Astrovirus infection in hospitalized children: Molecular, clinical and epidemiological features

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Enteric adenovirus (AdV), sapovirus (SaV), and human astrovirus (HAstV) are important pathogens involved in the gastroenteritis etiology. In this study, a total of 219 fecal samples and sera were collected from children hospitalized for acute gastroenteritis (AGE) in two large pediatric hospitals in Belém, from March 2012 to April 2015. The samples were analyzed by polymerase chain reaction (PCR) for AdV and HAstV (astrovirus) detection, and Nested-PCR and qPCR for SaV detection. AdV was detected in 50.2% (110/219) of the cases, with 42.7% (47/110) being sequenced and classified as: species F (63.9% - 30/47), A (4.2% - 2/47), B (6.4% - 3/47), C (17.1% - 8/47), D (4.2% - 2/47), and E (4.2% - 2/47). Of the 110 AdV-positive feces samples, 80 paired sera presented sufficient amounts and were also tested for this virus, of which 51 (63.7%) showed positive results and 26 (70.3%) pairs (feces plus sera) presented concordant results after sequencing being classified as: species F (21/26; 80.8%), A (1/26; 3.8%), B (1/26; 3.8%), and C (3/26; 11.5%). Overall, HAstV rate in the feces samples was 1.8% (4/219), including both HAstV-1a (2/4; 50%) and HAstV-2c (2/4; 50%). SaV was detected in 4.6% (10/219) of the fecal samples, out of which 50% (5/10) of the positive samples were characterized into the genogroups GI.1 (1), GI.2 (2), and GII.4 (2). These findings highlighted the important contributions of AdV, HAstV, and SaV in the enteric virus spectrum in our region and showed the high genetic diversity of AdV. In addition, it demonstrated for the first time in Brazil, the circulation of AdV in the serum of hospitalized children with AGE.

Section: Discussionsupporting

confidence: 68%

“…GI.2 was identified in two samples in our study. The GI.2 genotype is strongly associated with outbreaks and sporadic cases of AGE worldwide …”

Section: Discussionmentioning

confidence: 99%

Detection and genotyping of enteric viruses in hospitalized children with acute gastroenteritis in Belém, Brazil: Occurrence of adenovirus viremia by species F, types 40/41

Portal

Reymão

Neto

et al. 2018

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“…HAstV‐1 is still the predominant strain worldwide . The lineage −1a was found in Belém involving severe cases of AGE for 18 years, including hospitalized children . HAstV‐2 has been classified into four lineages (2a, 2b, 2c, and 2d), with lineage −2c already being related with AGE in children, and one outbreak involving Indians in the Maxakali Reserve, located in the State of Minas Gerais in the Southeast region of Brazil …”

Section: Discussionmentioning

confidence: 99%

“…In children living in Belém, also in the Amazon Region, HAstV circulated for 18 years (1982‐2000) as an important agent of infantile gastroenteritis . Recently, this virus was described in hospitalized children of Belém in the period from 2008 to 2011 …”

Section: Introductionmentioning

confidence: 99%

Epidemiological and molecular investigation of norovirus and astrovirus infections in Rio Branco, Acre, Northern Brazil: A retrospective study

Bitencurt

Siqueira

Medeiros

et al. 2019

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Norovirus (NoV) is a major cause of nonbacterial acute gastroenteritis (AGE) outbreaks worldwide, with infections reported in semiclosed environments, particularly in hospitals and nursing homes. Astrovirus (HAstV) is prevalent worldwide, especially in developing countries. We aimed to determine the prevalence, spatial distribution, and genetic diversity of NoV and HAstV in children under 5 years of age in Rio Branco city, Acre State, Amazon Region, Brazil. Stool samples from children with (n = 240) and without (n = 248) AGE were collected from January to December 2012 from seven neighborhoods. The overall NoV prevalence was 12.3% (60 of 488); representing 15.8% (38 of 240) of the symptomatic samples and 8.9% (22 of 248) of the controls. HAstVs infection was observed in 4.7% (23 of 488) of the samples tested, 6.2% (15 of 240) of AGE cases, and 2.4% (6 of 248) of the controls (plus two without information about feces consistency). Infections were found in all age groups with higher frequency in children less than two years of age, for both viruses. NoV was detected in all neighborhoods, with a higher concentration in the fourth (30%; 18 of 60). NoV nucleotide sequencing performed in 86.7% (52 of 60) of the positive samples showed the circulation of the strains GII.4 (57.7%; 30 of 52), GIIPe/GII.4 (19.2%; 10 of 52), GII.7, GII.Pg/GII.1, and GII.Pc (3.8%; 2 of 52 for each), GII.6 and GII.Pg (1.9%; 1 of 52 for each), and GI.3 (7.7%; 4 of 52). Three GII.4 variants were detected: Den Haag_2006b (n = 1), New Orleans_2009 (n = 1), and Sydney_2012 (n = 14). HAstV types HAstV‐1a (81.8%; 9 of 11) and HAstV‐2c (18.2%; 2 of 11) were observed in the 47.8% (11 of 23) of characterized samples. This is the first data obtained in Acre State regarding the prevalence of these viruses and provides epidemiological and molecular information for a better understanding of their role among children with and without AGE.

“…Classical HAstV (serotypes 1‐8) are phylogenetically distant from novel HAstV (namely MLB and VA) with amino acid identities being as low as 23% to a maximum of 54.5% depending on the open reading frames 1. Although classical HAstV are a leading cause of viral gastroenteritis, especially in children, elderly, and immunocompromised patients,2, 3, 4 the clinical manifestations of novel HAstV have not been fully characterized 5, 6, 7, 8. The spectrum of human diseases for classical and novel HAstV is not restricted to the gastrointestinal tract: both have been reported as causal agents of central nervous system infections 1.…”

Section: Introductionmentioning

confidence: 99%

Novel human astroviruses in pediatric respiratory samples: A one‐year survey in a Swiss tertiary care hospital

Cordey

Zanella

Wagner

et al. 2018

Although classical human astroviruses (HAstV) are known to be a leading cause of viral gastroenteritis, the pathogenesis and clinical manifestations of novel HAstV remain largely unknown. There is mounting evidence that, in contrast to classical astroviruses, novel HAstV exhibit tropism for the upper respiratory tract. This one‐year period prevalence screened all available clinical nasopharyngeal swab samples collected from pediatric patients aged ≤5 years for novel and classical HAstV using real‐time reverse transcription polymerase chain reaction. A total of 205 samples were tested; two novel HAstV cases were detected for a prevalence of 1.3%, with viral loads suggesting active upper respiratory tract replication. No classical HAstV was detected.