Sugata Ken, Hull Jennifer, Wang Houping, Foytich Kimberly, Moon Sung-Sil, Takahashi Yoshiyuki, Kojima Seiji, Yoshikawa Tetsushi, Jiang Baoming
Division of Viral Diseases, Centers for Disease Control and Prevention, CDC, Atlanta, GA, USA.
Department of Pediatrics, Fujita Health University, The Second Teaching Hospital, 3-6-10,Otobashi Nakagawaku Nagoya-shi, 454-8509 Aichi, Japan.
J Immunol Tech Infect Dis. 2017 Jan 14;6(1). doi: 10.4172/2329-9541.1000153.
Rotavirus (RV) is the most common cause of severe dehydrating diarrhoea in healthy infants and young children. The aims of this study were to investigate a RV outbreak in the pediatric hematology and oncology ward and to examine possible associations between immune status and RV infection.
Twenty-eight children (19 boys and 9 girls) who were hospitalized for treatment of hematological malignancy and solid organ tumor during the RV outbreak were enrolled in this study. Fourteen of the 28 patients developed RV gastroenteritis (GE) during the observation period. RV antigen and RV IgG and IgA were measured by enzyme-linked immunosorbent assays. RV G and P types were determined by reverse transcriptase-polymerase chain reaction.
Mean duration of RVGE in 14 patients was 13.9 days and mean severity score was 7.4. Two RV strains (G3P [8] and G2P [4]) were mainly circulating in the ward, which might result in the formation of a reassortant G2P [8] strain and mixed infection with G2+3P [8] in the immunocompromised patients. RV antigenemia was detected in 22 of the 28 patients (78.6%). RV-specific IgG titers in acute-phase sera of RVGE group were significantly lower than those in non-RVGE group (P=0.001). Mean age of the patients was significantly lower in RVGE group (5.5 ± 4.6 years) than non RVGE group (10.6 ± 4.5 years) (P=0.015).
Our data demonstrate that host factors including age, underlying diseases, and immune status may be associated with the susceptibility of RV infection in immunocompromised patients at the time of the nosocomial infection.
轮状病毒（RV）是健康婴幼儿严重脱水腹泻的最常见病因。本研究旨在调查儿科血液肿瘤病房的一次RV暴发，并探讨免疫状态与RV感染之间的可能关联。
本研究纳入了28名在RV暴发期间因血液系统恶性肿瘤和实体器官肿瘤住院治疗的儿童（19名男孩和9名女孩）。28例患者中有14例在观察期内发生了RV胃肠炎（GE）。采用酶联免疫吸附试验检测RV抗原、RV IgG和IgA。通过逆转录聚合酶链反应确定RV G和P型。
14例患者的RVGE平均病程为13.9天，平均严重程度评分为7.4。两种RV毒株（G3P[8]和G2P[4]）主要在病房传播，这可能导致免疫功能低下患者中形成重组G2P[8]毒株并发生G2+3P[8]混合感染。28例患者中有22例（78.6%）检测到RV抗原血症。RVGE组急性期血清中RV特异性IgG滴度显著低于非RVGE组（P=0.001）。RVGE组患者的平均年龄（5.5±4.6岁）显著低于非RVGE组（10.6±4.5岁）（P=0.015）。
我们的数据表明，包括年龄、基础疾病和免疫状态在内的宿主因素可能与免疫功能低下患者在医院感染时RV感染的易感性有关。
