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Updated: Oct 7, 2025
Detection and Genogrouping of Noroviruses from Children's Stools By Taqman One-step RT-PCR
Published on: July 22, 2012
Multiplex PCR Pathogen Detection in Acute Gastroenteritis Among Hospitalized US Children Compared With Healthy
Christopher J Harrison1, Ferdaus Hassan1, Brian Lee1
1Children's Mercy Kansas City and University of Missouri Kansas City-School of Medicine, Missouri, USA.
Insights
Despite rotavirus (RV) vaccine use, acute gastroenteritis (AGE) remains common in US children. Norovirus was the most frequent pathogen detected, but RV also remained significant in hospitalized children.
Area of Science:
- Infectious Diseases
- Pediatrics
- Vaccinology
Background:
- Acute gastroenteritis (AGE) continues to be a common illness in hospitalized children in the United States.
- The impact of rotavirus (RV) vaccination on the overall pathogen distribution of AGE in pediatric populations requires ongoing evaluation.
Purpose of the Study:
- To assess the distribution of AGE pathogens in hospitalized US children during the post-rotavirus vaccine era.
- To identify common and emerging infectious agents responsible for pediatric AGE.
Main Methods:
- Prospective, active, population-based surveillance was conducted by the New Vaccine Surveillance Network (NVSN) from December 2011 to June 2016.
- Stool samples from hospitalized children with AGE and age-matched healthy controls were tested using Luminex x-TAG Gastrointestinal Pathogen Panels (GPP).
- Clinical signs, symptoms, and modified Vesikari scores were analyzed.
Main Results:
- Overall organism detection was significantly higher in pediatric AGE inpatients (51.2%) compared to healthy controls (20.6%).
- Norovirus (NoV) was the most frequently detected virus (18.5% in AGE vs. 6.6% in controls), followed by rotavirus (RV) (16.1% vs. 9.8%).
- Bacterial pathogens including *Shigella*, *Salmonella*, and *Clostridioides difficile* were also detected more frequently in AGE patients. Co-detection of multiple pathogens was more common in AGE cases.
Conclusions:
- Norovirus is the leading cause of AGE in hospitalized children, but rotavirus remains a significant pathogen even after widespread vaccination.
- Active surveillance is crucial for monitoring vaccine effectiveness, identifying emergent pathogens, and establishing baselines for new vaccine development.
- Understanding pathogen distribution is key to managing pediatric gastroenteritis effectively.
Background:
Despite vaccine-induced decreases in US rotavirus (RV) disease, acute gastroenteritis (AGE) remains relatively common. We evaluated AGE pathogen distribution in hospitalized US children in the post-RV vaccine era.
Methods:
From December 2011 to June 2016, the New Vaccine Surveillance Network (NVSN) conducted prospective, active, population-based surveillance in hospitalized children with AGE. We tested stools from 2 NVSN sites (Kansas City, Houston) with Luminex x-TAG Gastrointestinal Pathogen Panels (Luminex GPP) and analyzed selected signs and symptoms.
Results:
For 660 pediatric AGE inpatients and 624 age-matched healthy controls (HCs), overall organism detection was 51.2% and 20.6%, respectively (P < .001). Among AGE subjects, GPP polymerase chain reaction detected >1 virus in 39% and >1 bacterium in 14% of specimens. Detection frequencies for AGE subjects vs HCs were norovirus (NoV) 18.5% vs 6.6%, RV 16.1% vs 9.8%, adenovirus 7.7% vs 1.4%, Shigella 4.8% vs 1.0%, Salmonella 3.1% vs 0.1%, and Clostridioides difficile in ≥2-year-olds 4.4% vs 2.4%. More co-detections occurred among AGE patients (37/660, 5.6%) than HCs (14/624, 2.2%; P = .0024). Per logistic regression analysis, ill contacts increased risk for NoV, RV, and Shigella (P < .001). More vomiting episodes occurred with NoV and RV, and more diarrheal episodes with Shigella and Salmonella. Modified Vesikari scores were highest for Shigella and lowest for C. difficile.
Conclusions:
NoV detection was most frequent; however, RV remained important in hospitalized AGE in the post-RV vaccine era. Continued active surveillance is important to document ongoing vaccine effects, pathogen emergence, and baseline disease burden for new vaccines.
