Clinical significance and intestinal microbiota composition in immunocompromised children with norovirus gastroenteritis

Abstract Our study aims to figure out the clinical differences and distribution of intestinal microbiota in immunocompromised children with norovirus (NoV) gastroenteritis. Pediatric patients admitted to Shang-Ho Hospital with diagnosis of acute gastroenteritis with different immune status were enrolled and their medical records were reviewed. NoV gastroenteritis was validated using RT-PCR molecular methods. Viral shedding period was determined by real-time RT-PCR assays. Intestinal microbiota enrichment analysis was carried out by next generation sequencing with Linear Discriminant Analysis (LDA) Effect Size (LEfSe) method. Significantly higher frequency [mean, (IQR), 3.8 (3–5) /day] and longer viral shedding time [mean, IQR, 8.5 (5–13) days] was found in immunocompromised NoV infections than in immunocompetent patients without NoV infections (P = 0.013) and immunocompetent patients with NoV infections (P = 0.030). The fever prevalence was significantly lower in immunocompromised NoV infections. Comparative metagenomics analysis showed a significant difference in richness at the phylum level, the family level, and the genus level in patients under different immune status. We evaluated the clinical significances and microbiota composition in immunocompromised children with norovirus gastroenteritis. This will futher facilitate studies regarding the intestinal microbiota in such patients in determination of bacterial infection control and probiotic supplements strategy.