Prospective study on Norovirus infection among allogeneic stem cell transplant recipients: Prolonged viral excretion and viral RNA in the blood

Lemes, Lucianna Gonçalves Nepomuceno; Corrêa, Thais Santos; Fiaccadori, Fabíola Souza; Cardoso, Divina das Dôres de Paula; Arantes, Adriano de Moraes; Souza, Keili Maria Cardoso de; Souza, Menira

doi:10.1016/j.jcv.2014.08.004

Cited by 33 publications

(32 citation statements)

References 33 publications

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“…Diarrhea was the predominant symptom, as previously stated [Baldwin et al, ; Lion et al, ; Symeonidis et al, ; Mynarek et al, ]. In the present study, the cohort of patients included two that presented coinfection with norovirus [Lemes et al, ], each had gastroenteric symptoms; and another two that presented coinfection with polyomavirus, each presenting urinary dysfunctions.…”

Section: Discussionsupporting

confidence: 62%

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Adenovirus infection among allogeneic stem cell transplant recipients

Santos

Almeida

Fiaccadori

et al. 2016

Journal of Medical Virology

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The human adenovirus (HAdV) infection can cause severe disease in immunocompromised patients, such as those undergoing allogeneic hematopoietic stem cell transplant (ASCT). The main objective of this study was to prospectively monitor ASCT recipients for HAdV occurrence in a reference center in Brazil, and also to correlate viral positivity, viral load, molecular variant, clinical symptoms, and patients' prognosis. From October/2012 to October/2014, blood and feces of 21 ASCT recipients were screened for HAdV by Nested-PCR. Viral loads were determined by real-time PCR. In total, 57% of the patients had at least one positive sample (serum or feces) for HAdV. Patients presented significantly higher viral load in feces when compared to serum. Positive samples were characterized as HAdVs of species HAdV-C, -D, and -F. The main clinical symptom presented by infected patients was diarrhea, and Graft-versus-host disease (GVHD) was the main intercurrence. An association was observed between HAdV-positivity and diarrhea and also between HAdV-positivity and GVHD. Results from this study may contribute to a better understanding of the HAdV infection pattern in patients submitted to ASCT. Data therein highlight the importance of including HAdV testing during all routine laboratory exams performed on ASCT patients. J. Med. Virol. 89:298-303, 2017. © 2016 Wiley Periodicals, Inc.

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Section: Discussionsupporting

confidence: 62%

“…Two other patients were coinfected with HAdV and polyomavirus. Two more patients were coinfected with HAdV and norovirus, as detected by TaqMan Real‐time PCR, in a previous study [Lemes et al, ].…”

Section: Resultsmentioning

confidence: 99%

Adenovirus infection among allogeneic stem cell transplant recipients

Santos

Almeida

Fiaccadori

et al. 2016

Journal of Medical Virology

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“…First, each of the FDA-cleared multiplex GI panels targets microbial nucleic acid (DNA or RNA), and, therefore, cannot distinguish between viable, replicating organisms that are responsible for disease and nonviable pathogens or remnant nucleic acid. This may be especially important in the diagnosis of GI infections, as a number of pathogens (e.g., norovirus, rotavirus, adenovirus, astrovirus, Salmonella) on these panels have been shown to be present in the stool of asymptomatic individuals or shed for long periods following the resolution of disease (21)(22)(23)(24)(25)(26). For example, a recent study used real-time PCR to demonstrate nearly constant shedding of a number of enteric viruses, including adenovirus, rotavirus, astrovirus, and enterovirus, in 2 healthy infant siblings during their first 12 months of life (22).…”

Section: What Are the Challenges Associated With Results Interpretatiomentioning

confidence: 99%

Multiplex Molecular Panels for Diagnosis of Gastrointestinal Infection: Performance, Result Interpretation, and Cost-Effectiveness

2015

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Gastrointestinal disease is a major cause of morbidity and mortality worldwide, especially among young children and immunocompromised patients. Diarrhea may result from infection with a variety of microbial pathogens, including bacteria, viruses, or parasites. Historically, the diagnosis of infectious diarrhea has been made using microscopy, antigen tests, culture, and real-time PCR. A combination of these traditional tests is often required due to the inability to distinguish between infectious etiologies based on the clinical presentation alone. Recently, several multiplex molecular assays have been developed for the detection of gastrointestinal pathogens directly from clinical stool samples. These panels allow for the detection and identification of up to 20 pathogens in as little as 1 h. This review will focus on the multiplex molecular panels that have received clearance from the FDA for the diagnosis of diarrheal disease and will highlight issues related to test performance, result interpretation, and cost-effectiveness of these new molecular diagnostic tools. Diarrheal disease remains a significant global health concern, with the World Health Organization estimating that there are ϳ1.7 billion total cases each year, resulting in Ͼ750,000 deaths among children younger than 5 years old (1). Gastrointestinal (GI) infection with bacteria (e.g., Clostridium difficile, Escherichia coli, Shigella), viruses (e.g., norovirus, rotavirus), or parasites (e.g., Cryptosporidium, Giardia) is a major cause of diarrheal illness worldwide, often resulting from contaminated food/water and poor sanitation. Rapid and accurate detection of GI pathogens is important so that appropriate therapy can be initiated and proper infection control and epidemiologic measures can be taken to help reduce or prevent the spread of disease (2, 3). Traditionally, the laboratory diagnosis of GI infections has relied on a combination of conventional techniques, including microscopy, culture, antigen detection, and individual real-time PCR assays. These methods have demonstrated good performance (4-6), but they are labor intensive, are time consuming, and require health care providers to select the appropriate tests, as a result of clinically indistinguishable illness caused by many infectious agents (7). Recently, there has been substantial interest in the development of multiplex molecular assays for the detection and identification of infectious diseases, including pathogens responsible for causing diarrhea. These syndromic panels allow health care providers to cast a broad net and achieve a timely diagnosis, which may be important in certain patient populations, such as immunocompromised hosts (ICH) and the critically ill (8). This review highlights three commercial multiplex panels (FilmArray GI panel [BioFire Diagnostics, Salt Lake City, UT], Luminex xTag GI pathogen panel [GPP] [Luminex Corporation, Toronto, Canada], and Nanosphere Verigene enteric pathogen [EP] test [Nanosphere, Inc., Northbrook, IL]) that have been cleared by the Food ...

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“…There is also limited knowledge of the pathogenesis of human NoV infection. Children, immunocompromised adults, and gnotobiotic pigs and calves used as models of human NoV infection all can develop NoV viremia (2)(3)(4)(5)(6)(7), suggesting that NoV infection may not be limited to the gut. However, no data on NoV viremia in immunocompetent adults exist.…”

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confidence: 99%