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Journal of Clinical Microbiology, June 2004, p. 2668-2674, Vol. 42, No. 6
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.6.2668-2674.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Etiology of Sporadic Cases of Pediatric Acute Gastroenteritis in Asturias, Spain, and Genotyping and Characterization of Norovirus Strains Involved

José Antonio Boga,1* Santiago Melón,1 Inés Nicieza,2 Isabel de Diego,1 Mercedes Villar,1 Francisco Parra,2 and María de Oña1

Servicio de Microbiología I, Hospital Universitario Central de Asturias,1 Departamento de Bioquímica y Biología Molecular, Universidad de Oviedo, Asturias, Spain2

Received 2 October 2003/ Returned for modification 6 February 2004/ Accepted 17 March 2004

From November 2000 to October 2001, a reverse transcription-PCR using primers directed to the norovirus RNA polymerase coding region was included in a viral and bacterial routine screening to diagnose sporadic cases of acute gastroenteritis among children in Asturias, Spain. The role of noroviruses (8.6% of the positively diagnosed cases) as the cause of sporadic pediatric gastroenteritis was evaluated with respect to the detection rates of other gastroenteritis-associated viruses and bacteria. The results indicated that noroviruses were less common than rotaviruses (36.9%), Campylobacter spp. (28.8%), and Salmonella spp. (18.4%) but more frequent than astroviruses (4.3%), adenoviruses (3.8%), and Yersinia spp. (2.2%). Mixed infections involving noroviruses were rarely observed (0.5%). The presence of a norovirus-associated pediatric gastroenteritis peak in summer, as well as the complete absence of norovirus-associated cases in colder months, challenges the view that norovirus infections exclusively have wintertime seasonality. On the other hand, phylogenetic analysis of the amplified fragments showed that the norovirus strains responsible were closely related. A further study using the full-length capsid region showed that these strains could be included into genogroup II, Bristol/Lorsdale cluster, and were closely related to the 1995 and 1996 U.S. subset of strains associated with outbreaks recorded worldwide between 1995 and 1996.

* Corresponding author. Mailing address: Servicio de Microbiología I, Hospital Universitario Central de Asturias, Celestino Villamil s/n, 33006 Oviedo, Spain. Phone: 34 985108720. Fax: 34 985108720. E-mail: jaboga{at}bioquimica.uniovi.es.

Journal of Clinical Microbiology, June 2004, p. 2668-2674, Vol. 42, No. 6
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.6.2668-2674.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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