{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:18:36Z","timestamp":1790468316155,"version":"4.1.0"},"reference-count":34,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2013,6,1]],"date-time":"2013-06-01T00:00:00Z","timestamp":1370044800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Diarrhea is a frequent complication after kidney transplantation, ascribed to adverse effects of the immunosuppressive therapy in case of negative microbiological examination of the stools. The aim of this study was to improve the microbiological diagnosis by implementing molecular tests. Fifty-four severe diarrhea events that occurred in 49 adult kidney transplant recipients from September 2010 to November 2011 were investigated. One or several enteric pathogens were detected in 13 (23%) stool samples using classical microbiological methods versus 39 (72%) for the seven commercially available multiplex PCR assays used retrospectively (\n                    <jats:italic>P<\/jats:italic>\n                    = 0.006). Interestingly, molecular diagnosis identified 15 multiple infections compared to none using classical techniques. The primary pathogens detected were enteropathogenic\n                    <jats:named-content content-type=\"genus-species\">Escherichia coli<\/jats:named-content>\n                    (EPEC) (\n                    <jats:italic>n<\/jats:italic>\n                    = 15; 38%),\n                    <jats:named-content content-type=\"genus-species\">Campylobacter<\/jats:named-content>\n                    spp. (\n                    <jats:italic>n<\/jats:italic>\n                    = 15; 38%), and\n                    <jats:named-content content-type=\"genus-species\">Norovirus<\/jats:named-content>\n                    (\n                    <jats:italic>n<\/jats:italic>\n                    = 14; 36%). Specificities for\n                    <jats:named-content content-type=\"genus-species\">Campylobacter<\/jats:named-content>\n                    and\n                    <jats:named-content content-type=\"genus-species\">Norovirus<\/jats:named-content>\n                    infection diagnosis were 75 and 100%, respectively, by comparison to reference methods. Based on molecular findings, a cyclosporine-mycophenolate mofetil combination was identified as a risk factor for developing\n                    <jats:named-content content-type=\"genus-species\">Norovirus<\/jats:named-content>\n                    -induced diarrhea.\n                    <jats:named-content content-type=\"genus-species\">Norovirus<\/jats:named-content>\n                    infections were also responsible for higher weight loss than all the other causes of diarrhea. In samples from asymptomatic immunocompromised and immunocompetent patients, EPEC but not\n                    <jats:named-content content-type=\"genus-species\">Norovirus<\/jats:named-content>\n                    and\n                    <jats:named-content content-type=\"genus-species\">Campylobacter<\/jats:named-content>\n                    infections were detected at a frequency similar to that observed in symptomatic kidney transplant recipients. In conclusion, molecular tools significantly improved the detection of single and multiple enteric infections by comparison to classical techniques and could quickly become the key element in the management of severe acute diarrhea in transplant recipients.\n                  <\/jats:p>","DOI":"10.1128\/jcm.03366-12","type":"journal-article","created":{"date-parts":[[2013,4,4]],"date-time":"2013-04-04T02:34:49Z","timestamp":1365042889000},"page":"1841-1849","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":99,"title":["Microbiological Diagnosis of Severe Diarrhea in Kidney Transplant Recipients by Use of Multiplex PCR Assays"],"prefix":"10.1128","volume":"51","author":[{"given":"Jean-Fran\u00e7ois","family":"Coste","sequence":"first","affiliation":[{"name":"Clinical and Molecular Virology Unit, University Hospital and EA-4684 Cardiovir SFR-CAP sante, Faculty of Medicine, Reims, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Vuiblet","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Transplantation, University Hospital, Reims, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betoul","family":"Moustapha","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Transplantation, University Hospital, Reims, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Bouin","sequence":"additional","affiliation":[{"name":"Clinical and Molecular Virology Unit, University Hospital and EA-4684 Cardiovir SFR-CAP sante, Faculty of Medicine, Reims, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie","family":"Lavaud","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Transplantation, University Hospital, Reims, 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France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurore","family":"Wolak-Thierry","sequence":"additional","affiliation":[{"name":"Clinical Research Coordination Unit, University Hospital, Reims, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Villena","sequence":"additional","affiliation":[{"name":"Parasitology Laboratory, University Hospital and EA-3800 SFR-CAP sante, Faculty of Medicine, Reims, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathy","family":"Chemla","sequence":"additional","affiliation":[{"name":"Parasitology Laboratory, University Hospital and EA-3800 SFR-CAP sante, Faculty of Medicine, Reims, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Le Magrex","sequence":"additional","affiliation":[{"name":"Bacteriology Laboratory, University Hospital and EA-4687 ERA SFR-CAP sante, Faculty of Medicine, Reims, 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