Abstract
BackgroundPrevious studies reported detection of influenza RNA in stools of patients with seasonal influenza infection. While this detection may have a clinical significance, other factors may influence the stool positivity for influenza viruses.ObjectivesThe objective of this study was to investigate demographical, clinical, and microbiological factors which could favor the presence of influenza viral RNA in the stools of patients with laboratory‐confirmed influenza infection.MethodsAcute respiratory infection (ARI) patients were enrolled by general practitioners (GP) during two winter seasons (2014‐2016). Nasopharyngeal swabs, stool specimens, and clinical data were collected. Samples were tested for 12 respiratory pathogen groups (nasopharyngeal and stool specimens) and for 12 enteric pathogens (stool specimens).ResultsAmong the 331 patients with ARI enrolled by GP, 114 (34.4%) presented influenza infection. Influenza RNA was detected in stool samples of 21% (24/114) of the 114 stool specimens analyzed. Hospitalization (adjusted odds ratio (aOR) = 7.8 (95% confidence interval (CI)) [1.7‐33.7], P = .02), age between 45 and 64 years (aOR = 4.8 [1.7‐14.5], P = .01), consumption of raw shellfish and/or mollusks (aOR = 16.7 [3.6‐90.9], P = .00), and use of antibiotics (aOR = 6.4 [2.1‐19.8], P = .006) or antiviral treatment (aOR = 7.4 [1.9‐29], P = .01) were significantly associated with an increased odds of the detection of influenza RNA in stools. Among the 24 stool samples subjected to viral isolation, no one showed virus growth.ConclusionsThese findings will be useful to studies investigating the dissemination route of influenza viruses to gastrointestinal tract.
Highlights
Seasonal and pandemic influenza virus enters and replicates in cells of the upper respiratory tract where the virus recognizes sialic acid molecules linked to the Gal of glycoprotein on the surface of host epithelial cells.[1]
In this prospective study, we investigated for the first time microbiological, demographical, and clinical factors which could influence the presence of influenza viral RNA in stools of patients with laboratory-confirmed influenza infection
This study reported for the first time the detection rate of seasonal influenza viruses in stools of laboratory-confirmed influenza patients of all ages, in general medicine, in France
Summary
Previous studies reported detection of influenza RNA in stools of patients with seasonal influenza infection. While this detection may have a clinical significance, other factors may influence the stool positivity for influenza viruses. Objectives: The objective of this study was to investigate demographical, clinical, and microbiological factors which could favor the presence of influenza viral RNA in the stools of patients with laboratory-confirmed influenza infection. Methods: Acute respiratory infection (ARI) patients were enrolled by general practitioners (GP) during two winter seasons (2014-2016). Influenza RNA was detected in stool samples of 21% (24/114) of the 114 stool specimens analyzed. KEYWORDS acute respiratory infection, enteric pathogens, gastrointestinal symptoms, general practitioner, influenza virus, stool samples.
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