Rotavirus Infection In Infants Research Articles

TLR3 and TLR7 prognostic role in early pediatric rotavirus infection

Introduction. Rotavirus infection is an urgent problem for pediatric infectology. The disease does not always proceed smoothly, it is assumed that TLR3 and TLR7 play an important role in its prognosis. The initial number of cells expressing such receptors in early children can probably be considered a predictor of unfavorable course and outcomes of rotavirus infection.
 Materials and methods. Infants with rotavirus infection were divided into groups depending on the initial count of TLR3- and TLR7-expressing immunocompetent cells. All patients were examined using general clinical methods. Rotavirus infection was diagnosed by molecular genetic (RNA detected by PCR) and immunochromatographic (determination of antigen) method. Parameters of cellular immunity were assessed by flow cytometry. Statistical data processing was carried out using the Statistica 8.0 program for independent samples using the nonparametric MannWhitney criterion and the Pearson criterion c2.
 Results. It was found that in patients with an initially small vs. high count of TLR3-expressing cells, the symptoms of exicosis were observed significantly longer, which determined a significantly longer infusion rehydration therapy. In patients with an initially small count of TLR7-expressing cells, no significant differences were observed during disease course. However, only this group similar to infants with a small count of TLR3-expressing cells were treated with antibiotics due to concomitant bacterial infections. Only convalescents with small count of simultaneously TLR3- and TLR7-expressing cells had repeated episodes of ARI and allergic diseases in catamnesis, whereas infants with extremely low count of TLR3-expressing cells developed additionally an unfavorable outcome such as reactive pancreatopathy.
 Conclusion. The initially low count of TLR3- and TLR7-expressing immunocompetent cells leads to a more severe course of rotavirus infection in infants requiring adjusted therapy by introducing antibacterial drugs and in some cases also contributes to arising adverse outcomes and consequences in 612 month catamnesis.

The role of TLR-3 in the course and outcomes of rotavirus infection in infants

It was found that the clinical picture of rotavirus infection in infants with an initially low number of immunocompetent cells expressing TLR-3 does not differ significantly from that of patients with an initially large number of cells expressing TLR-3. When analyzing the treatment, it turned out that antibacterial therapy due to the activation of bacterial microflora was used only in children with an initially low number of immunocompetent cells expressing TLR-3. In the same group of patients, the development of atopic dermatitis and food allergies was noted during catamnestic observation for 6—12 months after rotavirus infection.

Clinical and immunological efficacy of interferonotherapy in rotavirus infection in infants

Purpose: to improve the complex therapy of rotavirus infection in infants by including interferon and to evaluate its clinical and immunological effectiveness.Materials and methods. Infants without infectious pathology and with rotavirus infection, who were on standard therapy and treatment, including standard therapy and interferon (20 in each group), were examined using general clinical methods. The diagnosis of rotavirus infection was carried out by molecular-genetic method and immunochromatography. Indicators of cellular immunity were determined by flow cytometry. Statistical processing of the results was carried out using the STATISTICA 8.0 program for related and independent samples using the nonparametric Mann-Whitney test and χ2.Summary. In all infants with rotavirus infection, the disease occurred in a moderate form with symptoms of grade II exicosis. In the group of patients who received an additional interferon drug as part of complex therapy, the duration of intoxication symptoms was significantly less, and in the hemogram at discharge from the hospital, the relative content of neutrophils was higher and monocytes lower compared to infants who were only on standard treatment, which corresponded to the norm. In the acute period of rotavirus infection, the relative level of lymphocytes decreased, and NK cells and T-NK cells increased compared to healthy infants. The relative number of cells expressing TLR-3 at the beginning of the disease was lower than in the control group. The inclusion of interferon in the complex therapy contributes to normalization of the relative number of NK cells, while maintaining an increased content of T-NK cells in both relative and absolute terms compared to healthy infants, and a reduced content of cells expressing TLR-3.Conclusion. Currently, rotavirus infection in infants is typical, the most pronounced and long-lasting clinical symptom of the disease is watery diarrhea. The use of interferon in complex therapy helps to reduce the duration of intoxication and normalize the hemogram. Changes in the immune status in the acute period of rotavirus infection indicate increased antigenic stimulation of the cell link and inhibition of the synthesis of pro-inflammatory cytokines, including interferons, under the influence of rotavirus, which is the justification for the use of interferon therapy.

