Investigation of hospital‐acquired rotavirus gastroenteritis using RNA electrophoresis

Abstract

Rotavirus is a common cause of diarrhoea both in the community and in the hospital. Because of this, it may be difficult to determine whether crossinfection has occurred in the hospital, an important finding as review of hygienic techniques and ward closure may be indicated. We therefore investigated the use of Polyacrylamide gel electrophoresis (PAGE) of the rotavirus RNA genome as a means of distinguishing between rotavirus strains in order to assess its role in the evaluation of apparent hospital-acquired rotavirus diarrhoea. Suspected examples of hospital-acquired rotavirus gastroenteritis were studied on an infectious diseases ward and a general infant ward. PAGE analysis demonstrated that crossinfection had not occurred on the infectious diseases ward, even though this was indicated clinically; a single source outbreak involving 11 patients was confirmed on the general infant ward, as all cases showed an identical rotavirus electropherotype. Following ward closure an endemic rotavirus electropherotype was detected, which affected 17 patients over a 3-month period. Electrophoresis of rotavirus RNA is a useful and practical technique in the analysis of hospital-acquired gastroenteritis and can indicate appropriate clinical action.

Rotavirus Disease and Its Prevention in Infants and Children

“…20 Clinical infection occurs in adults with exposure to as little as 10 4 or 10 5 particles. 27 Most infections result from contact with infected persons, primarily by fecal to oral route. 12 Transmission can occur for 2 days before symptomatic gastroenteritis and for nearly 2 weeks after clinical illness is apparent.…”

Use of ward closure to control outbreaks among hospitalized patients in acute care settings: a systematic review

“…We identified 17 studies [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] on outbreaks involving C. difficile, norovirus, rotavirus, Salmonella panama, small round structured virus, or small round structured virus and small round featureless virus. The primary mode of transmission for all these pathogens is direct person-to-person contact and indirect contact with contaminated surfaces [20].…”

“…The definition of ward closure varied across the studies, and ward closure lasted between 3 days and 1 month among the studies that reported length of closure. Six studies defined ward closure as prohibiting new admissions to the affected clinical area (i.e., unit/ward/bay) [21][22][23][24][25][26]. Widdowson and colleagues reported on a study that utilized a phased approach, first halting new admissions and discharging all cases, then halting all admissions and discharging all patients from the area [27].…”

“…Of nine studies that reported achieving outbreak containment, six attributed it to all the measures used [21,25,26,28,31,33], two studies attributed it to multiple, but not all the measures used [27,37], and one study did not specify which measures contributed to the outcome [36]. In two studies, the reduced number of new cases of colonization and infection was attributed to all the measures used [30,32].…”

Paediatric gastroenterology 1966–2000

“…Sadly this technique was not available universally, but at QEHC it was a vital diagnostic technique because of the clinical frequency of acute gastroenteritis in the local population of children from East London. 22 The most dramatic advances for accurate diagnosis and clinical research concerning diseases of the small intestine, however, came from the widespread use of small intestinal suction biopsy using variations of the paediatric Crosby capsule. This transformed the accurate diagnosis and understanding of small intestinal diseases.…”