Prevalence Of Rotavirus Infection Research Articles

Epidemiological and clinical features of rotavirus among children younger than 5 years of age hospitalized with acute gastroenteritis in Northern Italy.

BackgroundRotavirus is the major cause of acute gastroenteritis and severe dehydrating diarrhea in young children.MethodsTo estimate the proportion of hospital admissions for rotavirus acute gastroenteritis and identify the circulating G and P genotypes among children under five years of age, we conducted a prospective observational study from January to December 2008, recruiting children consecutively admitted to six hospitals in Milan and nearby towns in northern Italy. Typing was done on stool samples by reverse transcriptase polymerase chain reaction amplification.ResultsOf the 521 stool samples from children with acute gastroenteritis, 34.9% (95%CI, 30.8 to 39.2%) were rotavirus-positive. Two thirds (67.6%) were under two years of age, and 13.2% were under six months. The predominant G type was G1 (40.7%), followed by G9 (22.5%), G2 (13.2%), G3 (5.5%), G4 (3.8%) and G10 (1.6%). Twenty-one (11.7%) mixed-G infections were identified: G1+G10 (8.8%); G1+G9 (1.6%); and G2+G10 (1.2%). Only P[8] (67.6%) and P[4] (12.6%) types were P genotyped. The predominant single G/P combination was G1P[8] (39.7%), followed by G9P[8] (25.3%), G2P[4] (14.3%), and G3P[8] (4.1%). All G-mixed types combined with P[8].ConclusionsThese findings show an high prevalence of rotavirus infections among children admitted to hospital for acute gastroenteritis caused by different rotavirus strains circulating in the area studied.

The prevalence of group A rotavirus infection and some risk factors in pediatric diarrhea in Zaria, North central Nigeria

Group A rotavirus cause infectious, severe and dehydrating diarrhea which have great impact on childhood morbidity and mortality worldwide. This study was designed to investigate the disease burden and risk factors of rotavirus infection among children 1 – 5 years in Zaria, Nigeria. Stool samples were collected from 666 diarrheic children and 170 matched non-diarrheic controls and screened for rotavirus antigen by ELISA. Their socio-demographic information and clinical presentations were also noted. There was a 15.6 and 7.6% prevalence of rotavirus infections among the diarrheic and non-diarrheic children, respectively, with the peak of infection occurring between 1 - 6 months of age. The most common clinical features included dehydration (59.1%), fever and vomiting (41.3%), vomiting (34.6%) and fever (19.2%). Age, feeding regimen, and the presence of another person in the house with diarrhea were found to be risk factors for rotavirus diarrhea while gender and socioeconomic status were not. In view of the peak of infection in infants in the study area, rotavirus vaccine will be best administered in early infancy. Key words: Rotavirus, prevalence, risk factors, pediatric, diarrhea.

Prevalence of Rotavirus Infections in Calves with Diarrhea in Konya Region

Prevalence of Rotavirus Infections in Calves with Diarrhea in Konya Region

Rotavirus gastroenteritis in a children's hospital specialized in craniofacial malformations

This study aimed to verify the relationship between acute diarrhea provoked by rotavirus and different indicators of craniofacial malformations. In the Hospital for Rehabilitation of Craniofacial Anomalies, 8,724 children with cleft lip and cleft palate were divided into the following groups: acute diarrhea and infection due to rotavirus (C1, n = 62), acute diarrhea (C2, n = 153) and without acute diarrhea (C3, n = 8,509). In C1, 29.03% of the cases consisted of hospital infections associated with the hospitalization period while 38.71% of the patients were aged less than six months. The percentage of children not having breastfed was significantly higher in acute diarrhea groups. Additionally, there was a seasonal prevalence of rotavirus infection between May and October. Finally, the present findings indicate that rotavirus is a predominant etiological agent for gastroenteritis in children with craniofacial malformations. Moreover, among infants younger than six months of age, type of craniofacial malformation, breastfeeding difficulty, socioeconomic level and longer hospitalization period appear to contribute to higher infection morbidity.