Rotavirus infection in infants and young children with acute gastroenteritis in the Islamic Republic of Iran

The incidence of rotavirus infection was studied in 704 children less than five years of age who were suffering from acute gastroenteritis, between July 1993 and June 1994 in Teheran. Rotavirus antigen was detected by ELISA in 15. 3% of the stool samples examined, as compared to 1. 1% in a group of healthy controls. The frequency of rotavirus infection was significantly higher among patients under 24 months of age [19. 7%] than among children two years old or more [5. 1%]. Breast-feeding had a protective action against rotavirus infection and the peak of incidence was in the spring. This study revealed that rotavirus is an important etiological agent of acute gastroenteritis among children in Teheran

Comparative assessment of clinical-paraclinical manifestations of rotavirus infection versus genotypical variety in infants

Introduction. RVI (rotavirus infection) is the most common cause of dehydration in infants and young children. The implementation of the sentinel surveillance of RVI in infants from 2008 in the Republic of Moldova demonstrated the high rate of this infection (40.0%), being an argument in recommending the antirotaviral immunization in children within the National Immunization Program.
 Material and methods. The study enrolled 193 children with acute diarrheal disease, included in the sentinel supervision (2012-2016) and treated in the Unit for Acute Diarrheal Diseases at Children’s Clinical Hospital no. 1. The biological material was examined by serological enzyme-linked immunosorbent assay (ELISA) and genotyping, revealed by polymerase chain reaction (PCR). 
 Results. The rotavirus infection was confirmed in 193 infants, of which 121 children were not vaccinated against RVI, and 72 were immunized. Depending on the genotypes encountered before and after vaccination, it was found that G9P [8], G3P[8], G4P[8] were detected before vaccination, although postvaccine prevailed G2P[4], G4P[8]. In addition, the incidence of RVI is decreasing and the disease evolution is much better.
 Conclusions. This article reflects the evolution of the genotypic properties of rotaviruses and the clinical-paraclinical particularities of RVI in infants, highlighting the importance of the implementation of antiretroviral immunization in children within the National Immunization Program in the Republic of Moldova.

Over-diagnosis of Rotavirus Infection in Infants Due to Detection of Vaccine Virus.

An accurate rotavirus diagnosis is important for clinical management and monitoring active disease and vaccine effectiveness. Between 2016-2018, rotavirus-positive results in our laboratory were from vaccine virus shedding in 71/152 (46.7%) infants with a request for rotavirus testing. Routine infant diagnostic testing should ideally distinguish vaccine from wild-type viruses.

The incidence of rotavirus infection compared to bacterial infections in different age groups of pediatric patients with gastroenteritis

Abstract Rotavirus is the important cause of acute gastroenteritis in pediatric patients. The aim of the present research was to determine the incidence of rotavirus infections in infants and children up to seven years of age in the town of Niš. Seasonal prevalence of rotavirus-associated acute gastroenteritis was also evaluated. An enzyme immunoassay (RIDASCREEN® Rotavirus; R-Biopharm AG, Darmstadt, Germany) was used to detect rotavirus in the stool specimens of 1,156 patients (newborns up to 7 years of age) presenting with gastroenteritis. Identification of bacteria and yeasts was performed by classical methods. The overall incidence of rotavirus in examined children was 5.97%. Among 144 hospitalized children, rotavirus infection was diagnosed in 28 (19.44%). In 1,012 children treated in outpatient setting for diarrheal diseases, rotaviruses were found in 41 (4.05%). The highest incidence of rotavirus infection was among the patients of one year of age. Among 1,156 pediatric children tested, bacterial pathogens were found in 6.31% and the most frequently isolated pathogens were Campylobacter spp. and Salmonella enteritidis. The highest prevalence of GE was recorded in the colder season, peaking in April (15.94%). Rotaviruses are an important factor in the etiology of the acute diarrheal diseases, especially in children hospitalized during the winter/spring season.

