Systemic illness signs such as feeding difficulty and neutropenia are specific for preterm infants with rotavirus infections. G4P[6] was exclusive, regardless of preterm birth or locations of infections. This study might be helpful in developing policies for management and prevention of rotavirus infections in NICUs.

One hundred forty-six fecal specimens collected between 2007 and 2008 from infants with acute gastroenteritis were screened for rotavirus by ELISA with VP6-specific antibody. One hundred twenty-three of the samples (84.2%) were confirmed to be positive for group A rotavirus (community-acquired, n = 90 [73.2%] and nosocomial, n = 33 [26.8%]), and were typed subsequently using RT-PCR and sequence analysis methods. Determination of G- and P-type combinations showed that G4P[6] (78.9%) was the most common strain, followed by G3P[8] (7.3%), G1P[8] (6.5%), G2P[4] (0.8%), G2P[6] (0.8%), G1P[6] (0.8%), and G9P[8] (0.8%) strains. Of the 97 G4P[6] strains, 62 (63.8%) were responsible for community-acquired cases and 35 (36.1%) were hospital-acquired cases. Phylogenetic analysis of the VP7 gene from the G4P[6] strains revealed that both the community-acquired and nosocomial strains were segregated to the human rotaviruses circulating world-wide, including the prototype vaccinal strain, ST3, which constituted a novel sublineage in lineage 1. Owing to the recent emergence of G4P[6] rotaviruses within the hospital, as well as in the community, the findings from this study are important since they provide new information concerning the community and nosocomial spread of rotaviruses.

Ninety-seven fecal specimens collected from children with acute gastroenteritis between 2007 and 2008 that were found to be negative for group A rotavirus in prescreening by ELISA with VP6-specific antibody were re-screened for viruses by reverse transcription (RT)-PCR. Forty (41.2%) samples were found to be positive for virus by RT-PCR; of these, norovirus (32.5%, n = 13) and rotavirus (32.5%, n = 13) were the most common, followed by astrovirus (5.0%, n = 2) and enterovirus (2.5%, n = 1). Co-infection was found in 11 (27.5%) samples. Phylogenetic analyses of the ORF2 nucleotide sequences of 21 norovirus strains showed that 19 (90.5%) belonged to the genogroup GII genotype 4 and two (9.5%) belonged to genogroup GI genotype 4. The GII.4 strains demonstrated high sequence homology and were closely related to new 2006b variants observed in Europe, China, Hong Kong, and Japan in 2006. This study provides new information concerning the recent global epidemic of 2006b strains.