Rotavirus infections with multiple emerging genotypes in Sri Lanka

Rotavirus diarrhea is an important cause of child mortality in developing countries, but studies on this diarrhea are scarce in Sri Lanka. A prospective study conducted in Sri Lanka on rotavirus infection among children in a hospital setting (n = 611) versus children residing in tsunami camps (n = 52) showed that prevalence of rotavirus infection was comparable, 21.9 and 20%, respectively. The hospital and camps were located in different districts. Analysis of the genotypes of 122 rotaviruses from the hospital and 12 from the camps indicated that G9P[8] was associated with 35 and 33%; G12P[8/nt] with 14.7 and 33%; G3P[8/4/nt] with 17 and 8% and G1P[8/4] with 6.5 and 16.7%. Rotaviruses with G2P[8/4/6] and G4P[8/4] were hospital-associated only, and some rotaviruses (9 and 8% from the hospital and the camps, respectively) were G- and P-nontypable. We conclude from the present study that multiple emerging genotypes were prevalent in Sri Lanka, and children in camps were at risk of developing diarrhea due to rotaviruses.

Prevalence of Rotavirus in Acute Diarrhea and its Association with Clinical Signs and Symptoms

Rotaviruses are the main etiological agents of acute infectious diarrhea in children. Thus, the objective of this study is to contribute to the information about the rotavirus variants circulating in Brazil. A cross-sectional study was conducted on 124 fecal samples collected from children up to the age of 5 years, with acute gastroenteritis. Thirty-one samples were positive for rotavirus A. Regarding the G genotyping, 16 (80%) were classified as G1 and regarding P genotyping all strains were classified as P[8]. The determination of the prevalence of rotavirus infection and the characterization of the viral strains circulating are expected to contribute to the information we have about the molecular biology and epidemiology of disease.

Molecular Epidemiologic Analysis of Group A Rotaviruses in Children with Diarrhea in Wuhan City, China, 2007

Background: Rotaviruses are the major etiological cause of acute viral gastroenteritis in infants and young children worldwide, primarily in developing countries, producing a significant disease burden. Methods: To describe epidemiologic features and genetic characteristics of group A rotaviruses causing diarrhea in children and to estimate the relatedness or origin of the rotaviruses, a survey was conducted in Wuhan, China, 2007. A total of 889 stool specimens from diarrheal patients under 14 years old from Wuhan Children’s Hospital were analyzed. Many symptoms such as vomit, cough, fever, dehydration were marked. The positive rotavirus specimens was determined by PAGE and rapid immunochromatographic assay. Results: A total of 236 positive specimens performed further genetic analysis. Genotyping of rotavirus was determined by RT-PCR. By sequencing and phylogenetically assigning, two G9 strains were found out. In total, rotavirus detection rate of all stool specimens is 26.55% (236/889). By PAGE and rapid immunochromatographic assay, the detection coincidence rate was 86.42%. Unfortunately, the detection rate was independent of the symptoms. There were extremly significant differences of the detection rates in different age groups ( 2 = 33.53, P < 0.01). The detection rates in the winter season (42-64%), from October to December, were significantly higher than the other seasons(P < 0.05). Throughout the study period, P[8] was the most frequent P serotype (88.9%), and G3 was the most frequent G serotype (75.3%), and was mostly associated with VP4 genotype P[8](68.4%). And the G-type/P-type combination G3P[8] was the most common, followed by G1P[8], G2P[4] and G3P[6]. G1 +G3P[8], G3 +G9P[8], G2 +G3P[4] and other mixed G/P types were detected also. VP7 gene sequences of G9 rotaviruses were detected out by sequencing for two strains, showed extremely high sequence identities (99—100%) to each other and to a few G9 rotavirus strains reported in Asia. Conclusion: In our present study, the rotavirus-positive rate in children specimens was 26.55% in total. The monthly prevalence of rotavirus infection showed significant winter seasonality. It was evident that the G3P[8] rotaviruses were the most prevalent throughout the study period. These findings suggest that transmission of the G3 rotaviruses might have occurred endemically in Wuhan. The two G9 strains were phylogenetically assigned to lineage 3.

