Cara A Minney-Smith1, Avram Levy2, Meredith Hodge2, Peter Jacoby3, Simon H Williams4, Dale Carcione5, Susie Roczo-Farkas6, Carl D Kirkwood7, David W Smith2. 1. PathWest Laboratory Medicine WA, Nedlands, Western Australia, Australia. Electronic address: cara.minney@health.wa.gov.au. 2. PathWest Laboratory Medicine WA, Nedlands, Western Australia, Australia; School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, Australia. 3. Telethon Institute for Child Health Research, Subiaco, Western Australia, Australia. 4. PathWest Laboratory Medicine WA, Nedlands, Western Australia, Australia. 5. Communicable Disease Control Directorate, Perth, Western Australia, Australia. 6. Enteric Virus group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia. 7. Enteric Virus group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia; Department of Microbiology, La Trobe University, Bundoora, Victoria, Australia.
Abstract
BACKGROUND: Intussusception, a condition where one segment of intestine invaginates into another, occurs predominantly in infants and young children. A number of potential causes have been identified including infectious agents and rotavirus vaccination. Following the introduction of rotavirus vaccination of infants in Western Australia, a laboratory surveillance programme testing notified intussusception cases for infectious agents was commenced. This led to a PCR-based study of the association between gastrointestinal viruses and intussusception. OBJECTIVES: Conduct viral testing on stool samples from intussusception patients to determine viruses that may have an association with intussusception. STUDY DESIGN: A retrospective case-control study was conducted using stool samples collected from children with intussusception (n=74) and matched controls (n=289) between 2008 and 2011. Samples were tested for rotavirus, norovirus, adenovirus, enterovirus, rhinovirus, astrovirus, parechovirus and bocavirus. Adenovirus, enterovirus and rhinovirus species were determined by DNA sequencing. RESULTS: Human adenovirus C was detected in significantly more cases than controls with 31/74 (41.9%) cases testing positive compared to 39/289 (13.49%) controls (OR=4.38, p<0.001). A significant difference was seen in Enterovirus B detections with 11/74 (14.9%) cases testing positive compared to 21/289 (7.3%) controls (OR=2.24, p=0.04). Rotavirus was detected in 7/74 (9.46%) cases and 11/289 (3.81%) controls, which was also a significant difference (OR=2.88, p=0.045). CONCLUSIONS: Our results show that intussusception is associated with non-enteric adenovirus infections, and Enterovirus B infections. While a statistical association was seen with rotavirus and intussusception, we were not able to determine if this was related to vaccine strain or wild type rotavirus.
BACKGROUND: Intussusception, a condition where one segment of intestine invaginates into another, occurs predominantly in infants and young children. A number of potential causes have been identified including infectious agents and rotavirus vaccination. Following the introduction of rotavirus vaccination of infants in Western Australia, a laboratory surveillance programme testing notified intussusception cases for infectious agents was commenced. This led to a PCR-based study of the association between gastrointestinal viruses and intussusception. OBJECTIVES: Conduct viral testing on stool samples from intussusception patients to determine viruses that may have an association with intussusception. STUDY DESIGN: A retrospective case-control study was conducted using stool samples collected from children with intussusception (n=74) and matched controls (n=289) between 2008 and 2011. Samples were tested for rotavirus, norovirus, adenovirus, enterovirus, rhinovirus, astrovirus, parechovirus and bocavirus. Adenovirus, enterovirus and rhinovirus species were determined by DNA sequencing. RESULTS:Human adenovirus C was detected in significantly more cases than controls with 31/74 (41.9%) cases testing positive compared to 39/289 (13.49%) controls (OR=4.38, p<0.001). A significant difference was seen in Enterovirus B detections with 11/74 (14.9%) cases testing positive compared to 21/289 (7.3%) controls (OR=2.24, p=0.04). Rotavirus was detected in 7/74 (9.46%) cases and 11/289 (3.81%) controls, which was also a significant difference (OR=2.88, p=0.045). CONCLUSIONS: Our results show that intussusception is associated with non-enteric adenovirus infections, and Enterovirus B infections. While a statistical association was seen with rotavirus and intussusception, we were not able to determine if this was related to vaccine strain or wild type rotavirus.
Authors: Jonathan D Windster; Werner J D Ouwendijk; Cornelius E J Sloots; Georges M G M Verjans; Robert M Verdijk Journal: J Infect Dis Date: 2020-06-29 Impact factor: 5.226