Hassan Zaraket1, Hadi Abou-El-Hassan2, Khalil Kreidieh3, Nadia Soudani4, Zainab Ali5, Moza Hammadi5, Lina Reslan6, Soha Ghanem5, Farah Hajar5, Adlette Inati7, Mariam Rajab8, Hassan Fakhouri9, Bassam Ghanem10, Ghassan Baasiri11, Nada M Melhem12, Ghassan Dbaibo13. 1. Department of Experimental Pathology, Immunology & Microbiology, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020 Beirut, Lebanon; Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020, Beirut, Lebanon. Electronic address: hz34@aub.edu.lb. 2. Department of Experimental Pathology, Immunology & Microbiology, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020 Beirut, Lebanon; Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020, Beirut, Lebanon. 3. Medical Laboratory Sciences Program, Faculty of Health Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020 Beirut, Lebanon. 4. Department of Experimental Pathology, Immunology & Microbiology, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020 Beirut, Lebanon; Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020, Beirut, Lebanon; Department of Biology, Faculty of Sciences, EDST, Lebanese University, Lebanon. 5. Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020, Beirut, Lebanon; Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, 1107-2020 Beirut, Lebanon. 6. Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020, Beirut, Lebanon; Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020 Beirut, Lebanon. 7. Department of Pediatrics, Nini Hospital, Tripoli, Lebanon. 8. Department of Pediatrics, Makassed General Hospital, Beirut, Lebanon. 9. Department of Pediatrics, Rafic Hariri University Hospital, Beirut, Lebanon. 10. Department of Pediatrics, Nabatieh Governmental Hospital, Nabatieh, Lebanon. 11. Department of Pediatrics, Hammoud Hospital, Saida, Lebanon. 12. Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020, Beirut, Lebanon; Medical Laboratory Sciences Program, Faculty of Health Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020 Beirut, Lebanon. Electronic address: melhemn@aub.edu.lb. 13. Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020, Beirut, Lebanon; Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, 1107-2020 Beirut, Lebanon; Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020 Beirut, Lebanon. Electronic address: gdbaibo@aub.edu.lb.
Abstract
PURPOSE: The aim of this study was to determine the incidence and genetic diversity of astrovirus (AstV) detected in children hospitalized for gastroenteritis (GE). METHODS: A multi-center, hospital-based surveillance study was conducted across Lebanon to investigate the incidence of AstV among diarrheal hospitalizations. Viral RNA was extracted from stool samples collected between 2011 and 2013 from children, below the age of 5years, hospitalized for GE at six medical centers across Lebanon. Demographic and clinical data were collected and analyzed. RNA of eligible samples (n=739) was screened by two AstV-specific PCR assays followed by genotype-specific PCR. Sanger sequencing and phylogenetic analysis were performed for genotypic characterization. RESULTS: Overall, 5.5% (41/739) of rotavirus-negative stool samples collected from hospitalized children <5years old tested positive for AstV infection. AstV infections were detected all year long. Diarrhea, dehydration, vomiting and fever were the most common symptoms associated with AstV infections. Children aged 48-59months had the highest incidence of AstV. Using the Vesikari Scoring System to assess clinical severity, 85.4% of children with AstV had a score>11, indicating severe GE. Genotype-specific PCR identified 22 classical and 4 MLB-like AstV specimens. Further sequencing and phylogenetic analysis of orf1b and orf2 genes revealed that AstV classical 1-3, 5, 6, and 8, MLB-1, VA-1 and -2 genotypes circulated in Lebanon. Recombination between classical AstV strains was detected in several cases as evident by the lack of congruency in the tree topologies of the orf1b and orf2. Two cases of mixed infections between classical and non-classical genotypic strains were recorded. CONCLUSION: High genetic diversity was detected among AstVs in Lebanon. AstVs are associated with 5.5% of non-rotavirus GE-associated hospitalizations in children under five years in Lebanon.
PURPOSE: The aim of this study was to determine the incidence and genetic diversity of astrovirus (AstV) detected in children hospitalized for gastroenteritis (GE). METHODS: A multi-center, hospital-based surveillance study was conducted across Lebanon to investigate the incidence of AstV among diarrheal hospitalizations. Viral RNA was extracted from stool samples collected between 2011 and 2013 from children, below the age of 5years, hospitalized for GE at six medical centers across Lebanon. Demographic and clinical data were collected and analyzed. RNA of eligible samples (n=739) was screened by two AstV-specific PCR assays followed by genotype-specific PCR. Sanger sequencing and phylogenetic analysis were performed for genotypic characterization. RESULTS: Overall, 5.5% (41/739) of rotavirus-negative stool samples collected from hospitalized children <5years old tested positive for AstV infection. AstV infections were detected all year long. Diarrhea, dehydration, vomiting and fever were the most common symptoms associated with AstV infections. Children aged 48-59months had the highest incidence of AstV. Using the Vesikari Scoring System to assess clinical severity, 85.4% of children with AstV had a score>11, indicating severe GE. Genotype-specific PCR identified 22 classical and 4 MLB-like AstV specimens. Further sequencing and phylogenetic analysis of orf1b and orf2 genes revealed that AstV classical 1-3, 5, 6, and 8, MLB-1, VA-1 and -2 genotypes circulated in Lebanon. Recombination between classical AstV strains was detected in several cases as evident by the lack of congruency in the tree topologies of the orf1b and orf2. Two cases of mixed infections between classical and non-classical genotypic strains were recorded. CONCLUSION: High genetic diversity was detected among AstVs in Lebanon. AstVs are associated with 5.5% of non-rotavirus GE-associated hospitalizations in children under five years in Lebanon.
Authors: Ana C Alcalá; Kriss Pérez; Ruth Blanco; Rosabel González; Juan E Ludert; Ferdinando Liprandi; Esmeralda Vizzi Journal: Gut Pathog Date: 2018-02-22 Impact factor: 4.181