Comparing single versus multiple virus detection in pediatric acute gastroenteritis postimplementation of routine...

Area of Science:

• Pediatric infectious diseases
• Virology
• Molecular diagnostics

Background:

• Gastroenteritis is a common illness in young children, often caused by viral pathogens.
• Multiplex real-time polymerase chain reaction (RT-PCR) allows for simultaneous detection of multiple viruses.
• Rotavirus vaccination was introduced in 2010, achieving high coverage.

Purpose of the Study:

• To compare disease characteristics between single and multiple viral infections causing gastroenteritis in children under 5.
• To analyze the prevalence and patterns of co-infections.
• To assess the impact of multivirus infections on disease severity and patient factors.

Main Methods:

• Retrospective analysis of rectal swabs from diarrheic children (<5 years) collected between December 2017 and March 2022.
• Utilized multiplex RT-PCR for simultaneous detection of viral pathogens.
• Excluded cases with positive bacterial PCR; defined single episodes as detection within 2 months.

Main Results:

• Out of 5879 samples, 86.9% had single virus detection and 13.1% had multiple viruses.
• Rotavirus and norovirus co-infection was the most frequent combination (27.8%).
• Multivirus infections were associated with higher immunodeficiency (OR 2.06) and greater disease severity (Vesikari score, p < 0.001, OR 1.12), but lower rates of food allergy and prematurity.

Conclusions:

• Multivirus gastroenteritis accounted for 13.1% of symptomatic cases in hospitalized young children.
• Despite vaccination, rotavirus remains a significant pathogen, often co-infecting with norovirus.
• Multivirus infections are linked to more severe disease outcomes than single-virus infections in this pediatric population.