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Group A rotavirus genotypes in hospital-acquired gastroenteritis in Italy, 2012-14
G Ianiro1, R Delogu2, L Fiore2
1Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy.
Insights
Group A rotavirus (RVA) causes severe gastroenteritis in children. This study found distinct RVA genotypes in Italian hospitals, with G1P[8] and G9P[8] strains common and G12P[8] causing an outbreak, informing prevention strategies.
Area of Science:
- Virology
- Epidemiology
- Public Health
Background:
- Group A rotaviruses (RVA) are a primary cause of acute gastroenteritis (AGE) in children under five, leading to approximately 250,000 global deaths annually, predominantly in developing nations.
- RVA nomenclature is based on VP7 (G-type) and VP4 (P-type) gene sequences, with over 32 G-types and 47 P-types identified.
- Globally, five G/P combinations (G1P[8], G2P[4], G3P[8], G4P[8], and G9P[8]) account for the majority of human RVA infections.
Purpose of the Study:
- To update Italian surveillance network hospitals with current information on RVA AGE.
- To analyze the distribution of RVA genotypes within hospital settings and compare it to community prevalence.
Main Methods:
- Surveillance of RVA gastroenteritis in Italy between 2012 and 2014.
- Collection and genotyping of 2341 RVA-positive fecal samples from children hospitalized with AGE, using standard EuroRotaNet protocols.
Main Results:
- The majority of analyzed RVA strains belonged to the five common human genotypes.
- Hospital-acquired RVA infections accounted for 5.0% (118/2341) of cases.
- A notable difference in genotype distribution was observed between community and hospital-acquired RVA infections, with G1P[8] and G9P[8] strains frequently detected in hospitals, and G12P[8] responsible for a significant nosocomial outbreak.
Conclusions:
- Findings provide crucial data for enhancing RVA AGE prevention guidelines.
- The study aids in optimizing patient management strategies within hospital environments.
- Understanding genotype-specific epidemiology is key to controlling RVA transmission in healthcare settings.
Background:
Group A rotaviruses (RVA) are the leading cause of acute gastroenteritis (AGE) in young (aged <5 years) children, causing ∼250,000 deaths worldwide, mostly in developing countries. Differences on nucleotide sequences of VP7 (G-type) and VP4 (P-type) genes are the basis for the binary RVA nomenclature. Although at least 32 G-types and 47 P-types of rotavirus are presently known, most RVA infections in humans worldwide are related to five major G/P combinations: G1P[8], G2P[4], G3P[8], G4P[8], and G9P[8].
Aim:
To provide the hospitals of the Italian surveillance network with update information on RVA AGE.
Methods:
During RVA gastroenteritis surveillance in Italy in 2012-14, a total of 2341 RVA-positive faecal samples were collected from children hospitalized with AGE, and RVA strains were genotyped following standard EuroRotaNet protocols.
Findings:
Most strains analysed belonged to the five major human genotypes and 118 out of 2341 (5.0%) were reported to be hospital-acquired. Comparison of the distributions of the RVA genotypes circulating in the community or associated with nosocomial infections showed a different distribution of genotypes circulating inside the hospital wards, with respect to those observed in the community. G1P[8] and G9P[8] RVA strains were detected frequently, whereas G12P[8] caused a single large nosocomial outbreak.
Conclusion:
The information from this study will be useful to implement guidelines for preventing RVA AGE and optimizing the management of patients in hospital wards.
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