Influenza and other respiratory viruses 2017 11 16() doi 10.1111/irv.12523
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 stools positivity for influenza viruses.
The objective of this study was to investigate demographical, clinical and microbiological factors which could favour the presence of influenza viral RNA in the stools of patients with laboratory-confirmed influenza infection.
Acute 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).
Among 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 analysed. Hospitalization [adjusted odds ratio(aOR)=7.8 (95% confidence interval (CI) [1.7-33.7], p=0.02), age between 45-64 years (aOR = 4.8 [1.7-14.5], p=0.01), consumption of raw shellfish and/or molluscs (aOR = 16.7 [3.6-90.9], p=0.00), and use of antibiotics (aOR = 6.4 [2.1-19.8], p=0.006) or antiviral treatment (aOR = 7.4 [1.9-29], p=0.01) 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.
These findings will be useful to studies investigating the dissemination route of influenza viruses to gastrointestinal tract. This article is protected by copyright. All rights reserved.