Key Points
- To determine the strain diversity, frequency of mixed infections, and prevalence of the uncommon serotype G9 among group A rotaviruses causing severe childhood diarrhea across multiple urban centers in India.
- Characterized 287 rotavirus strains isolated from children hospitalized with severe diarrhea in seven Indian cities between 1996 and 1998.
- Identified G and P genotypes via reverse transcription-PCR, with a subset analyzed by electropherotyping and VP6 subgrouping.
- Globally common strains accounted for only 43% of samples (P[8], G1: 15%; P[4], G2: 22%; P[8], G4: 6%), whereas serotype G9 strains represented 17% of all isolates across three distinct genotypic variants.
- Mixed G or P genotypes were detected in 21% (54/253) of fully typed strains.
- Serotype G2 strains were significantly more prevalent in single-strain infections, while serotype G1 strains occurred significantly more often in mixed infections (both P < 0.05).
Structured PICO
PPopulation313 rotavirus-positive stool samples from children <5 years of age hospitalized with severe diarrhea in seven Indian cities between 1996 and 1998.
OOutcomeRotavirus G and P genotypes and prevalence of mixed infections
The high diversity of rotavirus strains and prevalence of G9 and mixed infections in India highlight the need for rotavirus vaccines to target unusual serotypes like G9.
Limitations
- Clinical data such as severity of disease, symptoms, and history of prior RV infection were not collected
- Demographic and socioeconomic data were not collected
- Small sample sizes in some cities limited geographic diversity analysis