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[Value of rapid diagnostic methods in rotavirus infection in the neonatal period]
J B Gouyon1, E Kohli, A M Petion
1Service de Pédiatrie 2, Centre Hospitalier Régional Universitaire, Dijon.
Insights
During a rotavirus outbreak in newborns, rotavirus was detected in 12 infants. Diagnostic tests showed varied accuracy, with ELISA monoclonal tests offering the highest predictive values for rotavirus detection.
Area of Science:
- Pediatrics
- Virology
- Clinical Diagnostics
Background:
- Neonatal units are vulnerable to infectious outbreaks.
- Rotavirus is a common cause of gastroenteritis in infants.
Purpose of the Study:
- To evaluate diagnostic methods for rotavirus during a neonatal unit outbreak.
- To assess rotavirus shedding duration in infected newborns.
Main Methods:
- Collection of 148 fecal specimens from 40 newborn infants.
- Detection of rotavirus using immunoelectron microscopy (IEM) as the reference standard.
- Comparison of IEM with two ELISA and three Latex agglutination methods.
Main Results:
- Rotavirus was identified in 12 infants, with persistent excretion up to 6 days post-diarrhea resolution.
- ELISA monoclonal test demonstrated high positive (100%) and negative (95.5%) predictive values.
- Latex methods showed significant rates of equivocal results (13.8%-16.9%).
Conclusions:
- ELISA monoclonal assays are highly accurate for rotavirus detection in neonatal settings.
- Rotavirus can be shed by neonates for several days after clinical recovery.
- Careful selection of diagnostic tools is crucial during infectious outbreaks in neonatal intensive care units.
Abstract:
One hundred and forty eight faecal specimens were collected from 40 newborn infants during an outbreak of rotavirus infections in a neonatal unit. Rotavirus was sought every 3 days by immunoelectron microscopy (IEM) and was found in 12 newborn babies. Rotavirus excretion persisted for up to 6 days after healing of the diarrhoea. No significant difference was found between infected (n = 12) and uninfected (n = 28) infants with regard to gestational age (35.2 +/- 3.7 vs 36.9 +/- 2.6 weeks), birth weight (2,064 +/- 693 vs 2,197 +/- 529 g), and postnatal ages at the time of the outbreak. The 148 stool specimens were analysed by IEM considered the reference technique and compared with two ELISA methods, and three Latex methods. Rotavirus was identified by IEM in 20 stools. Equivocal results were observed with Slidex Rotakit Polyclonal (16.9%), Slidex Rotakit Monoclonal (2.7%) and Rotalex (13.8%). The positive and negative predictive values were respectively 87.5% and 96.9% for the Slidex Rotakit Monoclonal test, 86.7% and 94.7% for the Rotazyme II test, 100% and 95.5% for the ELISA monoclonal test.