title: Apparently non-specific results found using a norovirus antigen immunoassay for fecal specimens from neonates.
abstract: Norovirus is increasingly recognized as a frequent cause of non-bacterial gastroenteritis. Despite a 10-fold increase in the number of cases reported following the availability of enzyme immunoassays, there are no reports yet from preterm neonates. We report on a sudden clustering of antigen-positive enzyme immuno assays results in a level III neonatal intensive care unit, involving 22 of 43 infants screened. Although antigen-positive samples were significantly associated with bloody stools (P<0.001) and gastric residues (P<0.02), norovirus infection could not be confirmed by reverse-transcriptase polymerase chain reaction or electron microscopy. We question the validity of the so called norovirus-specific antigen assays and warn against overreacting to positive enzyme immunoassays results without reverse-transcriptase polymerase chain reaction confirmation especially in the neonatal setting.
authors.affiliation: Department of Neonatology, University Children's Hospital, Tuebingen, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Wiechers
authors.forename: A L
authors.initials: AL
authors.lastname: Bissinger
authors.forename: K
authors.initials: K
authors.lastname: Hamprecht
authors.forename: P
authors.initials: P
authors.lastname: Kimmig
authors.forename: G
authors.initials: G
authors.lastname: Jahn
authors.forename: C F
authors.initials: CF
authors.lastname: Poets
mesh_terms: D017250:Caliciviridae Infections / Q000175:diagnosis*; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods / Q000592:standards*; D005189:False Positive Reactions; D005243:Feces / Q000821:virology*; D005759:Gastroenteritis / Q000821:virology*; D005858:Germany; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D015931:Intensive Care, Neonatal; D029322:Norovirus / Q000302:isolation & purification*; D011933:Reagent Kits, Diagnostic / Q000821:virology; D020133:Reverse Transcriptase Polymerase Chain Reaction
chemical_list: D011933:Reagent Kits, Diagnostic