Use of a Heminested Reverse Transcriptase PCR Assay for Detection of Astrovirus in Environmental Swabs from an Outbreak of Gastroenteritis in a Pediatric Primary Immunodeficiency Unit

Abstract

An outbreak of astrovirus gastroenteritis occurred in the Primary Immunodeficiency Unit at Newcastle General Hospital in March 2004. Environmental swabbing of the unit was undertaken after the outbreak, with multiple sites swabbed pre- and postcleaning. Astroviruses were detected in four environmental swabs and from two patient fecal samples using heminested reverse transcriptase PCR. An astrovirus genotype 3 strain was identified in both environmental swabs and fecal specimens and was the strain identified as being responsible for the outbreak. Environmental transmission of the virus was thought to have occurred by contamination of a syringe pump outside the laminar-flow curtain of a patient who was admitted with astrovirus gastroenteritis. This was subsequently transmitted to a cubicle next door and to a television/games console in a parents' room in the ward. Environmental monitoring of surfaces/equipment, using PCR assays for gastroenteric viruses in hospital situations where infection can give rise to serious clinical complications, may have a role in controlling and monitoring cleaning and the subsequent prevention of nosocomial transmission of gastroenteritis.

Novel human astroviruses: challenges for developing countries

“…In this study, astroviruses were detected from four environmental swabs and two patient faecal samples using heminested reverse transcription and PCR. HAstV-3 genotypes were detected in environmental swabs and faecal specimens and these strains were responsible for the outbreak [13]. Astrovirus infection was reported from 335 infants with diarrhoea in Wuhan, China.…”

Environmental Monitoring for Gastroenteric Viruses in a Pediatric Primary Immunodeficiency Unit

“…The environmental swabs were taken approximately every 2 weeks for 6 months. Environmental swabs were collected from sites by methods previously described (14). The first batch of swabs was collected at the time of an AsV outbreak (14).…”

“…There have been few reports of environmental contamination with AsV (14), although several groups have examined the prevalence of AsV in hospitalized children with gastroenteritis (18,27,28). Cubitt et al monitored an outbreak of AsV gastroenteritis in a pediatric bone marrow transplant unit (7), using three different assays, including reverse transcriptase PCR, to examine fecal samples from patients.…”

“…This study was undertaken following an outbreak of AsV gastroenteritis that occurred in a pediatric primary immunodeficiency unit (PPIU) in March 2004 and in which environmental contamination with AsV was detected (14).…”

Molecular characterization of viruses associated with gastrointestinal infection in HIV-positive patients

“…Several viruses have been implicated of producing enteric disorders in those patients such as cytomegalovirus (CMV), herpes simplex virus (HSV), adenovirus (AdV), norovirus (NoV), astrovirus (AstV) and rotavirus (RV). 2,[4][5][6][7] However, except for CMV, which is an established etiological agent of gastrointestinal disease in patients with HIV the role of other viruses remains unclear. We sought to determine the frequency of viral gastrointestinal infections among Brazilian HIV-infected patients with diarrhea.…”