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Assays for the Specific Growth Rate and Cell-binding Ability of Rotavirus
Published on: January 28, 2019
Investigation of a Rotavirus Gastroenteritis Outbreak among Immunosuppressed Patients in a Hospital Setting
Ken Sugata1,2, Jennifer Hull1, Houping Wang1
1Division of Viral Diseases, Centers for Disease Control and Prevention, CDC, Atlanta, GA, USA.
Insights
Rotavirus (RV) infection in immunocompromised children is linked to age and immune status. Lower RV-specific IgG titers and younger age were associated with RV gastroenteritis in a pediatric oncology ward.
Area of Science:
- Pediatric Hematology and Oncology
- Infectious Diseases
- Virology
Background:
- Rotavirus (RV) is a leading cause of severe diarrhea in young children.
- Immunocompromised patients are at higher risk for severe infections.
- Nosocomial outbreaks of RV can occur in hospital settings.
Purpose of the Study:
- To investigate a Rotavirus outbreak in a pediatric hematology and oncology ward.
- To examine the association between immune status and RV infection susceptibility in these patients.
Main Methods:
- Enrolled 28 children undergoing treatment for hematological malignancy or solid organ tumors during an RV outbreak.
- Measured RV antigen, IgG, and IgA using ELISA; determined RV G and P types via RT-PCR.
- Analyzed clinical data, including duration and severity of RV gastroenteritis (GE).
Main Results:
- 14 of 28 patients developed RVGE, with a mean duration of 13.9 days.
- Circulating strains included G3P[8], G2P[4], and a reassortant G2P[8]; RV antigenemia was detected in 78.6% of patients.
- Lower RV-specific IgG titers and younger age were significantly associated with RVGE.
Conclusions:
- Host factors such as age, underlying disease, and immune status influence RV infection susceptibility in immunocompromised children.
- These findings highlight the vulnerability of immunocompromised pediatric patients to nosocomial RV infections.
- Understanding these associations is crucial for infection control in high-risk hospital environments.
Objective:
Rotavirus (RV) is the most common cause of severe dehydrating diarrhoea in healthy infants and young children. The aims of this study were to investigate a RV outbreak in the pediatric hematology and oncology ward and to examine possible associations between immune status and RV infection.
Patients And Methods:
Twenty-eight children (19 boys and 9 girls) who were hospitalized for treatment of hematological malignancy and solid organ tumor during the RV outbreak were enrolled in this study. Fourteen of the 28 patients developed RV gastroenteritis (GE) during the observation period. RV antigen and RV IgG and IgA were measured by enzyme-linked immunosorbent assays. RV G and P types were determined by reverse transcriptase-polymerase chain reaction.
Results:
Mean duration of RVGE in 14 patients was 13.9 days and mean severity score was 7.4. Two RV strains (G3P [8] and G2P [4]) were mainly circulating in the ward, which might result in the formation of a reassortant G2P [8] strain and mixed infection with G2+3P [8] in the immunocompromised patients. RV antigenemia was detected in 22 of the 28 patients (78.6%). RV-specific IgG titers in acute-phase sera of RVGE group were significantly lower than those in non-RVGE group (P=0.001). Mean age of the patients was significantly lower in RVGE group (5.5 ± 4.6 years) than non RVGE group (10.6 ± 4.5 years) (P=0.015).
Conclusion:
Our data demonstrate that host factors including age, underlying diseases, and immune status may be associated with the susceptibility of RV infection in immunocompromised patients at the time of the nosocomial infection.
