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High prevalence of cytomegalovirus infection in surgical intestinal specimens from infants with necrotizing enterocolitis and spontaneous intestinal perforation: A retrospective observational study
Karolinska Institute, Department of Medicine, Center for Molecular Medicine, Exp Cardiovascular Research Unit and Department of Neurology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology.
Paul Sabatier University, Children's Hospital, Unit of Neonatology.
Karolinska Institute, Karolinska University Hospital, Departments of Clinical Pathology and Cytology.
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2017 (English)In: Journal of Clinical Virology, ISSN 1386-6532, E-ISSN 1873-5967, Vol. 93, p. 57-64Article in journal (Refereed) Published
Abstract [en]

Background: Necrotizing enterocolitis (NEC) is a severe, often fatal gastrointestinal emergency that predominantly affects preterm infants, and there is evidence that neonatal cytomegalovirus (CMV) infection may in some cases contribute to its pathogenesis.

Objectives: This study aimed to evaluate the prevalence of CMV in infants with NEC.

Study design: Seventy intestinal specimens from 61 infants with NEC, spontaneous intestinal perforation (SIP), or related surgical complications were collected at Karolinska University Hospital and Uppsala University Hospital, Sweden. Ten specimens from autopsied infants without bowel disease served as controls. Samples were analyzed for CMV immediate-early antigen (IEA), CMV late antigen (LA), 5-lipoxigenase (5LO) and CMV-DNA by immunohistochemistry (IHC) and in situ hybridization (ISH), respectively. In 10 index samples, CMV DNA was analyzed with Taqman PCR after laser capture microdissection (LCM) of cells positive for CMV IEA by IHC.

Results: CMV IEA was detected by IHC in 57 (81%) and CMV LA in 45 (64%) of 70 intestinal specimens from index cases; 2 (20%) of 10 control specimens were positive for both antigens. 5LO was detected in intestinal tissue section obtained from all examined index and controls. CMV DNA was detected in 4 of 10 samples (40%) after LCM. By ISH, all 13 IHC-IEA-positive samples were positive for CMV DNA; however, 3 of 5 IHC-IEAnegative samples (60%) were also positive.

Conclusions: CMV-specific antigens and CMV DNA were highly prevalent in intestinal specimens from infants with NEC, SIP, and related surgical complications. Our findings provide further evidence that neonatal CMV infection contributes to the pathogenesis of these diseases and may affect patient outcome.

Place, publisher, year, edition, pages
2017. Vol. 93, p. 57-64
Keywords [en]
CMV, Cytomegalovirus, ELBW, Extremely low birth weight, NEC, Necrotizing enterocolitis, Spontaneous intestinal perforation, VLBW, Very low birth weight
National Category
Microbiology in the medical area
Identifiers
URN: urn:nbn:se:uu:diva-335752DOI: 10.1016/j.jcv.2017.05.022ISI: 000409425500012PubMedID: 28633098OAI: oai:DiVA.org:uu-335752DiVA, id: diva2:1163915
Funder
Swedish Research Council, K2014-99X-22627-014; 10350; K2014-99X-22627-01-4; K2013-57X-12615-16-5Torsten Söderbergs stiftelse, MF14/10Ragnar Söderbergs stiftelse, MF14/10Swedish Society for Medical Research (SSMF)Magnus Bergvall FoundationThe Swedish Medical AssociationAvailable from: 2017-12-08 Created: 2017-12-08 Last updated: 2018-01-13Bibliographically approved

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