RESEARCH ARTICLE


Molecular Study of Norovirus in Pediatric Patients with Gastroenteritis



Maysaa El Sayed Zaki1, *, Abdel-Rahaman Eid2, Amany Y. El Ashry1, Nashwa M. Al-Kasaby3
1 Clinical Pathology Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
2 Genetic Unit-Pediatric Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
3 Medical Microbiology and Immunology Department, Mansoura Faculty of Medicine, Medical Microbiology and Immunology Department, Mansoura Faculty of Medicine, Mansoura, Egypt Mansoura, Egypt


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Creative Commons License
© 2019 El Sayed Zaki et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Clinical Pathology Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt;
E-mail:may_s65@hotmail.com


Abstract

Aim:

The aim of the present study was to detect the prevalence of norovirus and genotypes determination by real-time PCR among children below 18 years as an etiology of acute gastroenteritis and to compare rapid detection of norovirus by Enzyme-Linked Immunoassay (ELISA) to virus detection by real-time PCR.

Methods:

The research was a cross-sectional study conducted on children below 18 years complaining of community-acquired acute gastroenteritis. A stool sample was subjected to direct-antigen detection by ELISA for norovirus and molecular study by real-time polymerase chain reaction.

Results:

The study included 200 children with acute gastroenteritis with a mean age of 6.7±3.8 years. Norovirus antigen was detected by EIA in 34.5% and by real-time PCR in 30.5% of studied children with genotype GII, the predominant detected genotype (80.97%). Both real-time PCR and antigen detection of norovirus were positive in 43 (70.5%) of the children and negative in 113(81.3%) of the studied children. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for antigen detection by ELISA were 70.5%, 81.3%, 62.3%, 86.3% and 78%, respectively. Comparison between patients positive for norovirus and those negative for norovirus by real-time PCR revealed non-significant difference as regards age, sex, the season of occurrence and residence.

Conclusion:

The present study highlights that norovirus prevalence is common among pediatric patients with gastroenteritis above 5 years with GII genotype as the prevalent genotype. There was a significant correlation between positive and negative results of antigen detection of norovirus by ELISA and detection of RNA of norovirus by real-time PCR in stool samples. However, the screening for norovirus by ELISA has limited sensitivity and needs to be associated with a molecular method for accurate diagnosis of sporadic cases of gastroenteritis.

Keywords: Norovirus, ELISA, Gastroenteritis, Children, Real-time PCR, GII genotype.