scholarly journals 1112. Detection of Enteric Viruses in Children With Acute Gastroenteritis

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S333-S334
Author(s):  
Lubna Hamdan ◽  
Einas Batarseh ◽  
Bhinnata Piya ◽  
Laura Stewart ◽  
Chris Fonnesbeck ◽  
...  
Keyword(s):  
Acute Gastroenteritis ◽  
Infection Prevention ◽  
Virus Detection ◽  
Hospital Inpatient ◽  
Infectious Agents ◽  
Research Support ◽  
Viral Pathogens ◽  
Additional Testing ◽  
Stool Specimens ◽  
Outpatient Settings

Abstract Background Acute gastroenteritis (AGE) is a major cause of morbidity in children. Viral pathogens are the most common infectious agents. Differences in illness characteristics of AGE with and without virus detection are poorly defined. We compared AGE illness characteristics between children with and without any-virus detected, and with single vs. multiple viruses detected. Methods Children between 15 days and 17 years with AGE defined as diarrhea (>3 loose stools/24 hours) or any vomiting within 10 days duration were enrolled in Vanderbilt Children’s Hospital inpatient, ED, and outpatient settings from December 2012 to November 2015. Stool specimens were tested by RT-qPCR for norovirus, sapovirus, and astrovirus and by ELISA (VP6 antigen [Rotaclone®]) for rotavirus. Results Of 3,705 children enrolled, 2,892 (78%) specimens were collected. A single virus was detected in 1,109 (38%) stools [51% norovirus, 20% rotavirus, 21% sapovirus, and 8% astrovirus], viral co-detections were found in 115 (4%) stools, and 1,665 (58%) had no detected viruses. Table 1 compares children with and without any-virus detected. Children with a single-virus detected were older than those with >1 virus detected (1.8 vs. 1.5 years [P < 0.05]) with no other significant differences. Conclusion Children with any-virus detected had more severe symptoms, higher MVS, and more frequently reported sick contacts compared with no-virus detected. Children with no-virus detected were more likely to present with fever and higher temperatures, which may be due to bacterial organisms. These data highlight the importance of infection-prevention precautions in the community and the need for additional testing to define the etiologic spectrum of AGE in children. Disclosures N. Halasa, sanofi pasteur: Investigator, Research support. GSK: Consultant, Consulting fee. Moderna: Consultant, Consulting fee.

scholarly journals 1101. Comparison of Clinical Characteristics and Demographics of GII.4 vs. Other GII Noroviruses Associated With Sporadic Acute Gastroenteritis in Children in Nashville, TN, 2012–2015

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S330-S330
Author(s):  
Einas Batarseh ◽  
Lubna Hamdan ◽  
Bhinnata Piya ◽  
Laura Stewart ◽  
James D Chappell ◽  
...  
Keyword(s):  
Acute Gastroenteritis ◽  
Clinical Characteristics ◽  
Age Groups ◽  
Severe Illness ◽  
Genotype Distribution ◽  
Research Support ◽  
Inpatient Settings ◽  
Prevalent Strain ◽  
Stool Specimens ◽  
Sporadic Acute Gastroenteritis

Abstract Background Norovirus is a leading cause of acute gastroenteritis (AGE) in all age groups. Although at least 28 different genotypes infecting humans have been reported, most outbreaks over the last 15 years have been caused by genogroup II (GII) viruses, of which GII.4 viruses have caused more than 50%. Since clinical differences between different genotypes are poorly understood, we sought to compare clinical characteristics in children infected with GII.4 and non-GII.4 viruses. Methods Children between 15 days and 17 years who presented with AGE defined as diarrhea (≥3 loose stools in a 24 hour period) or vomiting (≥1 episodes in a 24 hour period) within 10 days duration were recruited in outpatient, emergency, and inpatient settings in Nashville, TN, during 2012–2015. Stool specimens were tested by RT-qPCR for GI and GII norovirus. Norovirus-positive specimens were genotyped by sequencing of a partial region of the capsid gene. In this study, we excluded children infected with GI, mixed GI/GII and non-typeable GII viruses. Results Of 3,705 AGE subjects enrolled, 2,892 (78%) specimens were collected, 637 (22%) tested norovirus-positive (567 [89%] GII, 62 [10%] GI, and 8 [1%] mixed GI/GII). Of the 567 GII viruses, 461 (81%) were able to be genotyped and of those 238/461 (51.6%) were typed as GII.4 and 223/461 (48.3%) were typed as other GII genotypes (non-GII.4, primarily GII.3 [65/ 461, 14.1%], GII.6 [48/461, 10.4%] and GII.7 [36/461, 7.8%]). Over three AGE seasons, GII.4 represented 64/117 (54%), 79/178 (44%), and 71/166 (57%), of the GII infections, respectively. Compared with non-GII.4 subjects, GII.4 subjects were more likely to be younger (15.5 vs. 21.3 months, P < 0.01), and less likely to attend daycare (23% vs. 39%, P < 0.01). GII.4 subjects also were more likely to present with diarrhea (75% vs. 57%, P < 0.01) and had higher median modified Vesikari score (7 vs. 6, P < 0.01). Conclusion Children infected with GII.4 viruses were younger, less likely to attend child care, more likely to present with diarrhea, and had a more severe illness compared with those with non-GII.4 infections. These data provide important information on the genotype distribution of norovirus in children with AGE in Tennessee and highlight GII.4 as the most prevalent strain. Disclosures N. Halasa, sanofi pasteur: Investigator, Research support. GSK: Consultant, Consulting fee. Moderna: Consultant, Consulting fee.

