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O-118 High Prevalence Of Cytomegalovirus Proteins In Surgical Specimens Obtained From Infants With Necrotizing Enterocolitis, Bowel Perforation Or Bowel Stricture
  1. S Omarsdottir1,
  2. M Agnarsdottir2,
  3. A Orrego3,
  4. E Skantz1,
  5. M Vanpée4,
  6. A Rahbar1,
  7. C Söderberg-Nauclér1
  1. 1Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
  2. 2Institute of Immunology Genetics and Pathology, Uppsala University, Uppsala, Sweden
  3. 3Department of Clinical Pathology and Cytology, Karolinska University Hospital, Stockholm, Sweden
  4. 4Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden

Abstract

Background and aims Necrotizing enterocolitis (NEC) is a frequent cause of neonatal surgical emergency. The pathogenesis of the disease is incompletely understood. Postnatal cytomegalovirus (CMV) infection can present clinically as NEC and be related to bowel perforation or intestinal stricture in the neonate. The aim of this study was to evaluate the presence of CMV infection in intestinal samples obtained from infants with these conditions.

Methods Surgical specimens from infants diagnosed with NEC, bowel perforation or intestinal stricture during year 1997–2009 were collected from the pathology departments at Karolinska University Hospital and Uppsala University Hospital. The intestinal samples were retrospectively analysed for CMV Immediate Early Antigen (CMV-IEA) and CMV Late Antigen (CMV-LA) by immunohistochemistry.

Results Sixty-six intestinal specimens from 47 preterm infants and 10 full term infants were collected. The median gestational age of the infants was 27.9 weeks and their median birth weight was 1015 grams. The pathological diagnoses were NEC (n = 36), NEC and intestinal perforation (n = 12), intestinal perforation (n = 12), sequel after NEC (n = 3) and unspecific changes (n = 3). CMV-IEA and CMV-LA was detected in 85% and 61% of the intestinal tissue samples, respectively. Of these samples, 71% and 38% were classified as having a high-grade (≥ 25%) CMV infection.

Conclusions CMV proteins were detected in the vast majority of intestinal specimens obtained from infants diagnosed with NEC, bowel perforation or intestinal stricture. These findings support a possible role of CMV in the pathophysiology of NEC and other surgical conditions in the neonate.

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