Epidemiology of rotavirus and astrovirus infections in children in Northwestern Nigeria

Recent estimates attribute 527,000 deaths in children less than five years of age to rotavirus diarrhea annually, with 145,000 occurring in sub-Saharan Africa. Human astroviruses have been identified as one of the most frequent causes of infantile diarrhea, second in incidence only to rotavirus. This study was conducted to determine the prevalence of rotavirus and astrovirus and also to establish the circulating strains of rotavirus in a community in Nigeria where most diarrheic patients do not visit clinics or health care centers. A total of 154 stool samples (134 diarrheic and 20 non-diarrheic) were collected from infants and young children less than 5 years of age from January-March 2002. Samples were obtained by house-to-house visit in randomly selected districts in Zaria, Northwestern Nigeria. The samples were screened for rotavirus and astrovirus antigens using commercially available Enzyme Linked Immunosorbent Assay (ELISA) kits. All positive group A rotavirus samples were further subjected to VP6 sub-group ELISA, Polyacrylamide gel electrophoresis (PAGE) to determine their RNA electropherotypes and Reverse transcription polymerase chain reaction (RT-PCR) to determine their VP7 and VP4 genotypes. Rotavirus and astrovirus antigens were detected in 9% (12) and 5% (7) of the 134 diarrheic stool samples respectively. No viral antigen was detected in the non-diarrheic stools. Rotavirus infection was more common in younger children than astrovirus infection. VP6 sub-group II specificity (58.3%), long RNA electropherotypes (41.6%), VP7 genotype G1 (33.3%) and VP4 genotype P [6] (33.3%) were the most common strains in circulation at that time in the community. Of significance is the fact that a large proportion of the rotavirus strains in circulation could not be assigned either a VP6 subgroup or RNA electrophoretic pattern probably as a result of low viral load. In this community-based study, rotavirus and astrovirus were significantly associated with diarrhea. However, the prevalence of rotavirus infection among children appears to be low while that of astrovirus falls in the range seen in hospital-based studies around the continent.

Electropherotypes and subgroups of group A rotaviruses circulating among diarrhoeic children in Kano, Nigeria

It is estimated that about 600,000 children die annually as a result of severe dehydrating diarrhea caused by rotaviruses. The virus is a double stranded RNA (dsRNA) virus with 11 segments. Group A rotaviruses show a characteristic 4-2-3-2 pattern following electrophoresis. The VP6 subgroups, I and II exist. This work was carried out to study the prevalence of rotavirus infection among children 0-5 years with diarrhea in Kano, and to determine the circulating subgroups and electropherotypes and of the rotavirus isolates. Two hundred and eighteen stool specimens from children 0-60 months (198 diarrheic and 20 non-diarrheic) were collected from different hospitals and health care centers in Kano and subjected to group A rotavirus enzyme linked immunosorbent assay (ELISA) to determine presence of group A rotavirus, subgroup ELISA to determine the VP6 subgroups and polyacrylamide gel electrophoresis (PAGE) to determine the electropherotypes present. The long electropherotypes (47.05%) of four variations dominated over the short electropherotype (17.64%). About 11.76% of the isolates were of mixed infection. Dominance of subgroup II (45%) over subgroup I (25%), and the presence of both subgroups I and II (10%) and neither subgroup I nor II (15%) was observed in this study. Information on the genomic diversity of the RNA electropherotypes in this region, Kano, is reported in this study.

Infantile gastroenteritis in the community: a cost-of-illness study.

Rotavirus infections are the main cause of gastroenteritis in infants and children and it is expected that by the age of 5 years, nearly every child will have experienced at least one episode of rotavirus gastroenteritis. While severe cases are hospitalized, milder disease is either treated at home or by the GP, and as such the true prevalence of rotavirus infection in the community, and the burden of disease, is unknown. This paper reports the results of a cost-of-illness study which was conducted alongside a structured community surveillance study. Forty-eight percent of our sample was found to have rotavirus acute gastroenteritis; and the average total cost of a child presenting with rotavirus gastroenteritis ranged between pound sterling 59 and pound sterling 143 per episode, depending on the perspective. Given the prevalence and severity of the disease, the estimated burden of rotavirus gastroenteritis to society is pound sterling 11.5 million per year.

Molecular characterisation of the rotavirus strains prevalent in Maua, Meru North, Kenya

