title: Detection of astrovirus in premature infants with necrotizing enterocolitis.
abstract: BACKGROUND
  Necrotizing enterocolitis (NEC) is a major cause of mortality and morbidity in very low birth weight infants (<1500 g birth weight). Although the etiology remains unknown, infectious agents could play a key role. The aim of this analysis was to examine the role of human astrovirus (HAstV) in infants with NEC.
  
  
  METHODS
  All patients admitted during a 5-year period at a tertiary neonatal intensive care unit with NEC (Bell stage I-III) who had examination of stool specimens for bacterial and for viral infections were included. Clinical data were reviewed and compared between infants with NEC and astrovirus detection (NEC + HAstV) and infants with NEC without astrovirus detection (NEC - HAstV) in stool specimens.
  
  
  RESULTS
  Forty infants with NEC were identified between 2002 and 2006 and 8 patients were excluded from statistical evaluation because of incomplete viral examinations. HAstV was detected in stool specimens of 6 (19%) of the remaining 32 patients with NEC. Double infection with rotavirus was identified in 1 patient. No other viruses were detected. Significant differences in patients with NEC - HAstV and NEC + HAstV were only shown for age at onset of illness (P < 0.001) but not for severity of illness, need for surgical intervention, or mortality.
  
  
  CONCLUSIONS
  This study demonstrates that HAstV may be associated with the development of NEC in a subgroup of patients and provides further evidence for the important role of gastrointestinal viral infections in this most common gastrointestinal emergency in premature infants. HAstV should be included in microbiological examination of stool specimens in patients with NEC.
authors.affiliation: Department of Neonatology, Children's Hospital, University of Bonn, Bonn, Germany.
authors.forename: Soyhan
authors.initials: S
authors.lastname: Bagci
authors.forename: Anna M
authors.initials: AM
authors.lastname: Eis-Hübinger
authors.forename: Axel R
authors.initials: AR
authors.lastname: Franz
authors.forename: Gabriele
authors.initials: G
authors.lastname: Bierbaum
authors.forename: Axel
authors.initials: A
authors.lastname: Heep
authors.forename: Oliver
authors.initials: O
authors.lastname: Schildgen
authors.forename: Peter
authors.initials: P
authors.lastname: Bartmann
authors.forename: Bernd
authors.initials: B
authors.lastname: Kupfer
authors.forename: Andreas
authors.initials: A
authors.lastname: Mueller
mesh_terms: D000367:Age Factors; D019350:Astroviridae Infections / Q000821:virology*; D020345:Enterocolitis, Necrotizing / Q000821:virology*; D005243:Feces / Q000821:virology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D001257:Mamastrovirus / Q000302:isolation & purification*; D012401:Rotavirus / Q000302:isolation & purification; D012400:Rotavirus Infections / Q000821:virology