Abstract
In neonates, rotavirus (RV) infection is generally nosocomial. The control of rotaviral infection within hospital settings is challenging due to prolonged shedding of the virus and contamination of the surrounding environment. There are few studies that have reported asymptomatic infection within neonates. In this study, neonates were screened for RV infection and possible clinical manifestations that may play a role in RV acquisition were analysed. Stool samples were collected from 523 hospitalized neonates admitted for > 48 h in a low-cost and higher-cost tertiary centre. RV antigen was screened using ELISA and the samples which tested positive were confirmed by semi-nested RT-PCR. RV was detected in 34% of participants and genotypes identified included G12P[11] (44.4%), G10 P[11] (42.6%), G10G12P[11] (10.1%) and G3P[8] (2.9%). ICU admissions were associated with higher viral shedding (p < 0.05). Hospitalization in the low-cost facility ICU was associated with higher RV acquisition risk (p < 0.05). RV was detected in higher rates (36.9%) among neonates with gastrointestinal manifestations. G10P[11] was the predominant genotype for several years (1988–2016) among neonates within India. The preponderance of an emerging G12P[11] genotype and heterotypic distribution was documented. RV surveillance is important to identify emerging strains and establish the road ahead in managing RV infection.
Highlights
In neonates, rotavirus (RV) infection is generally nosocomial
Neonates who were admitted in the neonatal intensive care unit (NICU) and neonatal nursery of Sri Ramachandra Medical centre and Sri Ramachandra Hospital, Chennai, India were included in this study
Of the 178 samples that tested positive for RV antigen, 169 samples were genotyped for VP7 and VP4 genes
Summary
Rotavirus (RV) infection is generally nosocomial. The control of rotaviral infection within hospital settings is challenging due to prolonged shedding of the virus and contamination of the surrounding environment. There are few studies that have reported asymptomatic infection within neonates. Neonates were screened for RV infection and possible clinical manifestations that may play a role in RV acquisition were analysed. Hospitalization in the low-cost facility ICU was associated with higher RV acquisition risk (p < 0.05). RV was detected in higher rates (36.9%) among neonates with gastrointestinal manifestations. G10P[11] was the predominant genotype for several years (1988– 2016) among neonates within India. RV infection manifests in a varied spectrum of illnesses in humans ranging from mild asymptomatic to severe symptomatic illnesses. The link between genotype and clinical manifestation has not been well established. This study focuses on the identification of the co-circulating RV strains and to assess the associated risk factors among neonates
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