ROTAVIRUSES AS A CAUSE OF NOSOCOMIAL, INFANTILE DIARRHEA IN NORTHERN BRAZIL - PILOT-STUDY

Faecal samples were obtained from 190 children, aged 0 to 5 years, adm itted to a public hospital in Belem, Para, Brazil. These patients were placed in a pediatric ward with 40 beds distributed in six rooms. Cas es were classified into three groups: (a) nosocomial: children who dev eloped gastroenteritis 72 hr or later after admission; (b) community-a cquired: patients admitted either,vith diarrhoea or who had diarrhoea within 72 hr following admission; (c) non-diarrhoeic: those children , who had no diarrhoea three days before and three days after collection of formed faecal sample. Specimens were routinely processed for the p resence of rotaviruses, bacteria and parasites. Rotaviruses were detec ted through enzyme-linked immunosorbent assay (ELISA) and subsequently serotyped electrophoretyped. Rotaviruses were the most prevalent ente ropathogens among nosocomial cases, accounting for 39%(9/23) of diarrh oeal episodes; on the other hand, rotaviruses occurred in 8.3% (11/133 ) and 9% (3/34) of community-acquired and non-diarrhoeic categories, r espectively. Mixed infections involving rotavirus and Giardia intestin alis and rotavirus plus G. intestinalis and Entamoeba histolytica were detected infrequencies of 8.6 and 4.3%, respectively, in the nosocomi al group. The absence of bacterial pathogens in this category, and the unusual low prevalence of these agents in the other two groups may re flect the early and routine administration of antibiotics following ad mission to this hospital. Rotavirus serotype 2 prevailed over the othe r. types, accounting for 77.8% of isolates from nosocomial diarrhoeal episodes. In addition, at least five different genomic profiles could be observed, of which one displayed an unusual five-segment first RNA cluster Dehydration was recorded in all cases of hospital-acquired, ro tavirus-associated diarrhoea, whereas in only 57% of nosocomial cases of other aetiology. It was also noted that nosocomial, rotavirus-assoc iated diarrhoeal episodes occur earlier (7 days), following admission, if compared with those hospital-acquired cases of other aetiology (14 days).