Adenoviruses have recently been recognized as etiologic agents of enteric disease in hospitalized infants and young children. Patients who have undergone
surgical procedures related to the complications of neonatal
necrotizing enterocolitis constitute a population of infants who are often hospitalized for extended periods of time. We studied the incidence of enteric
adenovirus infections in infants with
necrotizing enterocolitis who had undergone intestinal surgery resulting in
colostomies or
ileostomies. These studies revealed that 31.7% of the hospital admissions in such patients were complicated by symptomatic
infection with enteric adenoviruses. The rate of
adenovirus infection in this population was significantly higher than the rate of such
infections encountered in infants undergoing
ostomy procedures for other conditions and in age-matched hospitalized infants without prior gastrointestinal surgery. The
infections with enteric adenovirus were generally accompanied by an increase in intestinal output which was temporally associated with the excretion of adenovirus in the intestinal fluid. In addition
infections with enteric adenoviruses in the infants with
necrotizing enterocolitis and
ostomies were associated with a marked increase in length of hospitalization as compared to uninfected infants with similar underlying gastrointestinal pathology. Epidemiologic analysis revealed that many of the cases of enteric
adenovirus infection in the study population occurred during seasons in which enteric
adenovirus infections were prevalent in the hospital population. These studies demonstrate that enteric
adenovirus infections are major causes of morbidity in hospitalized patients who have of morbidity in hospitalized patients who have undergone
ileostomy or
colostomy procedures for
necrotizing enterocolitis and that the prevention of enteric
adenovirus infections might result in a significant improvement in the hospital care of infants with these conditions.