{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:45:36Z","timestamp":1788306336400,"version":"build-2803163510"},"reference-count":38,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2019,6,27]],"date-time":"2019-06-27T00:00:00Z","timestamp":1561593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002809","name":"Generalitat de Catalunya","doi-asserted-by":"publisher","award":["Biotechnology Reference Network (XRB)"],"award-info":[{"award-number":["Biotechnology Reference Network (XRB)"]}],"id":[{"id":"10.13039\/501100002809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Certest Biotec Company","award":["Certest Biotec Company"],"award-info":[{"award-number":["Certest Biotec Company"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>A remarkable percentage of acute gastroenteritis cases remain etiologically undiagnosed. The aim of the study was to determine the prevalence of common and emerging enteric viruses, such as novel human astroviruses, among undiagnosed samples from children with acute gastroenteritis. Epidemiological studies for novel human astroviruses are still scarce. Stool samples collected over two consecutive winter seasons (2016\u20132017) from children with gastroenteritis in Spain, which were negative for bacteria, rotavirus, and adenovirus by routine diagnostics were screened by real-time RT-PCR assays for the presence of classical and novel astrovirus, rotavirus, norovirus GI and GII, sapovirus, and adenovirus. Overall, 220\/384 stool samples (57.3%) were positive for at least one virus. Co-infections were identified in 21% of cases. Among a total of 315 viruses identified, adenovirus was the most prevalent (n = 103), followed by rotavirus (n = 51), sapovirus (n = 50), classical astrovirus (n = 43), novel astroviruses (n = 42), and norovirus (n = 26). Novel astroviruses were present in 13.3% of virus-positive cases. Most novel astroviruses were found in children &lt;2-year-old (30\/39 children, 77%, p = 0.01) and were found in co-infection (66%). Only classical astroviruses demonstrated significant differences in the Cq values during mono-infections compared to co-infections. In conclusion, common enteric viruses may be frequently found in children with undiagnosed gastroenteritis, indicating the need to implement more sensitive diagnostic methods. Novel astroviruses circulate in the community and could be the cause of gastroenteritis among young children.<\/jats:p>","DOI":"10.3390\/v11070585","type":"journal-article","created":{"date-parts":[[2019,6,27]],"date-time":"2019-06-27T10:56:05Z","timestamp":1561632965000},"page":"585","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Novel Human Astroviruses: Prevalence and Association with Common Enteric Viruses in Undiagnosed Gastroenteritis Cases in Spain"],"prefix":"10.3390","volume":"11","author":[{"given":"Diem-Lan","family":"Vu","sequence":"first","affiliation":[{"name":"Enteric Virus Laboratory, Department of Genetics, Microbiology and Statistics, University of Barcelona, 08028 Barcelona, Spain"},{"name":"Nutrition and Food Safety Research Institute (INSA\u00b7UB), University of Barcelona, 08921 Santa Coloma de Gramenet, Spain"},{"name":"Department of Infectious Diseases, Geneva University Hospitals, 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurora","family":"Sabri\u00e0","sequence":"additional","affiliation":[{"name":"Enteric Virus Laboratory, Department of Genetics, Microbiology and Statistics, University of Barcelona, 08028 Barcelona, Spain"},{"name":"Nutrition and Food Safety Research Institute (INSA\u00b7UB), University of Barcelona, 08921 Santa Coloma de Gramenet, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuria","family":"Aregall","sequence":"additional","affiliation":[{"name":"Enteric Virus Laboratory, Department of Genetics, Microbiology and Statistics, University of Barcelona, 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Michl","sequence":"additional","affiliation":[{"name":"Enteric Virus Laboratory, Department of Genetics, Microbiology and Statistics, University of Barcelona, 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Rodriguez Garrido","sequence":"additional","affiliation":[{"name":"Microbiology Department, Hospital Universitari Vall d\u2019Hebron, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1471-4461","authenticated-orcid":false,"given":"Lidia","family":"Goterris","sequence":"additional","affiliation":[{"name":"Microbiology