Mixed viral infections causing acute gastroenteritis in children in a waterborne outbreak

2010 ◽  
Vol 138 (9) ◽  
pp. 1227-1234 ◽  
Author(s):  
S. RÄSÄNEN ◽  
S. LAPPALAINEN ◽  
S. KAIKKONEN ◽  
M. HÄMÄLÄINEN ◽  
M. SALMINEN ◽  
...  
Keyword(s):  
Campylobacter Jejuni ◽  
Acute Gastroenteritis ◽  
Viral Infections ◽  
Aichi Virus ◽  
Mixed Infections ◽  
Hospitalized Children ◽  
Point Scale ◽  
Viral Pathogens ◽  
Waterborne Outbreak ◽  
Stool Specimens

SUMMARYWe examined stool specimens for viral pathogens from 50 children referred to hospital due to acute gastroenteritis (AGE) resulting from consuming drinking water contaminated with sewage in a Finnish community using PCR methods. Rotavirus was detected in 33 (66%), human calicivirus in 31 (62%), and both in 40% of cases. Of the caliciviruses, 20/31 (65%) were noroviruses and 11 (35%) sapoviruses. Furthermore, Aichi virus was detected in 25 (50%), adenovirus in six (12%) and bocavirus in four (8%) cases.Campylobacter jejuniwas present in 20 (61%) andSalmonellain four (12%) of the 33 stools cultured for bacteria. On a 20-point scale median severity score of AGE in the 28 hospitalized children was 17; the severity was similar regardless of viruses detected. Bloody diarrhoea occurred only whenC. jejuniwas present. To conclude, massive exposure to several AGE viruses caused mixed infections and severe AGE regardless of the aetiological agents.

scholarly journals Prevention and Control of Infections

2021 ◽  
pp. 1-9
Author(s):  
Robin Sebastian ◽  
. Gopalakrishnan ◽  
P. Sanil Kumar ◽  
Lal Prashanth ◽  
Darly Jose
Keyword(s):  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Human Populations ◽  
Infectious Agents ◽  
Standard Precautions ◽  
Viral Pathogens ◽  
Contact Precautions ◽  
Route Of Transmission ◽  
And Control

Over the last 10 years several new viral pathogens have appeared in human populations in India. We have also seen the emergence of infectious diseases like COVID-19. It is time to reassess our current practice patterns and commit to a ‘NEW STANDARD’ for infection prevention and control. A two-tiered approach to precautions is used to interrupt the mode of transmission of infectious agents. Standard precautions to work practices that are applied to all patients receiving care in health facilities and Transmission-based precautions are precautions required to be taken based on the route of transmission of organisms like contact precautions, airborne precautions, etc.   If successfully implemented, standard and transmission-based precautions prevent any infection from being transmitted.

scholarly journals 913. Distribution of Respiratory Viral Pathogens in Infants Across Different Clinical Settings from December 2019 to April 2020

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S491-S492
Author(s):  
Zaid Haddadin ◽  
Danielle A Rankin ◽  
loren lipworth ◽  
Jon Fryzek ◽  
Mina Suh ◽  
...  
Keyword(s):  
Clinical Setting ◽  
Respiratory Viruses ◽  
Clinical Settings ◽  
Research Support ◽  
Viral Pathogens ◽  
Abrupt Decrease ◽  
Nasal Swabs ◽  
Viral Testing ◽  
Support Research ◽  
Research Grant

