title: Rotavirus Gastroenteritis in a Neonatal Unit of a Greek Tertiary Hospital: Clinical Characteristics and Genotypes.
abstract: BACKGROUND
  Rotavirus (RV) infection in neonatal age can be mild or even asymptomatic. Several studies have reported that RV is responsible for 31%-87% of pediatric nosocomial diarrhea and causes gastroenteritis outbreaks in pediatric and neonatal units.
  
  
  OBJECTIVE
  Study clinical characteristics, genotypes and risk factors of RV infection in neonatal age.
  
  
  METHODS
  A prospective study was conducted from April 2009 till April 2013 in the neonatal special care unit of the largest tertiary pediatric hospital of Greece. Fecal samples and epidemiological data were collected from each neonate with gastrointestinal symptoms. RV antigen was detected with a rapid immunochromatography test. RV positive samples were further genotyped with RT PCR and sequencing using specific VP7 and VP4 primers.
  
  
  RESULTS
  Positive for RV were 126/415 samples (30.4%). Mean age of onset was 18 days. Seventy four cases (58%) were hospital acquired. Seasonality of RV infection did not differ significantly throughout the year with the exception of 4 outbreaks. Genotypes found during the study period were G4P[8] (58.7%), G1P[8] (14.7%), G12P[8] (9.3%), G3P[8] (9.3%), G12P[6] (5.3%), G9P[8] (1.3%) and G2P[4] (1.3%). RV cases presented with: diarrhea (81%), vomiting (26.2%), fever (34.9%), dehydration (28.6%), feeding intolerance (39.7%), weight loss (54%), whilst 19% of cases were asymptomatic. Comparing community with hospital acquired cases differences in clinical manifestations were found.
  
  
  CONCLUSIONS
  Significant incidence of nosocomially transmitted RV infection in neonatal age including asymptomatic illness exists. Genotypes causing nosocomial outbreaks are not different from community strains. Circulating vaccines can be effective in prevention of nosocomial RV infection through herd immunity.
authors.affiliation: First Department of Pediatrics, Athens University, "Aghia Sophia" Children's Hospital, Athens, Greece.
authors.forename: Dimitra
authors.initials: D
authors.lastname: Koukou
authors.affiliation: First Department of Pediatrics, Athens University, "Aghia Sophia" Children's Hospital, Athens, Greece.
authors.forename: Panagiota
authors.initials: P
authors.lastname: Chatzichristou
authors.affiliation: Vaccine Unit, VIANEX/Sanofi Pasteur MSD, Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Trimis
authors.affiliation: First Department of Pediatrics, Athens University, "Aghia Sophia" Children's Hospital, Athens, Greece.
authors.forename: Tania
authors.initials: T
authors.lastname: Siahanidou
authors.affiliation: First Department of Pediatrics, Athens University, "Aghia Sophia" Children's Hospital, Athens, Greece.
authors.forename: Anna-Venetia
authors.initials: AV
authors.lastname: Skiathitou
authors.affiliation: Department of Microbiology, "Aghia Sophia" Children's Hospital, Athens, Greece.
authors.forename: Emmanouil I
authors.initials: EI
authors.lastname: Koutouzis
authors.affiliation: Department of Pediatrics, University of Thessaly, General University Hospital of Larissa, Larissa, Greece.
authors.forename: George A
authors.initials: GA
authors.lastname: Syrogiannopoulos
authors.affiliation: First Department of Pediatrics, Athens University, "Aghia Sophia" Children's Hospital, Athens, Greece.
authors.forename: Athanasia
authors.initials: A
authors.lastname: Lourida
authors.affiliation: First Department of Pediatrics, Athens University, "Aghia Sophia" Children's Hospital, Athens, Greece.
authors.forename: Athanasios G
authors.initials: AG
authors.lastname: Michos
authors.affiliation: First Department of Pediatrics, Athens University, "Aghia Sophia" Children's Hospital, Athens, Greece.
authors.forename: Vassiliki P
authors.initials: VP
authors.lastname: Syriopoulou
mesh_terms: D017714:Community-Acquired Infections; D003428:Cross Infection; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology*; D005838:Genotype; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012401:Rotavirus / Q000235:genetics*; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000821:virology*; D012621:Seasons; D062606:Tertiary Care Centers