The distinct impact of maternal antibodies on the immunogenicity of live and recombinant rotavirus vaccines

A high titre of maternal antibodies is one of the possible factors associated with decreased rotavirus vaccine efficacy in low-income countries where rotavirus-associated morbidity and mortality are high. Although some studies show a negative correlation between maternal antibody levels and seroconversion after vaccination, withholding breastfeeding does not improve rotavirus vaccine efficacy. Different types of recombined vaccines were developed as an alternative to produce higher protection in developing areas. In previous studies, we found that recombinantly expressed, truncated VP4* can stimulate high titres of neutralizing antibodies and can confer protection against rotavirus infections and rotavirus-induced diarrhoea. In this study, the impact of maternal antibodies on live and recombinant rotavirus vaccines (VP4*) was evaluated in a mouse model. Dams were infected orally with murine rotavirus 7 days after delivery to mimic a natural rotavirus infection in infants and to evaluate the separate effects of trans-placentally acquired and milk-acquired maternal antibodies, pups were half exchanged. After immunization with live rotavirus, both the neutralizing antibody and IgA antibody responses were inhibited by maternal antibodies, especially by milk antibodies; however, the neutralizing antibody responses after immunization with recombinant VP4* were enhanced. In addition, the in vitro incubation of VP4* with immune sera of rotavirus could also enhance the immune responses could also enhance the immune responses. Our finding provides a basis for the development of non-replicating vaccines to address the problem of live attenuated vaccines in low- and middle-income countries.

A milk-based self-assemble rotavirus VP6\u2013ferritin nanoparticle vaccine elicited protection against the viral infection

BackgroundRotavirus is the leading cause of severe dehydrating diarrhea in young children and the inner capsid protein VP6 is a potential vaccine candidate that can induce cross-protective immune responses against different Rotavirus strains. The use of ferritin nanoparticles as the scaffold of the antigen can improve the immunogenicity of the subunit vaccines and provide broader protection. We here present a non-live and self-assemble recombinant rotavirus VP6–ferritin (rVP6–ferritin) nanoparticle vaccine.ResultsThe rVP6–ferritin nanoparticles were expressed in E. coli and self-assembled to uniform spherical structure which similar to ferritin, and oral administration of them induced efficient humoral and mucosal immunogenicity in mice. The nanoparticles were further transgenically expressed in the milk of mice, and pup mice breastfed by transgenic rVP6–ferritin mothers had strongly induced immunogenicity and—compared to pups breastfed by wild type mothers—the proportion of rotavirus challenged pups with diarrhea symptoms, the duration and intensity of the diarrhea, and the deleterious effects on overall growth resulting from the diarrhea were all significantly reduced.ConclusionsThese results suggest that this recombinant VP6–ferritin nanoparticle vaccine can efficiently prevent the death and malnutrition induced by the rotavirus infection in infants and is a promising candidate vaccine for rotavirus.

Clinical and epidemiological aspects of rotavirus infection in infants in the Republic of Moldova

