Impact of Norovirus/Sapovirus-Related Diarrhea in Renal Transplant Recipients Hospitalized for Diarrhea

Roos‐Weil, Damien; Ambert-Balay, Katia; Lanternier, Fanny; Mamzer-Bruneel, Marie-France; Nochy, Dominique; Pothier, Pierre; Avettand-Fènoël, Véronique; Anglicheau, Dany; Snanoudj, Renaud; Bererhi, Lynda; Thervet, Éric; Lecuit, Marc; Legendre, Christophe; Lortholary, Olivier; Zuber, Julien

doi:10.1097/tp.0b013e31821c9392

Cited by 132 publications

(158 citation statements)

References 28 publications

Supporting

Mentioning

145

Contrasting

Unclassified

Order By: Relevance

“…In particular, significantly higher weight loss was observed in patients infected by Norovirus than in patients with other infectious and noninfectious causes of diarrhea. This confirms the previously reported specific severity of Norovirus-induced diarrhea in transplant recipients and supports an active role of the enteric pathogen detected (20,30,31). Furthermore, among the 5 patients who had several diarrheal episodes, an identical pathogen was detected only in one patient in the multiple samples.…”

Section: Discussionsupporting

confidence: 77%

Microbiological Diagnosis of Severe Diarrhea in Kidney Transplant Recipients by Use of Multiplex PCR Assays

Coste¹,

Vuiblet

Moustapha

et al. 2013

J Clin Microbiol

View full text Add to dashboard Cite

Diarrhea is a frequent complication after kidney transplantation, ascribed to adverse effects of the immunosuppressive therapy in case of negative microbiological examination of the stools. The aim of this study was to improve the microbiological diagnosis by implementing molecular tests. Fifty-four severe diarrhea events that occurred in 49 adult kidney transplant recipients from September 2010 to November 2011 were investigated. One or several enteric pathogens were detected in 13 (23%) stool samples using classical microbiological methods versus 39 (72%) for the seven commercially available multiplex PCR assays used retrospectively (P ‫؍‬ 0.006). Interestingly, molecular diagnosis identified 15 multiple infections compared to none using classical techniques. The primary pathogens detected were enteropathogenic Escherichia coli (EPEC) (n ‫؍‬ 15; 38%), Campylobacter spp. (n ‫؍‬ 15; 38%), and Norovirus (n ‫؍‬ 14; 36%). Specificities for Campylobacter and Norovirus infection diagnosis were 75 and 100%, respectively, by comparison to reference methods. Based on molecular findings, a cyclosporine-mycophenolate mofetil combination was identified as a risk factor for developing Norovirus-induced diarrhea. Norovirus infections were also responsible for higher weight loss than all the other causes of diarrhea. In samples from asymptomatic immunocompromised and immunocompetent patients, EPEC but not Norovirus and Campylobacter infections were detected at a frequency similar to that observed in symptomatic kidney transplant recipients. In conclusion, molecular tools significantly improved the detection of single and multiple enteric infections by comparison to classical techniques and could quickly become the key element in the management of severe acute diarrhea in transplant recipients.

show abstract

Section: Discussionsupporting

confidence: 77%

Microbiological Diagnosis of Severe Diarrhea in Kidney Transplant Recipients by Use of Multiplex PCR Assays

Coste¹,

Vuiblet

Moustapha

et al. 2013

J Clin Microbiol

View full text Add to dashboard Cite

show abstract

“…During the prolonged excretion period (i.e., 25 days and 28 days after onset of illness) in some individuals in an outbreak, both synonymous and nonsynonymous nucleotide substitutions in the VP1-encoding region have been identified (174), and this is a possible mechanism for the generation of new variants of sapovirus in vivo. Similar to the case for noroviruses, sapoviruses were also detected from an immunocompromised patient who showed prolonged diarrhea (147 days) (217), although further studies with quantitative analysis are necessary.…”

Section: Shedding Levels and Patterns In Fecesmentioning

confidence: 66%

Comprehensive Review of Human Sapoviruses

et al. 2015

View full text Add to dashboard Cite

SUMMARY Sapoviruses cause acute gastroenteritis in humans and animals. They belong to the genus Sapovirus within the family Caliciviridae . They infect and cause disease in humans of all ages, in both sporadic cases and outbreaks. The clinical symptoms of sapovirus gastroenteritis are indistinguishable from those caused by noroviruses, so laboratory diagnosis is essential to identify the pathogen. Sapoviruses are highly diverse genetically and antigenically. Currently, reverse transcription-PCR (RT-PCR) assays are widely used for sapovirus detection from clinical specimens due to their high sensitivity and broad reactivity as well as the lack of sensitive assays for antigen detection or cell culture systems for the detection of infectious viruses. Sapoviruses were first discovered in 1976 by electron microscopy in diarrheic samples of humans. To date, sapoviruses have also been detected from several animals: pigs, mink, dogs, sea lions, and bats. In this review, we focus on genomic and antigenic features, molecular typing/classification, detection methods, and clinical and epidemiological profiles of human sapoviruses.

show abstract

“…In a retrospective study of 15 renal allograft recipients with diarrhea and norovirus infection, 14 infections were caused by GII strains, mostly GII.4 strains (61). The mean duration of diarrhea was 8.7 months.…”

Section: Figmentioning

confidence: 99%

Norovirus

2015

View full text Add to dashboard Cite

SUMMARY Norovirus, an RNA virus of the family Caliciviridae , is a human enteric pathogen that causes substantial morbidity across both health care and community settings. Several factors enhance the transmissibility of norovirus, including the small inoculum required to produce infection (<100 viral particles), prolonged viral shedding, and its ability to survive in the environment. In this review, we describe the basic virology and immunology of noroviruses, the clinical disease resulting from infection and its diagnosis and management, as well as host and pathogen factors that complicate vaccine development. Additionally, we discuss overall epidemiology, infection control strategies, and global reporting efforts aimed at controlling this worldwide cause of acute gastroenteritis. Prompt implementation of infection control measures remains the mainstay of norovirus outbreak management.

show abstract

Impact of Norovirus/Sapovirus-Related Diarrhea in Renal Transplant Recipients Hospitalized for Diarrhea

Abstract: Our study indicates that NoV/SaV infection causes posttransplant chronic diarrhea potentially complicated by severe kidney graft impairment.

Cited by 132 publications

References 28 publications

Microbiological Diagnosis of Severe Diarrhea in Kidney Transplant Recipients by Use of Multiplex PCR Assays

Microbiological Diagnosis of Severe Diarrhea in Kidney Transplant Recipients by Use of Multiplex PCR Assays

Comprehensive Review of Human Sapoviruses

Norovirus

Contact Info

Product

Resources

About