title: Isolation of viruses from stools in stem cell transplant recipients: a prospective surveillance study.
abstract: We prospectively examined stool specimens for enteric viruses in 75 stem cell transplant recipients (autologous 48, allogeneic 27) to determine the frequency and significance of these infections. Only six patients (8%) had a positive isolate. Five of these were allograft recipients (18%) compared to one autograft recipient (2%) (P = 0.02). Unrelated donor BMT recipients were at the highest risk for a viral isolate (OR = 10.5). Adenovirus was the commonest isolate (four patients). One patient each had an echovirus, enterovirus and small round structured virus identified. No correlation was found between the severity of gastro-intestinal symptoms and detection of a viral pathogen. There was no correlation with GVHD or CMV status. The only risk factor identified for isolation of an enterovirus was allogeneic BMT from an unrelated donor. There was a negative correlation with PBSC grafts. All the patients infected with an enteric virus had concomitant infection with other pathogens, compared to only 18% of uninfected patients (P = 0.001). The non-relapse mortality of the infected patients was 50% and only 7% in the uninfected patients (P = 0.01, OR = 12.5), although the isolated virus was the direct cause of death in one patient only. This study indicates a low rate of enteric virus isolation in recipients of PBSC grafts, both autologous and allogeneic. However, unrelated donor BMT is associated with a higher risk of enteric virus infection and an adverse outcome. Bone Marrow Transplantation (2000) 25, 277-282.
authors.affiliation: Department of Haematology, Birmingham Heartlands Hospital, Birmingham, UK.
authors.forename: S
authors.initials: S
authors.lastname: Chakrabarti
authors.forename: K E
authors.initials: KE
authors.lastname: Collingham
authors.forename: R H
authors.initials: RH
authors.lastname: Stevens
authors.forename: D
authors.initials: D
authors.lastname: Pillay
authors.forename: C D
authors.initials: CD
authors.lastname: Fegan
authors.forename: D W
authors.initials: DW
authors.lastname: Milligan
mesh_terms: D000256:Adenoviridae / Q000302:isolation & purification; D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D003586:Cytomegalovirus Infections / Q000097:blood; D004770:Enterovirus / Q000302:isolation & purification; D029822:Enterovirus B, Human / Q000302:isolation & purification; D005243:Feces / Q000821:virology*; D005260:Female; D005759:Gastroenteritis / Q000821:virology; D006086:Graft vs Host Disease / Q000821:virology; D019337:Hematologic Neoplasms / Q000150:complications / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous / Q000009:adverse effects; D014184:Transplantation, Homologous / Q000009:adverse effects; D014780:Viruses / Q000302:isolation & purification*; D014916:Whole-Body Irradiation