Rotavirus is the most common cause of severe infantile diarrhoea disease in infants and young children below five years worldwide. Rotavirus is associated with high cases of morbidity and mortality and it is estimated that up to 650,000 deaths in young children occur annually in the less developed countries and approximately 150,000-200,000 deaths occur in Africa alone. To characterise the circulating rotavirus strains in Maua, Meru North district, Kenya. A prospective study to investigate and characterise rotavirus serotypes/genotypes and electropherotypes in infants and children with severe diarrhoea hospitalised and/or attending the outpatient department of Maua Methodist Hospital during the period April 2004 to September 2005. Maua Methodist Hospital, Meru North, Kenya. Faecal samples were collected from 135 infants and children with acute diarrhoea and were screened first for the presence of human Group A rotavirus antigen using commercially available enzyme linked immunosorbent assay kit (ELISA). The positive samples were evaluated by sodium dodecyl polycrylamide gel electrophoresis (SDS-PAGE) to determine the viral RNA electropherotype profile. Rotavirus strains were also genotyped using reverse transcriptase polymerase chain reaction (RT-PCR) of the VP7 gene. Assay of these samples with commercial ELISA showed that 17.8% (24/135) were positive for group A rotavirus antigen. Twenty of these ELISA positive samples were also analysed by SDS-PAGE of which 75% (15/20) gave detectable electropherotype pattern with the long electropherotype being predominant 80.0% (12/15) followed by the short RNA profile 20.0% (2/ 15). Seventeen of the ELISA positive samples were genotyped for VP7 and the results showed that G9 was the most predominant genotype comprising 47.1% (8/17) followed by G8 29.4% (5/17), GI 17.4% (3/17) and the mixed genotype was G8/G9 5.9% (1/17). Most patients with rotavirus infection were of the age of 3 - 60 months, with 79% being less than 18 months old. The overall prevalence of rotavirus infection in young children with diarrhoea hospitalised and/or attending the out-patient department of Maua Methodist Hospital was 17.8% with the predominant serotype being G9. These results show that rotavirus plays an important role in severe viral diarrhoea in young children in Maua Meru North district, Kenya. Furthermore, this high G9 rotavirus prevalence in Kenya may require vaccine trials to be held in Kenya so as to determine the efficacy of new rotavirus vaccine candidates that do not include the G9 serotype.

Rotavirus infection in Saudi Arabia

BACKGROUNDHuman rotavirus, an important causative agent of severe gastroenteritis in infants and young children worldwide, leads to high morbidity in both developing and developed countries, including Saudi Arabia, and high mortality in developing countries. Effective control depends upon an accurate understanding of disease burden and the relative importance of circulating serotypes.METHODSWe examined the epidemiology and disease burden of rotavirus in Saudi Arabia through a review of 22 published studies of rotavirus and the aetiology of diarrhoea carried out from 1982 to 2003.RESULTSThe prevalence of rotavirus infection ranged between 10% to 46% with a median of 30%. Most cases were among children less than 2 years of age, and particularly in the first year of life. There were significant differences in seasonality within Saudi Arabia, with increased infection during winter in some cities and during summer in others. G1 was the predominant serotype followed by G4, G3 and G2, in 4 studies where strains had been G-typed. The prevalence of nontypeable strains ranged from 11.0% to 31.3%. No data were available on P types. Results of electropherotyping in 4 studies revealed that the long electropherotype was predominant.CONCLUSIONRotavirus is an important cause of severe diarrhoea in Saudi children. However, the available data on rotavirus strains in circulation are limited and there is an urgent need for up-to-date and comprehensive studies to evaluate rotavirus strains in circulation and identify unusual types that could be incorporated into future vaccines.

Rotavirus Infection in Infants and Young Children

ABSTRACTRotaviruses are the major cause of severe gastroenteritis in infants and young children worldwide. The aim of the present study was to determine (1) the involvement of rotavirus in acute gastroenteritis (AGE) in children up to 3 years of age in geographical region of the study area, (2) the seasonal prevalence of rotavirus-related AGE and (3) the presence of asymptomatic rotavirus infection in children attending day care centers. A two-year retrospective study was carried out on 250 children with AGE aged 6 months to 3 years. Ninety children were hospitalized with pronounced disease symptoms, and 160 children with milder symptoms received ambulatory treatment. The investigation included 860 healthy children attending day care centers in Nis as well. A single stool sample was taken from each child for analysis. The samples were identified as rotavirus positive by antigen detection strategies, including latex agglutination (LA) tests. Out of 250 episodes of acute gastroenteritis 68 (27.20%) were associated with rotavirus antigen detection. Of 160 children with episodes of AGE treated ambulatory, rotavirus antigen was detected in 30 (18.75%). Of 90 children hospitalized with more severe AGE, higher percentage of rotavirus antigen-positive was recorded in 38 (42.22%). In the group of 860 healthy children attending day care centers in Nis, asymptomatic rotavirus infection was confirmed in 48 children (5.58%). The highest prevalence of rotavirus infection was observed in the period October-December (41.17%), and the lowest in the summer months July-September (14.71%). Rotaviruses are involved in a high percentage in the etiology of AGE in geographical region of the study area.

