1749. Clinical Characteristics and Genotypes of Rotavirus in Adults
Session: Poster Abstract Session: Viral Infections; Pathogenesis and Epidemiology
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Rotavirus Genotypes #40924.pdf (129.6 kB)
  • Background: Although well known as a pediatric pathogen, recent data suggest that rotavirus (RV) is also responsible for 3 – 18% of adult diarrhea particularly during Feb – May.  Several US retirement center RV outbreaks have identified G2P[4] strains.  Adult surveillance data correlating RV genotypes with patient characteristics are lacking.

    Methods: Stools during Feb – May 2006 – 2011 submitted for bacterial stool culture (BSC) at Northwestern Mem. Hosp., Chicago, were tested retrospectively for RV by EIA.  The 2006 BSC were only from inpatients (<72 hrs from admission), but subsequent years also included outpatient BSCs.  We excluded BSCs from subjects <18 yrs of age and duplicates.  Genotyping of the RV isolates was performed by RT-PCR. Clinical data were abstracted and compared with RV genotypes.

    Results: Of 4514 patients tested, 125 (2.8%) were RV positive. The median age was 47 (range 20 – 94), 52% were female, 60% white, 22% black, 7% Hispanic, and 11% other or unknown. Among 119 individuals with available data, immunocompromising conditions were present in 31% (active malignancy 12%, HIV 9%, stem cell or solid organ transplant 9%, were the most common). Among the 103 (82%) that could be at least partially genotyped, the predominant types included 40 G2P[4], 23 G1P[8], 15 G3P[8], and 10 G12P[6] isolates but marked variability in the predominant circulating type was observed each year. G2P[4] accounted for 30% of rotavirus in adults <60 years and 37% of rotavirus in those ≥60 years (p = 0.53).  G9P[4] was identified in 3/8 (37.5%) with documented travel (Mexico (2), India (1)) and in none without travel (p = 0.0002). Five of 23 G1P[8] isolates (24%) were identified from HIV-positive patients vs 4/80 (5%, p = 0.01) non-G1P[8] isolates.

    Conclusion: Adult patients hospitalized for RV frequently had immunocompromising conditions. G2P[4] did not occur more commonly in adults ≥60 years of age.  HIV was identified as a risk factor for G1P[8] while G9P[4] was associated with international travel. Of note, we observed substantial year-to-year variation in the most prevalent circulating RV genotype.

    Evan J. Anderson, MD1, Deanna Shippee, B.A.2, Bruce Larkin, BS2, Jacqueline E. Tate, PhD3, Melissa Davila, B.A.2, Melissa Weinrobe, B.A.2, Ben Katz, MD2,4, Gary Noskin, MD2, Andi L. Shane, MD, MPH, MSc5, Umesh D. Parashar, MBBS, MPH3 and Ram Yogev, MD4, (1)Pediatrics and Medicine, Emory University School of Medicine, Atlanta, GA, (2)Northwestern University Feinberg School of Medicine, Chicago, IL, (3)Centers for Disease Control and Prevention, Atlanta, GA, (4)Infectious Diseases, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL, (5)Division of Pediatric Infectious Diseases, Emory University School of Medicine, Atlanta, GA

    Disclosures:

    E. J. Anderson, Merck: Grant Investigator, Research grant

    D. Shippee, None

    B. Larkin, None

    J. E. Tate, None

    M. Davila, None

    M. Weinrobe, None

    B. Katz, None

    G. Noskin, None

    A. L. Shane, The Gerber Foundation: Grant Investigator, Research grant
    Medscape, LLC: Speaker's Bureau, Speaker honorarium

    U. D. Parashar, None

    R. Yogev, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.