Abstract Background Acute respiratory infections (ARI) are a major cause of morbidity and mortality in young children, with viral pathogens being the most common etiologies. However, due to limited and inconsistent clinical diagnostic viral testing in the outpatient (OP) setting compared to the inpatient (IP) setting, the actual burden and distribution of viral pathogens across these clinical settings remain largely underreported. We aimed to evaluate the frequency of common respiratory viruses in medically attended ARI in infants. Methods We conducted a prospective viral surveillance study in Davidson County, TN. Eligible infants under one year presenting with fever and/or respiratory symptoms were enrolled from OP, emergency department (ED), or IP settings. Nasal swabs were collected and tested for common viral pathogens using Luminex® NxTAG Respiratory Pathogen Panel and for SARS-CoV-2 using Luminex® NxTAG CoV extended panel. Results From 12/16/2019 to 4/30/2020, 364 infants were enrolled, and 361 (99%) had nasal swabs collected and tested. Of those, 295 (82%) had at least one virus detected; rhinovirus/enterovirus (RV/EV) [124 (42%)], respiratory syncytial virus (RSV) [101 (32%)], and influenza (flu) [44 (15%)] were the three most common pathogens detected. No samples tested positive for SARS-CoV-2. Overall, the mean age was 6.1 months, 50% were male, 45% White and 27% Hispanic. Figure 1 shows the total number of PCR viral testing results by month. RSV was the most frequent virus detected in the IP (63%) and ED (37%) settings, while RV/EV was the most common in the OP setting (Figure 2). Figure 3 displays viral seasonality by clinical setting, showing an abrupt decrease in virus-positive cases following the implementation of a stay-at-home order on March 23, 2020 in Nashville, TN. Distribution of Respiratory Viruses in Different Settings Distribution of Respiratory Viruses in Different Settings by Season Conclusion Most medical encounters in infants are due to viral pathogens, with RSV, RV/EV, and flu being the most common. However, distributions differed by clinical setting, with RSV being the most frequently detected in the IP and ED settings, and second to RV/EV in the OP setting. Continued active viral ARI surveillance in various clinical settings is warranted. Preventative measures such as vaccines and infection control measures deserve study to reduce viral ARI burden. Disclosures Zaid Haddadin, MD, CDC (Grant/Research Support, Research Grant or Support)Quidel Corporation (Grant/Research Support, Research Grant or Support)sanofi pasteur (Grant/Research Support, Research Grant or Support) Danielle A. Rankin, MPH, CIC, Sanofi Pasteur (Grant/Research Support, Research Grant or Support) Jon Fryzek, PhD, MPH, EpidStrategies (Employee) Mina Suh, MPH, International Health, EpidStrategies (Employee) Donald S. Shepard, PhD, Sanofi Pasteur (Grant/Research Support) Natasha B. Halasa, MD, MPH, Genentech (Other Financial or Material Support, I receive an honorarium for lectures - it’s a education grant, supported by genetech)Karius (Consultant)Moderna (Consultant)Quidel (Grant/Research Support, Research Grant or Support)Sanofi (Grant/Research Support, Research Grant or Support)

scholarly journals Frequency of Rotavirus, Adenovirus and Astrovirus among Patients with Acute Diarrhea by Chromatographic Immunoassay and Enzyme

2016 ◽  
Vol 10 (2) ◽  
pp. 58-64
Author(s):  
Arwa Mujahid Abdullah Al-Shuwaikh
Keyword(s):  
Clinical Settings ◽  
City Hospital ◽  
Viral Pathogens ◽  
Inappropriate Use ◽  
Medical City ◽  
Elisa Technique ◽  
Stool Samples ◽  
Infant And Young Children ◽  
Stool Specimens ◽  
Age Range

Diarrhea is a major cause of illness and death in children worldwide; however, little information exists about the origin of childhood diarrhea in Iraq. Rotavirus, Adenovirus and Astrovirus are the major causes of sever gastroenteritis in infant and young children, pattern also observed in adult. Confirmation of viral infection by laboratory testing is necessary for reliable surveillance and can be useful in clinical settings to avoid inappropriate use of antimicrobial therapy. Methods: A total of 188 patients their age range from 1-19 (Mean=5.57 ± S.D. = 4.81) years old suffering from diarrhea were included in this study. Stool samples were collected and tested for Rotavirus, Adenovirus and Astrovirus antigens by using the rapid chromatographic test and for Rotavirus and Adenovirus Antigens, ELISA also was done. Rotavirus, Adenovirus and Astrovirus antigens were determined by rapid chromatographic immunoassay in 27 specimens (14.36%), 0 (0%) and 0 (0%) of 188 frozen stool specimens, respectively. Moreover, of these 188 specimens, Rotavirus was found in 35 specimens (18.62%) and Adenovirus in 6 specimens (3.19 %) by using ELISA technique. The present results revealed that Rotaviruses and Adenoviruses have an important role in diarrhea among children especially those less than 5 year’s old and viral pathogens should be investigated routinely in diarrhea stool specimens. This study was aimed to determine the frequency of Rotavirus, Adenovirus and Astrovirus in patients with acute gastroenteritis admitted to Al-Emamain Al-Kadhemain Medical City Hospital in Baghdad-Iraq.

