Investigation of hospital-acquired rotavirus gastroenteritis using RNA electrophoresis

Rotavirus is a common cause of diarrhoea both in the community and in the hospital. Because of this, it may be difficult to determine whether crossinfection has occurred in the hospital, an important finding as review of hygienic techniques and ward closure may be indicated. We therefore investigated the use of Polyacrylamide gel electrophoresis (PAGE) of the rotavirus RNA genome as a means of distinguishing between rotavirus strains in order to assess its role in the evaluation of apparent hospital-acquired rotavirus diarrhoea. Suspected examples of hospital-acquired rotavirus gastroenteritis were studied on an infectious diseases ward and a general infant ward. PAGE analysis demonstrated that crossinfection had not occurred on the infectious diseases ward, even though this was indicated clinically; a single source outbreak involving 11 patients was confirmed on the general infant ward, as all cases showed an identical rotavirus electropherotype. Following ward closure an endemic rotavirus electropherotype was detected, which affected 17 patients over a 3-month period. Electrophoresis of rotavirus RNA is a useful and practical technique in the analysis of hospital-acquired gastroenteritis and can indicate appropriate clinical action.