesis for Chlamydia-induced fibrotic scarring through runaway positive feedback loops. In general, simultaneous RNA-Seq helps to reveal the complex interplay between invading bacterial pathogens and their host mammalian cells and is immediately applicable to any bacteria/host cell interaction.


Assuntos
Chlamydia trachomatis/genética , Células Epiteliais/metabolismo , Perfilação da Expressão Gênica , Metagenoma , Transcriptoma , Linhagem Celular Tumoral , Chlamydia trachomatis/metabolismo , Colágeno/genética , Colágeno/metabolismo , Células Epiteliais/microbiologia , Retroalimentação Fisiológica , Interações Hospedeiro-Patógeno , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/genética , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Análise de Sequência de RNA , Tenascina/genética , Tenascina/metabolismo
15.
Nat Commun ; 4: 2091, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23820484

RESUMO

DNA cytosine methylation is a widely conserved epigenetic mark in eukaryotes that appears to have critical roles in the regulation of genome structure and transcription. Genome-wide methylation maps have so far only been established from the supergroups Archaeplastida and Unikont. Here we report the first whole-genome methylome from a stramenopile, the marine model diatom Phaeodactylum tricornutum. Around 6% of the genome is intermittently methylated in a mosaic pattern. We find extensive methylation in transposable elements. We also detect methylation in over 320 genes. Extensive gene methylation correlates strongly with transcriptional silencing and differential expression under specific conditions. By contrast, we find that genes with partial methylation tend to be constitutively expressed. These patterns contrast with those found previously in other eukaryotes. By going beyond plants, animals and fungi, this stramenopile methylome adds significantly to our understanding of the evolution of DNA methylation in eukaryotes.


Assuntos
Metilação de DNA/genética , Diatomáceas/genética , Genoma/genética , Cromossomos/genética , Elementos de DNA Transponíveis/genética , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , Loci Gênicos/genética , Sequências Repetitivas de Ácido Nucleico/genética
16.
Genome Announc ; 1(2): e0013412, 2013 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-23516226

RESUMO

First identified in 1982, Escherichia coli O157:H7 is the dominant enterohemorrhagic serotype underlying food-borne human infections in North America. Here, we report the genomes of twenty-six strains derived from patients and the bovine reservoir. These resources enable detailed whole-genome comparisons and permit investigations of genotypic and phenotypic plasticity.

17.
J Bacteriol ; 194(19): 5450, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22965080

RESUMO

Mycobacterium massiliense (Mycobacterium abscessus group) is an emerging pathogen causing pulmonary disease and skin and soft tissue infections. We report the genome sequence of the type strain CCUG 48898.


Assuntos
Infecções por Mycobacterium/microbiologia , Mycobacterium/classificação , Mycobacterium/genética , Genoma Bacteriano , Humanos , Dados de Sequência Molecular , Filogenia , Polimorfismo de Nucleotídeo Único
18.
J Bacteriol ; 194(11): 3026-7, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22582382

RESUMO

We report the draft genome sequences of the collection referred to as the Escherichia coli DECA collection, which was assembled to contain representative isolates of the 15 most common diarrheagenic clones in humans (http://shigatox.net/new/). These genomes represent a valuable resource to the community of researchers who examine these enteric pathogens.


Assuntos
Diarreia/microbiologia , Infecções por Escherichia coli/microbiologia , Escherichia coli/genética , Genoma Bacteriano , Sequência de Bases , Pré-Escolar , Escherichia coli/classificação , Escherichia coli/isolamento & purificação , Feminino , Humanos , Lactente , Masculino , Dados de Sequência Molecular
19.
Am J Physiol Cell Physiol ; 302(1): C141-53, 2012 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-21865582

RESUMO

Neurotrophin-dependent activation of the tyrosine kinase receptor trkB.FL modulates neuromuscular synapse maintenance and function; however, it is unclear what role the alternative splice variant, truncated trkB (trkB.T1), may have in the peripheral neuromuscular axis. We examined this question in trkB.T1 null mice and demonstrate that in vivo neuromuscular performance and nerve-evoked muscle tension are significantly increased. In vitro assays indicated that the gain-in-function in trkB.T1(-/-) animals resulted specifically from an increased muscle contractility, and increased electrically evoked calcium release. In the trkB.T1 null muscle, we identified an increase in Akt activation in resting muscle as well as a significant increase in trkB.FL and Akt activation in response to contractile activity. On the basis of these findings, we conclude that the trkB signaling pathway might represent a novel target for intervention across diseases characterized by deficits in neuromuscular function.


Assuntos
Contração Muscular/genética , Junção Neuromuscular/genética , Receptor trkB/deficiência , Receptor trkB/genética , Animais , Cálcio/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Atividade Motora/genética , Atividade Motora/fisiologia , Contração Muscular/fisiologia , Junção Neuromuscular/fisiologia , Receptor trkB/fisiologia
20.
PLoS Pathog ; 4(8): e1000133, 2008 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-18725925

RESUMO

To determine the spatial and temporal dynamics of influenza A virus during a single epidemic, we examined whole-genome sequences of 284 A/H1N1 and 69 A/H3N2 viruses collected across the continental United States during the 2006-2007 influenza season, representing the largest study of its kind undertaken to date. A phylogenetic analysis revealed that multiple clades of both A/H1N1 and A/H3N2 entered and co-circulated in the United States during this season, even in localities that are distant from major metropolitan areas, and with no clear pattern of spatial spread. In addition, co-circulating clades of the same subtype exchanged genome segments through reassortment, producing both a minor clade of A/H3N2 viruses that appears to have re-acquired sensitivity to the adamantane class of antiviral drugs, as well as a likely antigenically distinct A/H1N1 clade that became globally dominant following this season. Overall, the co-circulation of multiple viral clades during the 2006-2007 epidemic season revealed patterns of spatial spread that are far more complex than observed previously, and suggests a major role for both migration and reassortment in shaping the epidemiological dynamics of human influenza A virus.


Assuntos
Genoma Viral , Vírus da Influenza A Subtipo H1N1/genética , Vírus da Influenza A Subtipo H3N2/genética , Influenza Humana/epidemiologia , Influenza Humana/genética , Filogenia , História do Século XXI , Humanos , Epidemiologia Molecular , Estados Unidos/epidemiologia
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