Coinfection of rotavirus with bacterial enteropathogens leads to more severe and prolonged disease, highlighting a potential secondary benefit of rotavirus vaccination in developing countries.
Supports bacterial testing in severe rotavirus cases; leaves open vaccination impact on coinfection rates in endemic areas.
Background: Many rotavirus infections occur as mixed infections with other microorganisms, including viruses, bacteria, and protozoa. In vitro, animal and clinical studies provide evidence for potentiation between rotavirus infection and coinfecting pathogens. The mechanisms of such interactions are not well studied or understood. Methods: A literature search was performed to identify publications on rotavirus coinfections. Results: The evidence for potentiation between infections with rotavirus and bacterial enteropathogens—particularly E. coli—is strong. A number of large clinical investigations has shown that children infected with rotavirus and a bacterial enteropathogen suffer from more severe diarrhea and/or dehydration, with diarrhea often lasting longer than in children infected with rotavirus alone. In general, but not exclusively, coinfections result in a poorer prognosis. Conclusions: In developing countries, rotavirus vaccination could possibly improve the poor prognosis associated with bacterial enteropathogen-rotavirus coinfections. However, further studies are needed to define the exact role of rotavirus vaccination in the context of coinfections.
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Grimprel et al. (2008) studied this question.
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