Implementing the sentinel surveillance program of rota­virus infection in infants beginning with the year 2008 in the Republic of Moldova has proven the high rate of this infection (40%), an argument for recommending the children’s immunization against rotavirus within the National Immunization Program. Acute gastroenteritis is one of the most prominent actual health problems in infants, rotaviral infection being a frequent cause of de­hy­dra­tion in infants and small children. Aim. The as­ses­sment of clinical-evolutive and epidemiological features, with treat­ment optimization of rotavirus family infection in non­vac­ci­nated and vaccinated children. Materials and method. There were included in the trial infants with acute diar­rhea, from the sentinel surveillance (2012-2016) of the Pediatrics Department from the IMSP Clinical Hospital for Children No. 1. There were examined 193 patients with acute gastroenteritis, included by a standard case definition. The biologic material was examined with last-generation tests for rotavirus infection, using ELISA and genotype high­lighting by PCR genic amplification. Results. The rotavirus infection was confirmed in 193 infants, from whom 121 were not vaccinated against rotavirus and 72 were immunized. In all patients, the disease began with toxic syndrome and dehydration in 100% of nonvaccinated cases, in comparison with vaccinated children – 82%. Conclusions. This article reflects the evolution of genotype characteristics of rotavirus family and of the clinical-para­cli­nical particularities of infection in infants, being of major importance in the context of implementing the im­munization against rotavirus within the National Im­mu­ni­za­tion Program in our country.

L-Isoleucine Administration Alleviates Rotavirus Infection and Immune Response in the Weaned Piglet Model.

Rotavirus (RV) infection is one of the main pathogenic causes of severe gastroenteritis and diarrhea in infants and young animals. This study aimed to determine how dietary l-isoleucine supplementation improves the growth performance and immune response in weaned piglets with RV infection. In cell culture experiment, after IPEC-J2 and 3D4/31 cells were treated by 8 mM l-isoleucine for 24 h, the gene expressions of β-defensins and pattern recognition receptors (PRR) signaling pathway were significantly increased. Then, in the in vivo experiment, 28 crossbred weaned pigs were randomly divided into two groups fed with basal diet with or without l-isoleucine for 18 days. On the 15th day, the oral RV gavage was executed in the half of piglets. Average daily feed intake and gain of piglets were impaired by RV infection (P < 0.05). RV infection also induced severe diarrhea and the increasing serum urea nitrogen concentration (P < 0.05), and decreased CD4+ lymphocyte and CD4+/CD8+ ratio of peripheral blood (P < 0.05). However, dietary l-isoleucine supplementation attenuated diarrhea and decreasing growth performance (P < 0.05), decreased the NSP4 concentration in ileal mucosa, and enhanced the productions and/or expressions of immunoglobulins, RV antibody, cytokines, and β-defensins in serum, ileum, and/or mesenteric lymph nodes of weaned piglets (P < 0.05), which could be relative with activation of PRR signaling pathway and the related signaling pathway (P < 0.05) in the weaned pigs orally infused by RV. These results indicate that dietary l-isoleucine could improve the growth performance and immune function, which could be derived from l-isoleucine treatment improving the innate and adaptive immune responses via activation of PRR signaling pathway in RV-infected piglets. It is possible that l-isoleucine can be used in the therapy of RV infection in infants and young animals.

Preventive Effect of a Synbiotic Combination of Galacto- and Fructooligosaccharides Mixture With Bifidobacterium breve M-16V in a Model of Multiple Rotavirus Infections.

Rotavirus (RV) causes morbidity and mortality among infants worldwide, and there is evidence that probiotics and prebiotics can have a positive influence against infective processes such as that due to RV. The aim of this study was to evidence a preventive role of one prebiotic mixture (of short-chain galactooligosaccharide/long-chain fructooligosaccharide), the probiotic Bifidobacterium breve M-16V and the combination of the prebiotic and the probiotic, as a synbiotic, in a suckling rat double-RV infection model. Hyperimmune bovine colostrum was used as protection control. The first infection was induced with RV SA11 and the second one with EDIM. Clinical variables and immune response were evaluated after both infections. Dietary interventions ameliorated clinical symptoms after the first infection. The prebiotic and the synbiotic significantly reduced viral shedding after the first infection, but all the interventions showed higher viral load than in the RV group after the second infection. All interventions modulated ex vivo antibody and cytokine production, gut wash cytokine levels and small intestine gene expression after both infections. In conclusion, a daily supplement of the products tested in this preclinical model is highly effective in preventing RV-induced diarrhea but allowing the boost of the early immune response for a future immune response against reinfection, suggesting that these components may be potential agents for modulating RV infection in infants.

