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Molecular characterization of potential healthcare associated respiratory syncytial virus in three referral hospitals in Kenya, 2009-2011
© Mayieka et al; licensee BioMed Central Ltd. 2015
Published: 16 June 2015
Respiratory syncytial virus (RSV) is a major cause of community-acquired severe respiratory illness in infants, immunocompromised individuals and the elderly. Limited information exists on healthcare associated RSV infections in developing countries.
To describe hospital-acquired RSV infections in three Kenyan referral hospitals
Ongoing surveillance for healthcare associated infections is conducted at three referral hospitals in Nairobi: Kenyatta National Hospital (KNH), Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) and Mbagathi District Hospital (MDH). We collected nasopharyngeal and oropharyngeal samples from patients with new-onset fever (≥38°C) and either cough or sore throat, after being afebrile for at least three days in the wards. Specimen were tested for RSV using real time polymerase chain reaction (RT-PCR) and those positive with a cycle threshold value of 30 and below were further grouped as RSV A or B using the same method. The ectodomain of the attachment G glycoprotein was sequenced and phylogenetically analyzed.
Among 255 cases tested from September, 2009 to September, 2011, 37 (14.5%) were positive for RSV, including 13 (35%) subgroup A, 6 (16%) B, 1 (3%) mixed AB and 17 (46%) could not be determined. Seventeen samples were successfully sequenced out of the twenty samples on which this was attempted. Majority of our RSV A isolates belonged to NA1 genotype prototype strain and all RSV B sequences clustered with the BAIV genotype. Three RSV A and 2 RSV B sequences from patients on the same ward at KNH were 100% identical in the G ectodomain suggesting potential common source. One RSV A positive specimen from MDH and one from JOOTRH showed 100% sequence identity.
Presence of identical sequences indicates potential patient to patient transmission of RSV within the hospitals. Effective and feasible infection control strategies should be enhanced in the Kenyan public hospitals.
Disclosure of interest
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.