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An investigation of the potential association between gastrointestinal viral and bacterial infection and development of intestinal acute graft versus host disease following allogeneic hematopoietic stem cell transplantation
Author(s) -
Bueno Felipe,
Albert Eliseo,
Giménez Estela,
Piñana José L.,
Pérez Ariadna,
Dolores Gómez María,
HernándezBoluda Juan C.,
GonzalezBarberá Eva M.,
Montoro Juan,
Buesa Javier,
Guerreiro Manuel,
BalaguerRoselló Aitana,
Hernani Rafael,
Sanz Jaime,
Solano Carlos,
Navarro David
Publication year - 2021
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.26892
Subject(s) - rotavirus , sapovirus , astrovirus , norovirus , hematopoietic stem cell transplantation , diarrhea , campylobacter , clostridium difficile , medicine , transplantation , hazard ratio , gastroenterology , virology , immunology , biology , virus , microbiology and biotechnology , bacteria , antibiotics , confidence interval , genetics
It is uncertain whether gastrointestinal (GI) infection caused by viral and bacterial pathogens may predispose to gastrointestinal acute Graft‐versus‐host disease (aGvHD‐GI) in allogeneic hematopoietic stem cell transplant recipients (allo‐HSCT). We investigated the potential association between detection of enteropathogenic viruses or bacteria in stools and subsequent occurrence of aGvHD‐GI in a cohort of 121 allo‐HSCT patients. Eighty‐six out of 121 patients (71%) had acute diarrhea and underwent screening for primary GI pathogens by molecular diagnostic methods. One or more GI pathogens were detected in 27 out of the 86 patients with diarrhea (31.3%). Specifically, Clostridioides difficile was found in 16 patients (18.6%), enteropathogenic viruses in 11 patients (12.7%) ( Astrovirus, n = 4; Norovirus, n = 2; Sapovirus, n = 2; Adenovirus, n = 2; and Rotavirus, n = 1), and Campylobacter spp. in two patients (2.3%). Thirty patients were diagnosed with all grade aGvHD‐GI by histopathology. Detection of primary GI pathogens was achieved in 12 out of 30 patients ( Clostridium difficile, n = 5; enteric viruses, n = 8; Campylobacter spp., n = 1) who either subsequently developed ( n = 9) or previously had ( n = 3) grade I‐IV IaGvHD ( n = 9). Neither the detection of these microorganisms (all combined), enteric viruses, nor C. difficile was significantly associated with subsequent aGvHD‐GI development in Cox models (hazard ratio [HR] = 1.11, p = .80; HR = 1.64, p = .62; HR = 0.75, p = .64, respectively). Analogous results were obtained when grade II–IV aGvHD‐GI was selected as the clinical outcome. In summary, data in the current study did not support an association between GI infection and subsequent occurrence of aGvHD‐GI in an unselected cohort of allo‐HSCT recipients.