title: Distribution of rotavirus genotypes causing nosocomial and community-acquired acute gastroenteritis at the Children's Hospital of Philadelphia in the new rotavirus vaccine era.
abstract: BACKGROUND
  Introduction of rotavirus vaccines in the United States beginning in 2006 led to a rapid decline in the frequency of acute rotavirus gastroenteritis necessitating medical attention. We examined whether serotype replacement was occurring as a result of vaccine use.
  
  
  METHODS
  Children with gastroenteritis presenting to CHOP have been tested for rotavirus antigen in the stool. Commencing with the 1999-2000 season, positive specimens were genotyped to establish the G (VP7) and P (VP4) type.
  
  
  RESULTS
  In 2009-2010, 4 hospital-acquired and 18 community-acquired cases of rotavirus gastroenteritis were identified at CHOP. For the third consecutive full season since the introduction of rotavirus vaccines, the proportion of annual G3 cases was higher than in the prevaccine era. Although G3 strains caused 50% of the community cases in 2009-10, the absolute number of G3 cases actually dropped from 15 in 2007-08 to 8 and 9 in the 2008-09 and 2009-10 seasons, respectively. P[8] accounted for > 90% of cases seen at CHOP in each of the last 3 seasons, including 20/22 (91%) cases during the 2009-10 season.
  
  
  CONCLUSIONS
  Findings to date provide suggestive but still inconclusive evidence for vaccine-driven serotype replacement. Given the increased proportion of G3 cases in the new vaccine era despite the overall marked reduction in rotavirus gastroenteritis, continued surveillance is prudent.
authors: The Children's Hospital of Philadelphia (CHOP), Philadelphia, PA, USA.
authors: H Fred
authors: HF
authors: Clark
authors: Diane
authors: D
authors: Lawley
authors: Daniel
authors: D
authors: DiStefano
authors: Jelle
authors: J
authors: Matthijnssens
authors: Mark J
authors: MJ
authors: Dinubile
mesh_terms: D000293:Adolescent; D000956:Antigens, Viral / Q000032:analysis; D036022:Capsid Proteins / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000821:virology; D003428:Cross Infection / Q000453:epidemiology* / Q000821:virology; D058872:Epidemics; D005243:Feces / Q000821:virology; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology; D005838:Genotype; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D015143:Philadelphia / Q000453:epidemiology; D012401:Rotavirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000821:virology; D022243:Rotavirus Vaccines / Q000008:administration & dosage* / Q000276:immunology
chemical_list: D000956:Antigens, Viral; D036022:Capsid Proteins; D022243:Rotavirus Vaccines; C060339:VP4 protein, Rotavirus; C050779:VP7 protein, Rotavirus