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

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

Ashok Srinivasan  1 , Corie Klepper, Anusha Sunkara, Guolian Kang, Jeanne Carr, Zhengming Gu, Wing Leung, Randall T Hayden
Affiliations

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

Ashok Srinivasan et al. Pediatr Infect Dis J. 2015 Jun.

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.

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Conflict of interest statement

Conflict of interest disclosure: The authors declare no competing financial interests.

Figures

Figure 1
Figure 1
Number of hematopoietic stem cell transplant (HSCT) patients with or without diarrhea, with or without adenovirus (adeno), sapovirus (sapo), norovirus (noro), astrovirus (astro), C. difficile (C. diff), rotavirus (rota), and vancomycin-resistant enterococcus (VRE) detected in stool.
See this image and copyright information in PMC

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