Limited diagnostic value of a multiplexed gastrointestinal pathogen panel for the detection of adenovirus infection in an oncology patient population

•Adenovirus type C/2 was the most common type recovered in stool samples of an oncology patient population followed by Adenovirus type F40/41.•Adenovirus type F/40/41 was recovered with high frequency in plasma samples of an oncology patient population.•Multiplexed GI panel should be more inclusive of a wider variety of adenovirus types for the diagnosis adenoviral infection in cancer patients.

BackgroundDiagnosis of Adenovirus infections in transplant patients may be accomplished using either plasma or stool samples. IVD-cleared multiplexed gastrointestinal (GI) PCR panels offer an option for rapid testing of stool samples but most only target Adenovirus (HAdV) types F40/41.ObjectivesGiven the potential significance of a positive adenovirus test in an immunocompromised patient, we sought to determine the frequency of type 40/41 in our patient population and the utility of a readily available multiplexed, FDA-cleared GI Panel for the detection of adenovirus infections.Study designA total of 215 specimens from immunocompromised patients mostly with hematologic malignancy or transplant recipients were evaluated including 107 plasma samples, 85 stool samples and 23 respiratory samples. Genotyping was performed successfully on 122 specimens.ResultsThe most common type detected in all samples including stools was Adenovirus C/2. In a subset of patients with multiple specimen types tested, similar types were detected in all samples.ConclusionsAlthough Adenovirus F40/41 is the most common enteric type, Adenovirus C/2 was the most common type identified in stools and subsequently plasma samples of our patient population. Implementation of assays that have wide reactivity for most adenovirus types is essential for optimal diagnostic yield.