Human Enteric Circulating Viruses and Co-infections Among Hospitalized Children with Severe Acute Gastroenteritis in Chihuahua, Mexico, During 2010 - 2011

Background: Rotavirus has been considered the main causal agent of gastroenteritis worldwide. However, after rotavirus vaccine implementation, new reports have revealed the prevalence of other viral gastroenteritis agents such as norovirus, adenovirus, astrovirus, and other rare rotaviruses. Their prevalence is increasing in both developed and developing countries and may become a serious public health problem. Objectives: The study aimed to determine the relationship between co-infections with enteric viruses and acute gastroenteritis in hospitalized children under five years of age. Methods: A total of 57 stool samples were collected during 2010 - 2011 in two hospitals in Chihuahua, México, located in northern Mexico. The genotypic analysis was done using RT-PCR of specific regions of the viral enteric genome. In addition, phylogenetic analysis was developed by sequencing of the complete genome characteristic for the classification of enteric viruses by the neighbor-joining method. Results: Molecular detection revealed the presence of at least one viral agent in 61.4% (n = 35) of the total analyzed samples. Among the positive samples, rotavirus was identified in 49.12% (n = 21), adenovirus in 14% (n = 8), and a co-infection of norovirus and astrovirus in 3.5% (n = 2) of the samples. Rotavirus co-infection with another viral agent was identified in 14.28% (n = 5) of positive samples. Conclusions: Viral gastroenteritis has been decreasing after the introduction of the rotavirus vaccine. However, the appearance of co-infections has significantly increased, as evidenced by the high prevalence of enteroviruses among hospitalized children in Chihuahua, Mexico.