Epidemiological Profile of Rotavirus Infection in the Republic of Korea: Results from Prospective Surveillance in the Jeongeub District, 1 July 2002 through 30 June 2004

To facilitate future decisions regarding the usefulness of rotavirus vaccines in the Republic of Korea, active surveillance was conducted in a network of clinics, emergency departments, and hospitals serving Jeongeub District, Korea. Children with diarrhea underwent standard clinical evaluations, and stool specimens were collected to test for the presence of rotavirus. Parents were interviewed to collect demographic and family information. From 1 July 2002 through 30 June 2004, a total of 4106 children, representing 1 (50%) of every 2 children <5 years old in the study population, were evaluated for rotavirus diarrhea. Of the 2232 stool specimens obtained throughout the year, 460 (20.6%) were rotavirus positive; however, the monthly prevalence of rotavirus infection peaked at 49.5% in February 2004. Of the 460 rotavirus-positive stool specimens, 366 were obtained from children who visited outpatient clinics, and 94 were obtained from children who were hospitalized. By extrapolating the proportion of rotavirus-positive patients to all children with diarrhea in the surveillance system, we calculate that 882 children in Jeongeub District had rotavirus infection (which would predict that there would be 702 associated clinic visits and 180 hospitalizations). Genotyping of rotavirus strains showed that 39% of strains were type G9P[8], 24% were type G1P[8], 17% were type G3P[8], and 13% were type G2P[4]. The incidence of rotavirus diarrhea peaked at age 13-24 months, and 94% of cases occurred during the first 3 years of life. The annual incidence of all rotavirus disease-associated outcomes was 56.9 cases/1000 children <5 years old (95% confidence interval [CI], 51.9-62.2 cases/1000 children <5 years old). The incidence of rotavirus disease-associated hospitalizations was 11.6 cases/1000 children <5 years old (95% CI, 9.5-14.2 cases/1000 children <5 years old). In Korea, diarrhea is common during childhood, and the incidence of diarrhea due to rotavirus infection suggests that improved programs for the prevention and control of both rotavirus diarrhea and diarrhea due to other causes are needed.

Detection of Group A Rotavirus Strains Circulating in Calves in Tunisia

Faecal samples were collected from 89 dairy calves to determine the prevalence of rotavirus infection in Tunisia and the genomic diversity of bovine rotavirus strains. After screening of all faecal samples by enzyme-linked immunosorbent assay, rotavirus strains were analysed by RNA polyacrylamide gel electrophoresis and characterized antigenically by monoclonal antibodies to the VP6 subgroup. The VP7 genotype was determined by nested RT-PCR. Of the 89 calves tested, 27 (30%) were positive for rotavirus antigen. Four different long electrophoretypes were identified. All VP6 typeable strains carried the subgroup I specificity. G8 genotype was the most prevalent, but G6 and mixed strains G(6 + 8) were also detected.

ROTAVIRUS INFECTION AMONG INFANTS AND YOUNG CHILDREN IN CHENNAI, SOUTH INDIA

Background: Group A rotavirus has been recognized as the major etiologic agent of childhood gastroenteritis in infants and young children worldwide. Rapid progress towards the development of an efficacious rotavirus vaccine has warranted extensive epidemiological studies on rotavirus serotypes that cause severe disease in developing and developed countries and to monitor the emergence of newer and unusual strains in different geographical settings that could represent variants not covered by existing vaccines. Methods: In this study, we determined the prevalence of rotavirus infection and characterised group A rotavirus in stool samples by using monoclonal antibody (MAb) based ELISA and polyacrylamide gel electrophoresis (PAGE). Stool samples were collected from 745 children of 0-3 years of age presenting to the hospital with acute diarrhea between March 1995 and August 1999. These were assayed for antigenic (group, subgroup, serotype) and genomic (viral RNA profile and VP7 and VP4 genotype) characterization by ELISA and PAGE. Results: Out of 745 stool samples analysed 168 were found to be positive for rotavirus. Among these 118 could be assigned a subgroup (SG), serotype and electropherotype (E-type). The study has evidenced the predominant occurrence of strains with short E-type, SGI and serotype G2 in 66.1% of the samples. The presence of strains representing 10 different E-types and mixed genotype specificities with G2 P[4,8] and G1-G2 P[4,8] has documented the prevailing high genomic diversity of rotaviruses in this geographical area. Conclusion: This study has described the predominant strains of rotavirus in south India. There is a need for further detailed studies on the molecular characterization of rotaviruses which would have important implications in vaccine evaluation programmes.

