Nosocomial rotavirus gastroenteritis in pediatric patients: A cross sectional study using molecular analysis

Objective: Rotavirus is one of the most important etiological agents of nosocomial infections in childhood. This cross sectional study was designed to determine the incidence and the main risk factors of rotavirus nosocomial infection in children admitted to the Bahrami Children Hospital, Tehran, Iran. Analyzing the genetic diversity and phylogenetic pattern of rotavirus was also performed. Identifying the most common genotypes of rotavirus contributes in establishing a suitable vaccination program. Study design: A total of 105 stool samples were obtained on the first day of admission of children admitted to different wards of Bahrami Children Hospital, Tehran, Iran during December 2009 to December 2010. An additional sample was collected from rotavirus-negative children within 48 hour of their admission. Children who were initially rotavirus-negative and became positive 2 days or more after admission were considered as certain nosocomial cases. Rotavirus infection was detected in the feces samples using RNA PAGE method and RT PCR in order to specify the rotavirus genotypes. Both VP4 and VP7 primers were utilized in order to identify the rotavirus genotypes. Results: During the study period, 105 children were enrolled. The incidence of rotavirus nosocomial infection was 20% with high rates in children aged 12-24months. Nausea, vomiting and high grade fever were the prominent symptoms in the infected patients. Existence of an underlying disease including congenital heart disease and intractable seizures predisposed the children to infection. The most commonly found genotype in nosocomial infection was G1P [8] and G1P [4]. Conclusion: Nosocomial rotavirus infection cause significant morbidity in hospitalized children especially young infants. According to the most common genotypes found in patients with nosocomial infection in this study, appropriate vaccination programs should be considered in developing countries.