Incidence of Coinfection between Rotavirus and Some Enteropathogenic Agents in Children Referred to Children Medical Center Hospital, Tehran, 2009

Background and Aims: One of the major causes of acute diarrhea in children during the cold season in Iran is infection by rotavirus. Children infected with rotavirus often require hospitalization. Several studies on human and animals have shown that enterotoxigenic Escherichia.coli and rotavirus are the most common coinfection causing diarrhea. There are other reports indicating occurrence of rotavirus coinfection with some other enteric agents such as Salmonella, Giardia, and Shigella flexeneri. In this study the rate of rotavirus infection and its coinfection with some other enteropathogenic agents in children which could influence the severity of the disease was investigated. Methods: Approximately 100 stool samples were collected from children with acute gastroenteritis. The specimens were cultured for bacteria isolation. They were also clarified and tested for rotavirus using the techniques of latex agglutination and negative staining electron microscopy. Results: Using negative staining, rotavirus particles were observed in 43 of the 100 stool specimen. The highest prevalence was observed in 6-12 months old children consisting 39.5% of the total specimens. Patients with mixed infection particularly rotavirus and E.coli had the highest incidence of severe vomiting and dehydration. Conclusion: Coinfection of children with rotavirus and other enteric agents can occur frequently. This coinfection has a synergistic effect which increases the severity of the clinical manifestation.