Infectious Etiologies of Intussusception Among Children <2 Years Old in 4 Asian Countries
作者：Eleanor Burnett, Furqan Kabir, Nguyễn Vân Trang, Ajit Rayamajhi, Syed M Satter, Jie Liu, Mohammad Tahir Yousafzai, Đặng Đức Anh, Anupama Thapa Basnet, Meerjady Sabrina Flora, Eric R. Houpt, Saqib Hamid Qazi, Tran Minh Canh, Anjana Karki Rayamajhi, Bablu Kumar Saha, Nasir Saleem Saddal, Sahrish Muneer, Phạm Hoàng Sơn Hưng, Towhidul Islam, Asad Ali, Jacqueline E. Tate, Catherine Yen, Umesh D. Parashar · 发表于：The Journal of Infectious Diseases · 年份：2019 · DOI：10.1093/infdis/jiz621 · 被引用次数：28 · 研究领域：Gastrointestinal disorders and treatments、Viral gastroenteritis research and epidemiology、Testicular diseases and treatments
BACKGROUND: The etiology of intussusception, the leading cause of bowel obstruction in infants, is unknown in most cases. Adenovirus has been associated with intussusception and slightly increased risk of intussusception with rotavirus vaccination has been found. We conducted a case-control study among children <2 years old in Bangladesh, Nepal, Pakistan, and Vietnam to evaluate infectious etiologies of intussusception before rotavirus vaccine introduction. METHODS: From 2015 to 2017, we enrolled 1-to-1 matched intussusception cases and hospital controls; 249 pairs were included. Stool specimens were tested for 37 infectious agents using TaqMan Array technology. We used conditional logistic regression to estimate odds ratio (OR) and 95% confidence interval (CI) of each pathogen associated with intussusception in a pooled analysis and quantitative subanalyses. RESULTS: Adenovirus (OR, 2.67; 95% CI, 1.75-4.36) and human herpes virus 6 (OR, 3.50; 95% CI, 1.15-10.63) were detected more frequently in cases than controls. Adenovirus C detection <20 quantification cycles was associated with intussusception (OR, 18.59; 95% CI, 2.45-140.89). Wild-type rotavirus was not associated with intussusception (OR, 1.07; 95% CI, 0.52-2.22). CONCLUSIONS: In this comprehensive evaluation, adenovirus and HHV-6 were associated with intussusception. Future research is needed to better understand mechanisms leading to intussusception, particularly after rotavirus vaccination.