Adenovirus infection in pediatric liver and intestinal transplant recipients: utility of DNA detection by PCR.
To evaluate the incidence of adenovirus (AdV) infection in pediatric liver and intestinal transplant recipients, the records of patients with possible AdV infection were reviewed for demographic data, symptomatology, methods of diagnosis, treatment and outcome. To evaluate the impact of polymerase chain reaction (PCR) amplification and identification of AdV DNA as a diagnostic test, the incidence and outcome of AdV before and after the introduction of PCR were compared. Adenovirus infection was identified in 4.1% of liver recipients and 20.8% of intestinal transplant recipients. The overall incidence of AdV did not increase over time, even following the introduction of PCR for virus detection. The higher incidence of AdV in the pediatric intestinal transplant recipients may be attributed to the frequent application of PCR methodology to intestinal biopsy material. Detection of AdV by PCR was associated with reduced mortality compared with detection by culture, either because of earlier detection of invasive disease or because PCR detects the presence of latent as well as active AdV.
McLaughlin
Gwenn E
GE
Depajtment of Pediatrics, University of Miami School of Medicine, Miami, FL, USA. gmclaugh@med.miami.edu
Delis
Spiros
S
Kashimawo
Lutifat
L
Cantwell
G Patricia
GP
Mittal
Naveen
N
Cirocco
Robert E
RE
Ruiz
Phillip
P
Kato
Tomoaki
T
Tzakis
Andreas G
AG
D000256:Adenoviridae / Q000235:genetics* / Q000302:isolation & purification; D000258:Adenovirus Infections, Human / Q000175:diagnosis* / Q000453:epidemiology*; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000302:isolation & purification*; D005431:Florida / Q000453:epidemiology; D006801:Humans; D007082:Ileum / Q000473:pathology; D015994:Incidence; D007223:Infant; D007422:Intestines / Q000637:transplantation*; D016031:Liver Transplantation / Q000706:statistics & numerical data*; D010043:Outcome and Process Assessment, Health Care; D016133:Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D015996:Survival Rate
D004279:DNA, Viral