Department, Hospital Universitari Vall d\u2019Hebron, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8111-9059","authenticated-orcid":false,"given":"Albert","family":"Bosch","sequence":"additional","affiliation":[{"name":"Enteric Virus Laboratory, Department of Genetics, Microbiology and Statistics, University of Barcelona, 08028 Barcelona, Spain"},{"name":"Nutrition and Food Safety Research Institute (INSA\u00b7UB), University of Barcelona, 08921 Santa Coloma de Gramenet, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa Maria","family":"Pint\u00f3","sequence":"additional","affiliation":[{"name":"Enteric Virus Laboratory, Department of Genetics, Microbiology and Statistics, University of Barcelona, 08028 Barcelona, Spain"},{"name":"Nutrition and Food Safety Research Institute (INSA\u00b7UB), University of Barcelona, 08921 Santa Coloma de Gramenet, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1588-3198","authenticated-orcid":false,"given":"Susana","family":"Guix","sequence":"additional","affiliation":[{"name":"Enteric Virus Laboratory, Department of Genetics, Microbiology and Statistics, University of Barcelona, 08028 Barcelona, Spain"},{"name":"Nutrition and Food Safety Research Institute (INSA\u00b7UB), University of Barcelona, 08921 Santa Coloma de Gramenet, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,6,27]]},"reference":[{"key":"ref_1","first-page":"337","article-title":"Sustained decrease in laboratory detection of rotavirus after implementation of routine vaccination-united states, 2000\u20132014","volume":"64","author":"Aliabadi","year":"2015","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1016\/S0140-6736(75)92581-7","article-title":"Letter: Viruses and gastroenteritis in infants","volume":"1","author":"Appleton","year":"1975","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1128\/CMR.00013-14","article-title":"Human astroviruses","volume":"27","author":"Bosch","year":"2014","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Vu, D.L., Bosch, A., Pinto, R.M., and Guix, S. (2017). Epidemiology of classic and novel human astrovirus: Gastroenteritis and beyond. Viruses, 9.","DOI":"10.3390\/v9020033"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1186\/1743-422X-6-161","article-title":"Human stool contains a previously unrecognized diversity of novel astroviruses","volume":"6","author":"Finkbeiner","year":"2009","journal-title":"Virol. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.jcv.2014.03.024","article-title":"New astrovirus in human feces from burkina faso","volume":"60","author":"Phan","year":"2014","journal-title":"J. Clin. Virol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"169","DOI":"10.3201\/eid2001.131259","article-title":"Mlb1 astrovirus in children with gastroenteritis, italy","volume":"20","author":"Medici","year":"2014","journal-title":"Emerg. Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e00619-13","DOI":"10.1128\/genomeA.00619-13","article-title":"Complete genome sequence of an mlb2 astrovirus from a turkish child with diarrhea","volume":"1","author":"Mitui","year":"2013","journal-title":"Genome Announc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1186\/s12985-015-0299-z","article-title":"Prevalence of classic, mlb-clade and va-clade astroviruses in kenya and the gambia","volume":"12","author":"Meyer","year":"2015","journal-title":"Virol. J."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Holtz, L.R., Bauer, I.K., Rajendran, P., Kang, G., and Wang, D. (2011). Astrovirus mlb1 is not associated with diarrhea in a cohort of indian children. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0028647"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/j.meegid.2018.08.024","article-title":"Molecular epidemiology of classic, mlb and va astroviruses isolated from <5year-old children with gastroenteritis in thailand, 2011-2016","volume":"65","author":"Kumthip","year":"2018","journal-title":"Infect. Genet. Evol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.jinf.2018.02.006","article-title":"Co-circulation of classic and novel astrovirus strains in patients with acute gastroenteritis in germany","volume":"76","author":"Jacobsen","year":"2018","journal-title":"J. Infect."