Department of Child Health, Soetomo Hospital, Airlangga University, Surabaya, Indonesia ; Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Surabaya, Indonesia.
Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan ; Department of Infection Control and Prevention, Kobe University Hospital, Kobe, Japan.
Gut Pathog. 2015 Feb 8;7:3. doi: 10.1186/s13099-015-0048-2. eCollection 2015.
Rotavirus infections are a major cause of diarrhea in children in both developed and developing countries. Rotavirus genetics, patient immunity, and environmental factors are thought to be related to the severity of acute diarrhea due to rotavirus in infants and young children. The objective of this study was to provide a correlation between rotavirus genotypes, clinical factors and degree of severity of acute diarrhea in children under 5 years old in Surabaya, Indonesia.
A cross-sectional study was conducted in children aged 1-60 months with acute diarrhea hospitalized in Soetomo Hospital, Surabaya, Indonesia from April to December 2013. Rotavirus in stool specimens was identified by ELISA and genotyping (G-type and P-type) using multiplex reverse transcription PCR. Severity was measured using the Ruuska and Vesikari scoring system. The clinical factors were investigated included patient's age (months), hydration, antibiotic administration, nutritional state, co-bacterial infection and co-viral infection.
A total of 88 children met the criteria; 80.7% were aged 6-24 months, watery diarrhea was the most common type (77.3%) and 73.6% of the subjects were co-infected with bacteria, of which pathogenic Escherichia coli was the most common (42.5%). The predominant VP7 genotyping (G-type) was G2 (31.8%) and that of VP4 genotyping (P-type) was P[4] (31.8%). The predominant rotavirus genotype was G2P[4] (19.3%); G1P[4] and G9P[4] were uncommon with a prevalence of 4.5%. There were significant differences between the common genotype and uncommon genotype with respect to the total severity score of diarrhea (p <0.05). G3, G4 and G9 were significantly correlated with severe diarrhea (p = 0.009) in multivariate analyses and with frequency of diarrhea (>10 times a day) (p = 0.045) in univariate analyses, but there was no significant correlation between P typing and severity of diarrhea. For combination genotyping of G and P, G2P[4] was significantly correlated with severe diarrhea in multivariate analyses (p = 0.029).
There is a correlation between rotavirus genotype and severity of acute diarrhea in children. Genotype G2P[4] has the highest prevalence. G3, G4, G9 and G2P[4] combination genotype were found to be associated with severe diarrhea.
轮状病毒感染是发达国家和发展中国家儿童腹泻的主要原因。轮状病毒的遗传学、患者的免疫力和环境因素被认为与婴幼儿轮状病毒急性腹泻的严重程度有关。本研究的目的是提供印度尼西亚泗水市 5 岁以下儿童轮状病毒基因型、临床因素与急性腹泻严重程度之间的相关性。
2013 年 4 月至 12 月，对印度尼西亚泗水苏托莫医院因急性腹泻住院的 1-60 月龄儿童进行了一项横断面研究。采用酶联免疫吸附试验（ELISA）和多重反转录 PCR 进行粪便标本的轮状病毒基因分型（G 型和 P 型）。采用 Ruuska 和 Vesikari 评分系统测量严重程度。调查的临床因素包括患者年龄（月）、水合作用、抗生素使用、营养状况、合并细菌感染和合并病毒感染。
共有 88 名儿童符合标准；80.7%的儿童年龄为 6-24 个月，水样腹泻是最常见的类型（77.3%），73.6%的儿童合并细菌感染，其中致病性大肠杆菌最常见（42.5%）。主要的 VP7 基因分型（G 型）为 G2（31.8%），主要的 VP4 基因分型（P 型）为 P[4]（31.8%）。主要的轮状病毒基因型为 G2P[4]（19.3%）；G1P[4]和 G9P[4]少见，发生率分别为 4.5%。常见基因型和少见基因型在腹泻总严重程度评分上有显著差异（p<0.05）。多元分析显示，G3、G4 和 G9 与严重腹泻显著相关（p=0.009），单因素分析显示，与腹泻频率（>10 次/天）显著相关（p=0.045），但 P 型与腹泻严重程度无显著相关性。对于 G 和 P 的组合基因分型，G2P[4]在多元分析中与严重腹泻显著相关（p=0.029）。
轮状病毒基因型与儿童急性腹泻的严重程度有关。基因型 G2P[4]的流行率最高。G3、G4、G9 和 G2P[4]组合基因型与严重腹泻相关。
