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Assays for the Specific Growth Rate and Cell-binding Ability of Rotavirus
Published on: January 28, 2019
Rotavirus disease course among immunocompromised patients; 5-year observations from a tertiary care medical centre
P Bruijning-Verhagen1, M D Nipshagen2, H de Graaf3
1Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Huispostnummer STR.6.131, Postbus 85500, 3508 GA Utrecht, The Netherlands.
Insights
Rotavirus gastroenteritis (RVGE) is severe in immunocompromised patients, often requiring disease management changes. Routine rotavirus testing is recommended for these individuals with suspected gastroenteritis.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Immunology
Background:
- Rotavirus (RV) is a common cause of gastroenteritis, posing significant risks to immunocompromised individuals.
- Disease severity and outcomes of rotavirus gastroenteritis (RVGE) in immunocompromised populations are not well-characterized.
- Rotavirus testing is not standard practice for immunocompromised patients beyond infancy.
Purpose of the Study:
- To assess the severity and characteristics of rotavirus disease in immunocompromised hospitalized patients.
- To determine if immunocompromised status predisposes individuals to RVGE.
- To evaluate rotavirus testing practices in a hospital setting.
Main Methods:
- Retrospective analysis of 5-year laboratory records for rotavirus infections.
- Chart review to evaluate disease course in immunocompromised patients.
- Matched case-control analysis comparing immunocompromised and non-immunocompromised patients.
- Assessment of rotavirus testing rates over a 3-year period.
Main Results:
- Immunocompromised patients constituted a significant proportion of adult (57%) and pediatric (12%) RVGE cases.
- A complicated disease course occurred in 81% of immunocompromised patients, with 33% requiring management adaptations.
- Immunocompromised adults were 7.4 times more likely to develop RVGE than controls.
- Rotavirus testing was infrequent (12%) in adult patients with suspected infectious gastroenteritis.
Conclusions:
- Adult immunocompromised patients represent the majority of RVGE cases in a hospital setting.
- RVGE in immunocompromised individuals is linked to substantial morbidity and impacts underlying disease management.
- Routine rotavirus testing should be considered for immunocompromised patients presenting with suspected infectious gastroenteritis.
Abstract:
Rotavirus (RV) is highly endemic inside and outside hospital-settings. Immunocompromised children and adults are at risk of complicated rotavirus gastroenteritis (RVGE), but general rotavirus disease severity in this group remains poorly described and rotavirus testing is not routinely performed beyond infancy. We assessed rotavirus disease among immunocompromised hospitalized patients.
Methods:
Rotavirus infections at a Dutch tertiary-care centre were identified from 5-year laboratory records. Rotavirus disease course was evaluated by chart review for each immunocompromised patient. In a matched case-control analysis, we assessed whether being immunocompromised predisposed to RVGE. Rotavirus testing practice for suspected infectious gastroenteritis in our hospital was determined over a 3-years period.
Results:
Out of 4584 RV tests performed, 294 were positive among hospitalized patients. Immunocompromised patients represented 57% (N = 20) of adult, and 12% (N = 32) of paediatric RVGE. A complicated disease course occurred in 81% of them and 33% required adaptations in underlying disease management. Immunocompromised adults were 7.4 times more likely todevelop RVGE compared to non-immunocompromised matched hospital-controls. Rotavirus testing in adult patients with suspected infectious gastroenteritis was uncommon (12% tested).
Conclusions:
In our hospital, most adults with RVGE are immunocompromised compared to a much smaller proportion in children. RVGE in immunocompromised patients is associated with significant morbidity. Routine rotavirus testing beyond infancy should be recommended for immunocompromised patients with suspected infectious gastroenteritis.
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