scholarly journals Clinical Correlation of a Clostridium difficile Testing Algorithm Reflexing PCR Positive Specimens to Toxin Enzyme Immunoassay (EIA)

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S395-S396 ◽  
Author(s):  
Maria Bueno Rios ◽  
James Karichu ◽  
Abhishek Deshpande ◽  
Thomas Fraser ◽  
Carlos Isada ◽  
...  
Keyword(s):  
Clinical Assessment ◽  
Cleveland Clinic ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Microbiology Laboratory ◽  
Research Support ◽  
The United Kingdom ◽  
Stool Specimens ◽  
Testing Algorithm ◽  
Positive Results

Abstract Background An algorithm promoted in the United Kingdom reflexes specimens positive for C. difficile by a nucleic acid amplification test (NAAT) to toxin EIA. Samples positive by NAAT and negative by toxin EIA are reported as “C. difficile could be present (ie, potential C. difficile excretor).” We explored the potential utility of this algorithm to distinguish C. difficile infection (CDI) from colonization compared with retrospective clinical assessment. Methods Liquid stool specimens (n = 300) from inpatients (or the Emergency Department) submitted to the Cleveland Clinic Microbiology laboratory for C. difficile PCR testing (Cepheid Xpert C. difficile/Epi) with positive results were included in the study. The CDIFF QUICK CHEK COMPLETE GDH/toxin EIA assay (Alere) was performed according to manufacturer’s instructions. The charts of all patients were reviewed by Infectious Diseases physicians blinded to the EIA results. Using the American College of Gastroenterology (ACG) classification system, CDI status was determined to be mild, moderate, severe, or complicated. Patients without significant diarrhea (<3 unformed stools / 24 hours) were considered colonized. Those without documentation of stools were classified as indeterminate. Correlation of clinical assessment with EIA results was assessed. Results Most of the PCR positive specimens (75%) were toxin EIA negative. Correlation of clinical assessment with toxin EIA is summarized in the table below. Among patients colonized vs. those with CDI, the percentages with negative toxin EIA results were 80% and 73%, respectively. GDH antigen results were negative for 25 specimens—17 were from patients considered to have CDI. Conclusion Toxin EIA performed on samples positive for C. difficile by PCR does not reliably identify patients considered to have CDI with ACG criteria applied. GDH as an initial screen would not have detected 6.8% of patients with CDI. Disclosures S. S. Richter, bioMerieux: Investigator, Research support; BD Diagnostics: Investigator, Research support; Roche: Investigator, Research support; BioFire: Investigator, Research support; OpGen: Investigator, Research support

scholarly journals Human Bocavirus Infection Markers in Peripheral Blood and Stool Samples of Children with Acute Gastroenteritis

Viruses ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 639 ◽  
Author(s):  
Zaiga Nora-Krukle ◽  
Anda Vilmane ◽  
Man Xu ◽  
Santa Rasa ◽  
Inga Ziemele ◽  
...  
Keyword(s):  
Acute Gastroenteritis ◽  
Human Bocavirus ◽  
Plasma Samples ◽  
Infectious Agents ◽  
Viral Dna ◽  
Widespread Distribution ◽  
Gastrointestinal Pathogens ◽  
Stool Samples ◽  
First Time ◽  
Infection Markers

Human bocaviruses (HBoVs) 1–4 belong to the Parvoviridae family, and they infect the respiratory or gastrointestinal tracts in children. We investigated the prevalence of HBoV1–4 DNAs in the blood and stool samples, and of HBoV1–4 IgG and IgM in the plasma samples, of children presenting with acute gastroenteritis (AGE). In addition, we identified HBoV co-infections with the five most frequent gastrointestinal pathogens. A total of 83 paired blood and stool samples were collected from children aged five years or less. Infection markers of HBoV1, 2, or 3 (viral DNA in blood and/or stool and/or antibodies) were detected in 61 out of 83 (73.5%) patients. HBoV1, 2, or 3 DNA as a monoinfection was revealed in 18.1%, 2.4%, and 1.2%, respectively, and 21.7% in total. In 56.1% of the HBoV DNA-positive patients, the presence in stool of another virus—most frequently norovirus or rotavirus—was observed. In conclusion, this study, for the first time, illustrates the prevalence and genetic diversity of HBoVs in Latvian children with gastroenteritis, and shows a widespread distribution of these viruses in the community. HBoV1 and 2 are commonly found as single infectious agents in children with AGE, suggesting that the viruses can be as pathogenic by themselves as other enteric agents are.

