High prevalence of GII norovirus in hospitalized children with acute diarrhea, in Beijing.

Liping Jia,You Zhang,Huijin Dong,Linqing Zhao,Liying Liu,Yuan Qian,Dong-Yan Jin

doi:10.1371/journal.pone.0179839

Abstract

This study was addressed to the relationship between norovirus and acute diarrhea in hospitalized children, including hospital-acquired infection (HAI) and community-acquired infection (CAI) in a children's hospital in Beijing. RT-PCR was used to detect norovirus in stool specimen, followed by sequence analysis for PCR products. From 2010 to 2013, a total of 1248 specimens, including 661 from the HAI group and 587 from the CAI group were tested for norovirus. Norovirus were detected in 380 of 1248 (30.4%) diarrheal specimens. The positive rate for norovirus detection was higher in children within HAI group than CAI group (35.3%, 232/661 vs. 25.6%, 148/587), and the difference was significant (X2 = 14.35, P<0.05). For age distribution, the highest positivity rates of norovirus were in age of 0–5 months for HAI group and 12–23 months for CAI group. In the study, 262 amplicons of the VP1 region from norovirus-positive specimens were sequenced, which showed GII.3 and GII.4 norovirus were the most common genotypes detected in 50.0% (n = 131) and 48.9% (n = 128) of the positive specimens, respectively. Regarding the wards distribution, GII.3 norovirus was mainly detected in ward for neonatal diseases (36/85 in HAI group; 19/46 in CAI group), GII.4 norovirus was mainly detected in ward for respiratory and digestive diseases (21/85 in HAI group; 15/33 in CAI group). Conclusion: The data elaborated the importance of norovirus in hospital associated infectious diarrhea. The prevalence of norovirus is higher from HAI group than CAI group, and the norovirus from the patients in CAI group could be the source of infection in HAI group.

Highlights

Acute diarrhea is one of the most important causes of high morbidity and mortality in infants and young children worldwide
When the children with positive samples were divided into 5 age groups (S1 Table), it was shown that the positivity rate of norovirus for hospital-acquired infection (HAI) group was higher than community-acquired infection (CAI) group, whether for boys (X2 = 7.38, p
GII.3 norovirus mainly detected in ward 1 (36/85 in HAI group; 19/46 in CAI group), GII.4 norovirus mainly detected in ward 2 (21/85 in HAI group; 15/33 in CAI group)

Summary

Introduction

Acute diarrhea is one of the most important causes of high morbidity and mortality in infants and young children worldwide. Norovirus used to be called Norwalk virus within the family Caliciviridae was the first recognized viral agent causing acute gastroenteritis in humans [3,4]. With developing of molecular techniques for virus detection, the importance of the role of norovirus in acute diarrhea has been better appreciated and norovirus has become the leading cause of acute gastroenteritis in all age-groups [5,6,7]. Acute diarrhea due to norovirus infection has been better recognized in young children in recent years. This study was to further elaborate the role of norovirus in hospital-associated infectious diarrhea and related risks in general wards which mean not specialized ward for gastroenteritis in children’s hospital

Materials and methods

Result

Findings

Discussion