A shift in circulating rotaviral genotypes among hospitalized neonates

Abstract

In neonates, rotavirus (RV) infection is generally nosocomial. The control of rotaviral infection within hospital settings is challenging due to prolonged shedding of the virus and contamination of the surrounding environment. There are few studies that have reported asymptomatic infection within neonates. In this study, neonates were screened for RV infection and possible clinical manifestations that may play a role in RV acquisition were analysed. Stool samples were collected from 523 hospitalized neonates admitted for > 48 h in a low-cost and higher-cost tertiary centre. RV antigen was screened using ELISA and the samples which tested positive were confirmed by semi-nested RT-PCR. RV was detected in 34% of participants and genotypes identified included G12P[11] (44.4%), G10 P[11] (42.6%), G10G12P[11] (10.1%) and G3P[8] (2.9%). ICU admissions were associated with higher viral shedding (p < 0.05). Hospitalization in the low-cost facility ICU was associated with higher RV acquisition risk (p < 0.05). RV was detected in higher rates (36.9%) among neonates with gastrointestinal manifestations. G10P[11] was the predominant genotype for several years (1988–2016) among neonates within India. The preponderance of an emerging G12P[11] genotype and heterotypic distribution was documented. RV surveillance is important to identify emerging strains and establish the road ahead in managing RV infection.

Increase in rotavirus prevalence with the emergence of genotype G9P[8] in replacement of genotype G12P[6] in Sabah, Malaysia

“…Fluctuations in the distribution of the predominant rotavirus genotypes have been reported worldwide [ 18 , 22 – 26 ]. These fluctuations may be driven by herd immunity, and the emergence of a particular genotype may reflect the presence of a sufficiently large population of susceptible children [ 22 ].…”

“…For G and P genotyping, multiplex PCR was performed using a master mix (Promega Corporation, Madison, WI, USA). Primers for the detection of the G1, G2, G3, G4, G8, G9, G10, and G12 genotypes were used as described previously [ 15 , 18 ]. For P genotyping, primers for the detection of P[4], P[6], P[8], P[9], P[10], and P[11] were used [ 17 , 18 ].…”

“…Primers for the detection of the G1, G2, G3, G4, G8, G9, G10, and G12 genotypes were used as described previously [ 15 , 18 ]. For P genotyping, primers for the detection of P[4], P[6], P[8], P[9], P[10], and P[11] were used [ 17 , 18 ]. The nucleotide sequences of the VP7 (1,062 bp) and VP8* (876 bp) regions of the VP4 gene were determined using a BigDye Terminator v3.1 Cycle Sequencing Kit (Applied Biosystems).…”

Neonatal microbiota-epithelial interactions that impact infection

“…Newborns are highly susceptible to enteric pathogens, particularly during the first year of life ( Liu et al, 2012 ; Lanata et al, 2013 ; Darmstadt et al, 2014 ; Miller et al, 2016 ). Most common enteric pathogens linked to neonatal morbidity and mortality include Enteropathogenic Escherichia coli (EPEC), Group B streptococci (GBS), Listeria monocytogenes, Salmonella , Rotavirus, and Cryptosporidium parasites ( Abba et al, 2009 ; Stoll et al, 2011 ; Pedersen et al, 2014 ; Bergin et al, 2015 ; Shane et al, 2017 ; Reju et al, 2022 ; Yoon et al, 2022 ). These pathogens can gain entry orally, invade the gastrointestinal (GI) tract, and lead to further blood or systemic infections in neonates.…”