Neonatal rotavirus infection in Belém, Northern Brazil: nosocomial transmission of a P[6] G2 strain

Ministério da Saúde. Fundação Nacional de Saúde. Instituto Evandro Chagas. Belém, PA, Brasil / University of Pará state. Belém, PA, Brazil.Ministério da Saúde. Fundação Nacional de Saúde. Instituto Evandro Chagas. Belém, PA, Brasil.Ministério da Saúde. Fundação Nacional de Saúde. Instituto Evandro Chagas. Belém, PA, Brasil.Ministério da Saúde. Fundação Nacional de Saúde. Instituto Evandro Chagas. Belém, PA, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Department of Virology. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Department of Virology. Rio de Janeiro, RJ, Brazil.A total of 614 fecal specimens were obtained during a survey for rotavirus infection conducted between May 1996 and May 1998 among 437 newborns admitted to special care nurseries at a public hospital in the urban area of Belém, Brazil. Routine stool samples were taken weekly from all babies up to the age of 28 days. Overall, 51 (11.7 per cent) of the neonates excreted rotaviruses while in hospital, of whom 42 (82.3 per cent) developed asymptomatic nosocomial infection; nosocomial infection was also proved in five of the nine patients with diarrhea. Three distinct RNA profiles were detected, of which one short electropherotyping pattern was far more frequent ( approximately 90 per cent of the strains). Using monoclonal antibody-based enzyme immunoassays, 32 (62.7 per cent) of the rotavirus-positive strains were classified as G2, and 1 (1.9 per cent) as mixed G1 and G2. A G serotype could not be assigned to 18 (35.3 per cent) of the isolates. A reverse transcription-polymerase chain reaction was used for determining the VP4 type-specificity of a subset of 28 rotavirus-positive samples. Characterization of the VP7-genotype specificity was also sought for 18 of these latter strains. Overall, P[6] and G2 genotypes were identified in 93 per cent and 94 per cent of tested samples respectively, with results being further confirmed by Southern hybridization. Although surveillance was conducted during a 25-month period, 50 (98 per cent) of 51 rotavirus isolates clustered between January and December 1997. The earliest [P6]G2 rotavirus infections were detected by late January 1997, involving two (13- and 14-day-old) babies admitted with acute diarrhea. Thereafter, strains bearing these genotype specificities were identified among five infants with hospital-acquired gastroenteritis, followed by 16 others who were infected asymptomatically. This is the first report from Brazil describing nosocomial transmission of P[6]G2 rotavirus strains among neonate