Rotaviruses as a Cause of Nosocomial, Infantile Diarrhoea in Northern Brazil: Pilot Study

• Published in: Memórias do Instituto Oswaldo Cruz Vol. 90; no. 6; pp. 743 - 749
• Main Authors: Gusmão, R H, Mascarenhas, J D, Gabbay, Y B, Lins-Lainson, Z, Ramos, F L, Monteiro, T A, Valente, S A, Linhares, A C
• Format: Journal Article
• Language: English
• Published: Brazil Fundação Oswaldo Cruz, Fiocruz 01-12-1995; Instituto Oswaldo Cruz, Ministério da Saúde; Fundação Oswaldo Cruz (FIOCRUZ)
• Subjects: Brazil; Child, Preschool; Cross Infection - virology; Diarrhea, Infantile - virology; Feces - virology; Female; Genome, Viral; Humans; Infant; Infant, Newborn; infantile diarrhoea; Inpatients; Male; nosocomial; PARASITOLOGY; rotavirus; Rotavirus - genetics; rotavirus - nosocomial - infantile diarrhoea; Rotavirus Infections - complications; TROPICAL MEDICINE; Brazil; nosocomial; infantile diarrhoea; rotavirus
• ISSN: 1678-8060; 0074-0276; 0074-0276; 1678-8060
• DOI: 10.1590/S0074-02761995000600016

Faecal samples were obtained from 190 children, aged 0 to 5 years,
admitted to a public hospital in Belem, Para,Brazil. These patients
were placed in a pediatric ward with 40 beds distributed in six rooms.
Cases were classified into three groups: (a) nosocomial: children who
developed gastroenteritis 72 hr or later after admission; (b)
community-acquired: patients admitted either with diarrhoea or who had
diarrhoea within 72 hr following admission; (c) non-diarrhoeic: those
children who had no diarrhoea three days before and three days after
collection of formed faecal sample. Specimens were routinely processed
for the presence of rotaviruses, bacteria and parasites. Rotaviruses
were detected through enzyme-linked immunosorbent assay (ELISA)and
subsequently serotyped/electrophoretyped. Rotaviruseswere the most
prevalent enteropathogens among nosocomial cases, accounting for 39%
(9/23) of diarrhoeal episodes; on the other hand, rotaviruses occurred
in 8.3% (11/133) and 9% (3/34) of community-acquired and non-diarrhoeic
categories, respectively. Mixed infections involving rotavirus and
Giardia intestinalis and rotavirus plus G. intestinalis and Entamoeba
histolytica were detected in frequencies of 8.6 and 4.3%, respectively,
in the nosocomial group. The absence of bacterial pathogens in this
category, and the unusual low prevalence of these agents in the other
two groups may reflect the early and routine administration of
antibiotics following admission to this hospital. Rotavirus serotype 2
prevailed over the other types, accounting for 77.8% of isolates from
nosocomial diarrhoeal episodes. In addition, at least five different
genomic profiles could be observed, of which one displayed anunusual
five-segment first RNA cluster. Dehydration was recordedin all cases of
hospital-acquired, rotavirus-associated diarrhoea, whereas in only 57%
of nosocomial cases ofother aetiology. It was also noted that
nosocomial, rotavirus-associated diarrhoeal episodes occur earlier (7
days), following admission, if compared with those hospital-acquired
cases of other aetiology (14 days).