Clinical study of extra intestinal damage after rotavirus infection in infants

Objective To investigate the incidence of extra intestinal organ damage in infants with acute rotavirus(RV)infection, the relative risk factors in patients with extra intestinal organ damage, the significance of procalcitonin(PCT)in those infants with multiple organ injury. Methods One hundred and three infants with acute diarrhea whose rotavirus antigens were positive and 65 negative ones were divided into two groups.The differences between these two groups in incidences of extra intestinal organ damage were analyzed.Meanwhile, variables from the clinical data that may lead to extra intestinal organ damage were analyzed.Then, the relationship of multiple organ damage and serum concentration of PCT was also analyzed. Results There were significant differences between positive group and negative group in the rates of respiratory system injury, myocardial damage and hepatic involvement(P<0.05). High fever was the only high risk factor in myocardial damage through multi factor Logistic regression analysis.There were also significant differences among the group with multiple organ damage and only one extra intestinal organ damage and no extra intestinal organ damage in serum concentration of PCT(P<0.05). Conclusion It is common to be attacked by extra intestinal organ damage in infants with acute rotavirus infection.High fever is the risk factor for RV enteritis complicated with myocardial damage.The elevation of PCT concentration suggest that multiple organ injury out of the intestinal tract may take place in infants with acute RV infection. Key words: Rotavirus; Multiple organ injury; Complication; Risk factor; Infant

Prevalence of Rotavirus Infection in Infants and Young Children with Gastroenteritis in Two North-East States, Nigeria

Prevalence of Rotavirus Infection in Infants and Young Children with Gastroenteritis in Two North-East States, Nigeria

Optimization of Therapeutic Measurements in Rotavirus Infection in Infants with Perinatal Exposure to HIV

The features of the clinical course of rotavirus infection in infants with perinatal exposure to HIV were studied. Serum level of procalcitonin as a marker of inflammatory activity and the need for antimicrobial therapy was determined. The efficiency of the proposed additions to basic treatment (low-lactose mixture for two months, antibiotic therapy in case of elevated procalcitonin level) was demonstrated.

The Role of Rotavirus Genotype in the Severity of Acute Diarrhea in Children Under 5 Years Old at Surabaya, Indonesia

Background: Rotavirus infection is a major cause of diarrhea in children under five years of age in both the developed and developing countries. Rotavirus is often associated with acute infection with high severity level that causes death. The rotavirus genotype, patient immunity, and environmental condition are thought to be related to the severity of the incidence of acute diarrhea due to rotavirus infection in infants and young children. Objective: To correlate the rotavirus genotypes and the severity degree of acute diarrhea in children under 5 years. Methods: Cross sectional study was conducted in children aged 1-60 months with acute diarrhea that hospitalized at Gastroenterology ward Dr. Soetomo General Hospital, Surabaya between January to June 2014. Rotavirus examination in stool specimen made from bed-side examination using BD-Rota/Adeno Examine kit, while Rotavirus genotypes examined by molecular methods, namely Reserve Transcription-Polymerase Chain Reaction (RT-PCR) two-steps at the Institute of Tropical Disease (ITD) University of Airlangga. The severity of diarrhea was measured by using a scoring system: Ruuska and Vesikari scores (1990). Results: A total of 88 children were met the criteria of the study. Of the sample 80.7% were aged 6-24 months. Average value of the total score of severity of diarrhea was 10.21 (SD±2.12). Most Rotavirus genotype G2P(4) (19.3%) to group common genotype and genotype G1P(4) and G9P(4) for group genotyping uncommon with a prevalence of respectively 4.5%. There are significant differences between the types of common genotype and uncommon genotype to the total score of the severity degree of diarrhea (p< 0.05). Conclusion: The severity degree of acute diarrhea in children with genotype G2P(4) is the highest prevalence genotype of Rotavirus infection in Dr. Soetomo General Hospital.

