Impact of adenoviral stool load on adenoviremia in pediatric hematopoietic stem cell transplant recipients

The Pediatric Infectious Disease Journal
Ashok SrinivasanR T Hayden

Abstract

Adenoviremia adversely affects prognosis in the post-hematopoietic stem cell transplant setting. 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. 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 (P = 0.05; odds ratio: 2.57; 95% confidence interval: 0.98-6.75) and male sex (P = 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 >10 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. Quantitative detection of adenovirus in stool may have implications for preemptive therapy. Testing for other enteric viruses may have implications for infection control.

References

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Citations

May 21, 2016·Journal of Medical Virology·Hugo César Pereira SantosMenira Souza
Jun 10, 2016·Journal of Clinical Microbiology·N Esther Babady
Sep 25, 2019·Journal of the Pediatric Infectious Diseases Society·Jennifer E SchusterJanet A Englund
Nov 28, 2017·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Brandon M TriplettWing Leung
May 1, 2019·Pediatric Hematology and Oncology·Salah AliTal Schechter
Oct 30, 2020·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Ana Milena BravoEduardo López-Medina

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