Some serotypes of enterovirus (EV) may lead to transient and symptomatic gastrointestinal infections while others are commensal residents of the human gut. To determine whether certain EV types are more often associated with diarrhea, we conducted a preliminary study on the prevalence of EV serotypes and common diarrhea viruses in fecal samples of diarrhea children and healthy controls. EV was tested with one step nest polymerase chain reaction and typed by direct sequencing while common causative diarrhea viruses rotavirus (RV), norovirus (NoV), adenovirus (AdV), bocavirus (HBoV), and astrovirus (AstV) were screened with multiplex PCR assays. Human Rhinovirus (HRV) and human EVs that were present in both groups were further quantified and their odds ratios (OR) were calculated. Enteric pathogens were detected in 89 (32.6%) of 273 children with diarrhea and included human EVs (51, 18.68%), HRV (32, 11.72%), RV (38, 13.92%), AdV (24, 8.79%), NoVGII (16, 8.79%), HBoV (8, 2.93%) and AstV (3, 1.09%). Potential enteric pathogens were found in 25 (6.93%) of 361 healthy controls and included human EV (59, 16.34%), HRV (8, 2.22%), RV (1, 0.28%), NoVGII (5, 1.39%), AstV (2, 0.55%), AdV (16, 4.43%) and HBoV (1, 0.28%). In addition, EV71, echovirus 3,9,14,25 and coxsackievirus A14 existed in healthy controls only, while HRV, echovirus11,18, coxsackievirus A2,4,6 and B2,4 were found in both patients and healthy controls. OR assessment confirmed a strong association of HRV (P < 0.001) and a weak one for echovirus 11 and coxsackievirus A6 with diarrhea (P > 0.05). Our results indicate the diversity of EV serotypes in diarrhea and healthy control groups varies, and the potential etiological role of HRV in diarrhea.
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We acknowledge the children’s hospital of Hebei Province, China for providing clinical specimen. This work was supported by the National key research and development plan (2016YFC1202700, 2016YFC1200900); China Mega-Project for Infectious Disease (2017ZX10302301-004 and 2017ZX10104001) and Medical Research Key Project of Hebei Province (20180616).
Compliance with ethical standards
Conflict of interest
All the authors approved the final manuscript and they have no conflict of interest to declare.
All aspects of the study were performed in accordance with national ethics regulations and approved by the Institutional Review Boards of National Institute for Viral Disease Control and Prevention, Center for Disease Control and Prevention of China and the Ethics Committee of Children’s hospital of Hebei Province, china. Informed consent was obtained from all individual participants included in the study.
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1.Key Laboratory for Medical Virology, National Health and Family Planning Commission, Chinese Center for Disease Control and PreventionNational Institute for Viral Disease Control and PreventionBeijingChina
2.Hebei Medical UniversityShijiazhuangChina
3.Children’s Hospital of Hebei ProvinceShijiazhuangChina
4.School of Life SciencesShandong University of TechnologyZiboChina