Molecular Study of Norovirus in Pediatric Patients with Gastroenteritis

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 (ELIA) 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 ELIA 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 ELIA and

detection of RNA of norovirus by real-time PCR in stool samples. However, the screening for norovirus by ELIA has limited sensitivity and

needs

to be associated with a molecular method for accurate diagnosis of sporadic cases of gastroenteritis.