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. 2015 Jul 27;10(7):e0133891.
doi: 10.1371/journal.pone.0133891. eCollection 2015.

Rotavirus Gastroenteritis in a Neonatal Unit of a Greek Tertiary Hospital: Clinical Characteristics and Genotypes

Dimitra Koukou  1 , Panagiota Chatzichristou  1 , Georgios Trimis  2 , Tania Siahanidou  1 , Anna-Venetia Skiathitou  1 , Emmanouil I Koutouzis  3 , George A Syrogiannopoulos  4 , Athanasia Lourida  1 , Athanasios G Michos  1 , Vassiliki P Syriopoulou  1
Affiliations

Rotavirus Gastroenteritis in a Neonatal Unit of a Greek Tertiary Hospital: Clinical Characteristics and Genotypes

Dimitra Koukou et al. PLoS One. .

Abstract

Introduction: Rotavirus (RV) infection in neonatal age can be mild or even asymptomatic. Several studies have reported that RV is responsible for 31%-87% of pediatric nosocomial diarrhea and causes gastroenteritis outbreaks in pediatric and neonatal units.

Objectives: Study clinical characteristics, genotypes and risk factors of RV infection in neonatal age.

Methods: A prospective study was conducted from April 2009 till April 2013 in the neonatal special care unit of the largest tertiary pediatric hospital of Greece. Fecal samples and epidemiological data were collected from each neonate with gastrointestinal symptoms. RV antigen was detected with a rapid immunochromatography test. RV positive samples were further genotyped with RT PCR and sequencing using specific VP7 and VP4 primers.

Results: Positive for RV were 126/415 samples (30.4%). Mean age of onset was 18 days. Seventy four cases (58%) were hospital acquired. Seasonality of RV infection did not differ significantly throughout the year with the exception of 4 outbreaks. Genotypes found during the study period were G4P[8] (58.7%), G1P[8] (14.7%), G12P[8] (9.3%), G3P[8] (9.3%), G12P[6] (5.3%), G9P[8] (1.3%) and G2P[4] (1.3%). RV cases presented with: diarrhea (81%), vomiting (26.2%), fever (34.9%), dehydration (28.6%), feeding intolerance (39.7%), weight loss (54%), whilst 19% of cases were asymptomatic. Comparing community with hospital acquired cases differences in clinical manifestations were found.

Conclusions: Significant incidence of nosocomially transmitted RV infection in neonatal age including asymptomatic illness exists. Genotypes causing nosocomial outbreaks are not different from community strains. Circulating vaccines can be effective in prevention of nosocomial RV infection through herd immunity.

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Conflict of interest statement

Competing Interests: GlaxoSmithKline Biologicals and Sanofi Pasteur MSD and VIANEX provided funding towards this study. Georgios Trimis has to declare that he is Consultant in the pharmaceutical company VIANEX Athens-Greece, representative of Sanofi Pasteur MSD Lyon-France in Greece, which has the marketing authorization of RotaTeq (rotavirus vaccine) in Greece. There are no further patents, products in development or marketed products to declare. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Seasonal distribution of RV cases in hospitalized pediatric patients and neonates.
Fig 2
Fig 2. RV Genotypes distribution in neonatal cases during the 4-year study period (n = 126).
Fig 3
Fig 3. Annual distribution of RV in neonatal cases (n = 126).
See this image and copyright information in PMC

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