Rotavirus infection in under-five children in Jimma Hospital, Southwest Ethiopia

Background: Rotavirus is the leading etiological agent among the causes of acute diarrhea in infants and young children. However, there is no attempt to indicate its significance in other regions of Ethiopia, out of the capital, Addis Ababa. Objective: This study is aimed at revealing the prevalence of rotavirus infection among infants and young children in Jimma Hospital. Method: A cross-sectional study was designed and a total of 154 children less than 5 years of age, who had acute diarrhea were studied from January 14 to February 19, 2002 at Jimma Hospital, pediatrics out patient department. Result: Rotavirus was detected in 26.6 % (41/154) of fecal specimens collected from children of < 5 years of age with acute diarrhea, tested by Enzyme Linked Immunosorbent Assay. Of all cases of rotavirus, 90.2% (37/41) occurred in children < 2 years of age. The highest rate of Rotavirus Antigen detection was observed among the 7 to 12 months of age group (34%). Children infected with rotavirus were more likely to have watery stool (90.2% Vs 43.4%), vomiting (31.7% Vs 15.9%) and some (moderate) dehydration (31.7% Vs 12.4%) with P

Prevalence of rotavirus infections and strain types detected among under-five children presenting with diarrhoea at selected MCH clinics in Mwanza City, Tanzania

Prevalence of rotavirus infections and strain types detected among under-five children presenting with diarrhoea at selected MCH clinics in Mwanza City, Tanzania

Circulation of the novel G9 and G8 rotavirus strains in Nigeria in 1998/1999.

An epidemiological survey investigating the prevalence of rotavirus infection in infants and young children with acute diarrhoea was undertaken in Jos State, Nigeria, between January 1998 and April 1999. In total, 672 faecal specimens were collected from children aged between 1 and 60 months with acute infantile gastroenteritis. The 10-20% stool suspensions were examined by an ELISA for the presence of group A rotavirus antigen (Rotavirus IDEIA, Dako, UK). Only 116 specimens (17.3%) were positive for the group A rotavirus antigen detected by this ELISA. The rotavirus-positive specimens were analysed with monoclonal antibodies specific for rotavirus VP6 subgroup I and II, and for VP7 serotypes G1-G4, G8, and G9. Of the rotavirus strains that could be subgrouped, VP6 subgroup I and II strains circulated at similar levels. Amongst the strains that could be serotyped, VP7 G9 strains predominated occurring in 17 cases, with G3 (n = 10) and G1 (n = 9) strains occurring in lower numbers. Four G8 strains were detected and only one G2 and no G4 strains were identified. This report extends the description of the global distribution of G9 rotavirus strains.

Efficacy of Lactobacillus GG in prevention of nosocomial diarrhea in infants

Objective: Nosocomial diarrhea is a major problem in pediatric hospitals worldwide. We evaluated the efficacy of orally administered Lactobacillus GG (LGG) in the prevention of this disease in young children. Study design: Eighty-one children aged 1 to 36 months who were hospitalized for reasons other than diarrhea were enrolled in a double-blind trial and randomly assigned at admission to receive LGG (n = 45) at a dose of 6 × 109 colony-forming units or a comparable placebo (n = 36) twice daily orally for the duration of their hospital stay. Results: LGG reduced the risk of nosocomial diarrhea (≥3 loose or watery stools/24 h) in comparison with placebo (6.7% vs 33.3%; relative risk: 0.2; [95% CI: 0.06–0.6]; number needed to treat: 4 [95% CI: 2–10]). The prevalence of rotavirus infection was similar in LGG and placebo groups (20% vs 27.8%, respectively; relative risk: 0.72; 95% CI: 0.33–1.56). However, the use of LGG compared with placebo significantly reduced the risk of rotavirus gastroenteritis (1/45 [2.2%] vs 6/36 [16.7%], respectively; relative risk: 0.13; 95% CI: 0.02–0.79; number needed to treat: 7; 95% CI: 3–40). Conclusions: Prophylactic use of LGG significantly reduced the risk of nosocomial diarrhea in infants, particularly nosocomial rotavirus gastroenteritis. (J Pediatr 2001;138:361-5)