腺病毒粪便负荷对儿科造血干细胞移植受者腺病毒血症的影响。
Impact of adenoviral stool load on adenoviremia in pediatric hematopoietic stem cell transplant recipients.
作者信息
Srinivasan Ashok, Klepper Corie, Sunkara Anusha, Kang Guolian, Carr Jeanne, Gu Zhengming, Leung Wing, Hayden Randall T
机构信息
From the *Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN; †Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN; ‡University of Toledo, Toledo, OH; §Department of Biostatistics, and ¶Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN.
出版信息
Pediatr Infect Dis J. 2015 Jun;34(6):562-5. doi: 10.1097/INF.0000000000000678.
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.
背景
腺病毒血症对造血干细胞移植后的预后产生不利影响。
方法
我们对接受异基因造血干细胞移植的儿童进行回顾性研究，以确定粪便中腺病毒的临界载量作为腺病毒血症的预测指标。同时还研究了粪便中札幌病毒、诺如病毒和星状病毒的流行情况。
结果
研究队列包括117例患者，其中71例（60%）出现腹泻。71例患者中有39例（55%）粪便中检测到腺病毒。单因素分析显示，年龄≤10岁（P = 0.05；比值比：2.57；95%置信区间：0.98 - 6.75）和男性（P = 0.04；比值比：2.67；95%置信区间：1.02 - 6.99）会增加粪便中检测到腺病毒的风险。肠道病原体合并感染较少见。粪便病毒载量>10拷贝/克可预测腺病毒血症，敏感性和特异性为82%。分别在3例、4例和1例患者中检测到札幌病毒、诺如病毒和星状病毒。
结论
粪便中腺病毒的定量检测可能对抢先治疗有意义。检测其他肠道病毒可能对感染控制有意义。
Zotero 插件