Сучасні погляди на ротавірусну інфекцію у дітей: епідеміологічні та клініко-патогенетичні особливості

На підставі аналізу епідеміологічних, клінічних та лабораторних даних, що характеризують перебіг ротавірусної інфекції у дітей Запорізької області, наведені сучасні особливості хвороби. Відмічені динамічні зміни клініко-лабораторних показників лактазної недостатності, що мають місце на тлі ротавірусної інфекції в дітей раннього віку. Доведена ефективність застосування Saccharomyces boulardii в комплексному лікуванні дітей, хворих на ротавірусну інфекцію.

Severe Viral Gastroenteritis in Children After Suboptimal Rotavirus Immunization in Taiwan

The study aimed to investigate the molecular epidemiology of severe viral gastroenteritis (AGE) in children in Taiwan after the implementation of the rotavirus vaccine in the private sector. Fecal samples from hospitalized children with severe AGE from April 2004 to March 2011 were examined by reverse transcription-polymerase chain reaction or polymerase chain reaction to identify enteric viral pathogens. The study period was divided to prevaccine (before September 2006) and postvaccine (after October 2006) periods. The prevalence of enteric viruses between the 2 periods was analyzed. The disease burdens of rotavirus- and norovirus-associated diseases were assessed according to vaccine implementation status and were adjusted for age. A total of 755 stool samples were collected from hospitalized patients with AGE; enteric viruses were identified in 586 patients (77.6%), including 44 with concomitant bacterial infection. Viral enteric infection by rotavirus, norovirus, astrovirus, sapovirus, enteric adenovirus, multiple viruses and bacterial coinfections were found in 216 (28.6%), 128 (17.0%), 24 (3.2%), 6 (0.8%), 69 (9.1 %), 99 (13.1%) and 44 (5.8%) patients, respectively. A significant increase of norovirus infection was found in the postvaccine period (P < 0.001); on the other hand, rotavirus infection in infants has been reduced substainally (P = 0.056) and the annual peak of rotavirus infection has gradually become less prominent, with a significant decline of coinfection of rotavirus with other pathogens. Suboptimal use of rotavirus vaccines in the private sector caused a slow but modest impact on severe rotavirus AGE, whereas norovirus infection became more common.

La vaccination rotavirus en Europe en 2010

The important burden of rotavirus infections in infants largely justifies vaccine prevention. Two attenuated oral vaccines were licensed in Europe in 2006 and have proven effective against severe rotavirus gastroenteritis in infants, yet few countries have implemented vaccination. This hesitation may be related to a very low risk of intussusception in vaccinees, but is mainly due to national differences in cost-effectiveness.

Breastfeeding protects against acute gastroenteritis due to rotavirus in infants

To assess whether breastfeeding protects against acute gastroenteritis (AGE) due to rotavirus (RV) infection compared to RV-negative AGE (RV-) in children age 0-12 months. Data from a community-based study of children with AGE from 30 pediatric practices in Germany, Switzerland, and Austria were evaluated. A case-control design was conducted with RV-positive AGE (RV+) cases and RV- AGE as controls. Odds ratios and 95% confidence intervals were estimated using log-linear regression models adjusting for child's age, family size, number of siblings, child care attendance, and nationality. A total of 1,256 stool samples were collected from infants with AGE; 315 (25%) were RV+ and 941 RV-. Being breastfed in the period of disease inception reduced the risk of AGE due to RV+ (OR, 0.53; 95% CI, 0.37-0.76). In infants 0-6 months of age, the protective effect was stronger (OR, 0.33; 95% CI, 0.19-0.55) than in 7-12-month-old children. Our study adds to the evidence of a protective concurrent effect of breastfeeding against rotavirus infection in infants, particularly in children 6 months and younger. Breastfeeding is important to diminish rotavirus-related gastroenteritis in infants before vaccination can be introduced.