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

Pediatr Infect Dis J. 2015 Jun;34(6):562-5. doi: 10.1097/INF.0000000000000678.

Abstract

Background: Adenoviremia adversely affects prognosis in the post-hematopoietic stem cell transplant setting.

Methods: 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.

Results: 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.

Conclusions: Quantitative detection of adenovirus in stool may have implications for preemptive therapy. Testing for other enteric viruses may have implications for infection control.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoviridae / isolation & purification*
  • Adenoviridae Infections / virology*
  • Adolescent
  • Blood / virology*
  • Child
  • Child, Preschool
  • Feces / virology*
  • Female
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Infant
  • Male
  • Mamastrovirus / isolation & purification
  • Norovirus / isolation & purification
  • Retrospective Studies
  • Sapovirus / isolation & purification
  • Viral Load*
  • Viremia / virology*
  • Young Adult