Multi‐organism gastrointestinal polymerase chain reaction positivity among pediatric transplant vs non‐transplant populations: A single‐center experience. (8th July 2020)

• Record Type: Journal Article
• Authors: Stone, John M.; Savage, Andrew; Hudspeth, Michelle; Twombley, Katherine; Kasi, Nagraj; Quiros, Jose Antonio; Arbizu, Ricardo A.; Curry, Scott
• Is Part Of: Pediatric transplantation. Volume 24:Number 6(2020)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-07-08
• Subjects: diarrhea -- multi‐organism -- pediatric -- polymerase chain reaction -- transplant; Transplantation of organs, tissues, etc. in children -- Periodicals; 617.95408305
• DOI: 10.1111/petr.13771
• Languages: English
• ISSNs: 1397-3142

Abstract

Abstract: Background: Diarrhea is a common problem in the pediatric post‐solid organ transplant and post‐hematopoietic stem cell transplant populations. Infectious etiology incidences are poorly defined, and the possibility of multi‐organism positivity is often uninvestigated. The aim of this study is to utilize stool multiplex GIP assays to compare the PTP and NTP regarding the incidence and profiles of single‐organism and multi‐organism infectious diarrhea. Methods: A single‐center retrospective review was conducted, investigating stool multiplex GIP panel results over a more than 3‐year period, for pediatric patients. Assays test for 23 viral, bacterial, and protozoal organisms. Results: Positive assays in the PTP and NTP were 70/101 (69.3%) and 962/1716 (56.1%), respectively ( P = .009). Thirty‐two percent (32/101) of assays within the PTP were multi‐organism positive, significantly more than 14.8% (254/1716) in the NTP ( P < .00001). There was no significant difference in the incidence of single‐organism positives, 37.6% (38/101) in PTP and 41.3% (708/1716) in the NTP. The PTP demonstrated a statistically significantly higher incidence of the following organisms within multi‐agent positive GIPs ( P < .05 for each): Clostridioides difficile, Cryptosporidium, EPEC, norovirus, and sapovirus. Conclusions: The pediatric PTP demonstrates higher incidence of positive GIPs, higher rate of multi‐organism positivity, and unique infectious organism incidence profiles. These data can provide a framework for understanding organism‐specific pathogenicity factors, assessing the clinical impact of enteric co‐infection, and understanding the utility of this testing modality in this unique population.