scholarly journals Unveiling Viruses Associated with Gastroenteritis Using a Metagenomics Approach

Viruses ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 1432
Author(s):  
Xavier Fernandez-Cassi ◽  
Sandra Martínez-Puchol ◽  
Marcelle Silva-Sales ◽  
Thais Cornejo ◽  
Rosa Bartolome ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Acute Gastroenteritis ◽  
Clinical Analysis ◽  
Viral Metagenomics ◽  
Next Generation ◽  
Sequencing Data ◽  
Viral Pathogens ◽  
Viral Pathogen ◽  
Infectious Gastroenteritis ◽  
Generation Sequencing

Acute infectious gastroenteritis is an important illness worldwide, especially on children, with viruses accounting for approximately 70% of the acute cases. A high number of these cases have an unknown etiological agent and the rise of next generation sequencing technologies has opened new opportunities for viral pathogen detection and discovery. Viral metagenomics in routine clinical settings has the potential to identify unexpected or novel variants of viral pathogens that cause gastroenteritis. In this study, 124 samples from acute gastroenteritis patients from 2012–2014 previously tested negative for common gastroenteritis pathogens were pooled by age and analyzed by next generation sequencing (NGS) to elucidate unidentified viral infections. The most abundant sequences detected potentially associated to acute gastroenteritis were from Astroviridae and Caliciviridae families, with the detection of norovirus GIV and sapoviruses. Lower number of contigs associated to rotaviruses were detected. As expected, other viruses that may be associated to gastroenteritis but also produce persistent infections in the gut were identified including several Picornaviridae members (EV, parechoviruses, cardioviruses) and adenoviruses. According to the sequencing data, astroviruses, sapoviruses and NoV GIV should be added to the list of viral pathogens screened in routine clinical analysis.

scholarly journals Trends in Incidence of Norovirus-associated Acute Gastroenteritis in 4 Veterans Affairs Medical Center Populations in the United States, 2011–2015

2019 ◽  
Vol 70 (1) ◽  
pp. 40-48 ◽  
Author(s):  
Scott Grytdal ◽  
Hannah Browne ◽  
Nikail Collins ◽  
Blanca Vargas ◽  
Maria C Rodriguez-Barradas ◽  
...  
Keyword(s):  
Los Angeles ◽  
Acute Gastroenteritis ◽  
Medical Center ◽  
Seasonal Pattern ◽  
Adult Population ◽  
Diagnostic Testing ◽  
The United States ◽  
Incidence Rates ◽  
Veterans Affairs ◽  
Stool Specimens

Abstract Background Norovirus is an important cause of epidemic acute gastroenteritis (AGE), yet the burden of endemic disease in adults has not been well documented. We estimated the prevalence and incidence of outpatient and community-acquired inpatient norovirus AGE at 4 Veterans Affairs Medical Centers (VAMC) (Atlanta, Georgia; Bronx, New York; Houston, Texas; and Los Angeles, California) and examined trends over 4 surveillance years. Methods From November 2011 to September 2015, stool specimens collected within 7 days of AGE symptom onset for clinician-requested diagnostic testing were tested for norovirus, and positive samples were genotyped. Incidence was calculated by multiplying norovirus prevalence among tested specimens by AGE-coded outpatient encounters and inpatient discharges, and dividing by the number of unique patients served. Results Of 1603 stool specimens, 6% tested were positive for norovirus; GII.4 viruses (GII.4 New Orleans [17%] and GII.4 Sydney [47%]) were the most common genotypes. Overall prevalence and outpatient and inpatient community-acquired incidence followed a seasonal pattern, with higher median rates during November–April (9.2%, 376/100 000, and 45/100 000, respectively) compared to May–October (3.0%, 131/100 000, and 13/100 000, respectively). An alternate-year pattern was also detected, with highest peak prevalence and outpatient and inpatient community-acquired norovirus incidence rates in the first and third years of surveillance (14%–25%, 349–613/100 000, and 43–46/100 000, respectively). Conclusions This multiyear analysis of laboratory-confirmed AGE surveillance from 4 VAMCs demonstrates dynamic intra- and interannual variability in prevalence and incidence of outpatient and inpatient community-acquired norovirus in US Veterans, highlighting the burden of norovirus disease in this adult population.

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