[Viral gastroenteritis. Application of a protocol for astrovirus detection in childhood gastroenteritis].
OBJECTIVE
Diagnosis of viral gastroenteritis is an important subject in clinical virology which is mainly determined by the availability of reagents in laboratories, such as in the case of astrovirus. The aim of this study was to estimate the increase in the diagnostic performance achieved after the incorporation of astrovirus search in the diagnosis protocol of acute viral gastroenteritis. We also analyzed the trend of infections in other more commonly searched virus, such as rotavirus and enteric adenovirus.


METHODS
Retrospective study during 20 years that included 12,980 stool samples processed for gastroenteritis virus diagnosis. Since 1997 an enzyme immunoassay for astrovirus has been applied to those samples that are negative for rotavirus and adenovirus. The study was divided in two periods (1986-1996 and 1997-2005, without and with astrovirus diagnosis) and the percentage of patients diagnosed in each period was compared. The trend of positive results as well as the percentage of positive results over all patients studied was modelled using the least squares method.


RESULTS
The percentages of positive patients for rotavirus, adenovirus and astrovirus were 10.3%, 2.3% and 6.0% respectively, and there were uncommon co-infections by rotavirus and adenovirus (0.2%). The protocol applied to the astrovirus diagnosis increased the diagnosis rate up to 16.8% of the studied cases. Significant statistical differences were observed between the 2 study periods. A quadratic growth was observed in the results of positive diagnosis of viral gastroenteritis during the study period.


CONCLUSIONS
The search of astrovirus in gastroenteritis cases by a selective protocol increased the diagnostic performance of gastrointestinal virus by 6%. In view of these results, it would be useful to implement astrovirus diagnosis in faeces with liquid or semi-liquid consistency when rotavirus and adenovirus detection is negative.
Ortiz de Lejarazu Leonardo
Raúl
R
Sección de Virología, Hospital Clínico Universitario de Valladolid, Valladolid, España. luquero@gmail.com
Luquero Alcalde
Francisco Javier
FJ
Eiros Bouza
José María
JM
Castrodeza Sanz
José Javier
JJ
Tenorio Abreu
Alberto
A
Tamames Gómez
Sonia
S
Gracia Ahufinger
Irene
I
Reguera Useros
Juan Ignacio
JI
D000260:Adenoviruses, Human / Q000302:isolation & purification; D019350:Astroviridae Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D002460:Cell Line; D002648:Child; D002675:Child, Preschool; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000821:virology*; D006801:Humans; D007124:Immunoenzyme Techniques; D007223:Infant; D008297:Male; D001257:Mamastrovirus / Q000302:isolation & purification*; D015995:Prevalence; D012189:Retrospective Studies; D012401:Rotavirus / Q000302:isolation & purification; D012680:Sensitivity and Specificity; D013030:Spain / Q000453:epidemiology; D013048:Specimen Handling; D014776:Virus Cultivation