Abstract
While rotavirus vaccine programs effectively protect against severe rotavirus gastroenteritis, rotavirus vaccine strains have been identified in the stool of vaccinated children and their close contacts suffering from acute gastroenteritis. The prevalence of vaccine strains, the emergence of vaccine-derived strains, and their role in acute gastroenteritis are not well studied. We developed a locked nucleic acid reverse transcription real-time PCR assay (LNA-RTqPCR) to detect the monovalent rotavirus vaccine (RV1) Rotarix nonstructural protein 2 (NSP2) in children with acute gastroenteritis and healthy controls, and validated it using sequence-confirmed RV1 strains. The association between RV1-derived strains and gastroenteritis was determined using logistic regression. The new assay exhibited 100% (95% CI 91.7%, 100%) diagnostic sensitivity and 99.4% (95% CI 96.2%, 100%) diagnostic specificity, with a detection limit of 9.86 copies/reaction and qPCR efficiency of 99.7%. Using this assay, we identified the presence of RV1-derived NSP2 sequences in 7.7% of rotavirus gastroenteritis cases and 98.6% of rotavirus-positive healthy children (94.4% had previously received the RV1). Among gastroenteritis cases, those whose stool contained RV1-derived strains had milder gastroenteritis symptoms compared to that of natural rotavirus infections. We observed no significant association between RV1-derived strains and gastroenteritis (odds ratio [OR] 0.98; 95% CI 0.60, 1.72). Our study demonstrated that the new assay is suitable for monitoring RV1-derived rotavirus strain circulation and that the RV1-derived strains are not associated with development of gastroenteritis symptoms.
| Original language | English (US) |
|---|---|
| Article number | e01154-21 |
| Journal | Journal of clinical microbiology |
| Volume | 59 |
| Issue number | 11 |
| DOIs | |
| State | Published - Nov 2021 |
Bibliographical note
Funding Information:We thank the children and their families for participating in this study. We gratefully acknowledge all APPETITE investigators, study nurses, and staff members for contributing to this study. This work was supported by the Alberta Provincial Pediatric EnTeric Infection TEam (APPETITE), which is funded by a grant from the Alberta Innovates-Health Solutions Team Collaborative Innovation Opportunity. APPETITE is also supported by the Alberta Children’s Hospital Research Institute (Calgary, Alberta) and the Women and Children’s Partnership Award Health Research Institute (Edmonton, Alberta). S. B. Freedman is supported by the Alberta Children’s Hospital Foundation Professorship in Child Health and Wellness. The Pediatric Emergency Medicine Research Associate Program (PEMRAP) is supported by a grant from the Alberta Children’s Hospital Foundation. In-kind support to enable the conduct of this study is provided by Calgary Laboratory Services, ProvLab Alberta, Luminex Corporation, and Copan Italia.
Funding Information:
This work was supported by the Alberta Provincial Pediatric EnTeric Infection TEam (APPETITE), which is funded by a grant from the Alberta Innovates-Health Solutions Team Collaborative Innovation Opportunity. APPETITE is also supported by the Alberta Children’s Hospital Research Institute (Calgary, Alberta) and the Women and Children’s Partnership Award Health Research Institute (Edmonton, Alberta). S. B. Freedman is supported by the Alberta Children’s Hospital Foundation Professorship in Child Health and Wellness. The Pediatric Emergency Medicine Research Associate Program (PEMRAP) is supported by a grant from the Alberta Children’s Hospital Foundation. In-kind support to enable the conduct of this study is provided by Calgary Laboratory Services, ProvLab Alberta, Luminex Corporation, and Copan Italia.
Publisher Copyright:
Copyright © 2021, American Society for Microbiology. All Rights Reserved.
Keywords
- Rotarix
- children
- monovalent rotavirus vaccine
- reverse transcription real-time PCR
- rotavirus gastroenteritis
- vaccine safety
- vaccine shedding and transmission
