Impact of Adenoviral Stool Load on Adenoviremia in Pediatric Hematopoietic Stem Cell Transplant Recipients. Issue 6 (June 2015)

• Record Type: Journal Article
• Authors: Srinivasan, Ashok; Klepper, Corie; Sunkara, Anusha; Kang, Guolian; Carr, Jeanne; Gu, Zhengming; Leung, Wing; Hayden, Randall T.
• Is Part Of: Pediatric infectious disease journal. Volume 34:Issue 6(2015)
• Publication Date: 2015-06
• Subjects: Communicable diseases in children -- Periodicals; Infection in children -- Periodicals; 618.929
• DOI: 10.1097/INF.0000000000000678
• Languages: English
• ISSNs: 0891-3668

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Background:</title> <p>Adenoviremia adversely affects prognosis in the post-hematopoietic stem cell transplant setting.</p> </sec> <sec> <title>Methods:</title> <p>We sought to determine retrospectively the cutoff load of adenovirus in the stool as a predictor of adenoviremia, in children who underwent an allogeneic hematopoietic stem cell transplant. The prevalence of sapovirus, norovirus and astrovirus in the stool was also studied.</p> </sec> <sec> <title>Results:</title> <p>The study cohort consisted of 117 patients, of which 71 (60%) had diarrhea. Adenovirus was detected in the stool in 39 of 71 (55%) patients. Age ⩽10 years (<italic>P</italic> = 0.05; odds ratio: 2.57; 95% confidence interval: 0.98–6.75) and male sex (<italic>P</italic> = 0.04; odds ratio: 2.67; 95% confidence interval: 1.02–6.99) increased risk for detection of adenovirus in stool on univariate analysis. Coinfections with enteric pathogens were infrequent. Viral load &gt;10⁶ copies/g stool predicted adenoviremia with a sensitivity and specificity of 82%. Sapovirus, norovirus and astrovirus were detected in 3, 4 and 1 patient, respectively.</p> </sec> <sec> <title>Conclusions:</title> <p>Quantitative detection of adenovirus in stool may have implications for preemptive therapy. Testing for other enteric viruses may have implications for infection control.</p> </sec> </abstract>