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.meegid.2017.05.016","article-title":"Characterization of astrovirus-associated gastroenteritis in hospitalized children under five years of age","volume":"53","author":"Zaraket","year":"2017","journal-title":"Infect. Genet. Evol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e84","DOI":"10.1038\/emi.2017.71","article-title":"Novel and classical human astroviruses in stool and cerebrospinal fluid: Comprehensive screening in a tertiary care hospital, switzerland","volume":"6","author":"Cordey","year":"2017","journal-title":"Emerg. Microbes Infect."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1002\/jmv.24337","article-title":"Multiple astrovirus mlb1, mlb2, va2 clades, and classic human astrovirus in children with acute gastroenteritis in japan","volume":"88","author":"Khamrin","year":"2016","journal-title":"J. Med. Virol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Xavier, M.d.P.T.P., Carvalho Costa, F.A., Rocha, M.S., Andrade, J.d.S.R.d., Diniz, F.K.B., Andrade, T.R.d., Miagostovich, M.P., Leite, J.P.G., and Volot\u00e3o, E.d.M. (2015). Surveillance of human astrovirus infection in brazil: The first report of mlb1 astrovirus. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0135687"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"918","DOI":"10.3201\/eid1606.091536","article-title":"Astrovirus encephalitis in boy with x-linked agammaglobulinemia","volume":"16","author":"Quan","year":"2010","journal-title":"Emerg. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1093\/cid\/ciu940","article-title":"Astrovirus va1\/hmo-c: An increasingly recognized neurotropic pathogen in immunocompromised patients","volume":"60","author":"Brown","year":"2015","journal-title":"Clin. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1093\/cid\/ciu912","article-title":"Diagnosis of neuroinvasive astrovirus infection in an immunocompromised adult with encephalitis by unbiased next-generation sequencing","volume":"60","author":"Naccache","year":"2015","journal-title":"Clin. Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1111\/tid.12607","article-title":"An emerging opportunistic infection: Fatal astrovirus (va1\/hmo-c) encephalitis in a pediatric stem cell transplant recipient","volume":"18","author":"Lum","year":"2016","journal-title":"Transpl. Infect. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e53","DOI":"10.1093\/jpids\/piv040","article-title":"Next-generation sequencing for diagnosis and tailored therapy: A case report of astrovirus-associated progressive encephalitis","volume":"4","author":"Fremond","year":"2015","journal-title":"J. Pediatric Infect. Dis. Soc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"846","DOI":"10.3201\/eid2205.151807","article-title":"Astrovirus mlb2, a new gastroenteric virus associated with meningitis and disseminated infection","volume":"22","author":"Cordey","year":"2016","journal-title":"Emerg. Infect. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.jcv.2016.03.010","article-title":"Acute encephalopathy in an immunocompromised boy with astrovirus-mlb1 infection detected by next generation sequencing","volume":"78","author":"Sato","year":"2016","journal-title":"J. Clin. Virol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2668","DOI":"10.1128\/JCM.42.6.2668-2674.2004","article-title":"Etiology of sporadic cases of pediatric acute gastroenteritis in asturias, spain, and genotyping and characterization of norovirus strains involved","volume":"42","author":"Boga","year":"2004","journal-title":"J. Clin. Microbiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1007\/s10096-010-1094-9","article-title":"Epidemiology and clinical features of gastroenteritis in hospitalised children: Prospective survey during a 2-year period in a parisian hospital, france","volume":"30","author":"Lorrot","year":"2011","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.anpedi.2016.08.006","article-title":"[acute gastroenteritis and enteric viruses: Impact on the detection of norovirus]","volume":"87","year":"2017","journal-title":"An Pediatr (Barc)"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1002\/jmv.24980","article-title":"Changing pattern of prevalence, genetic diversity, and mixed infections of viruses associated with acute gastroenteritis in pediatric patients in new delhi, india","volume":"90","author":"Gupta","year":"2018","journal-title":"J. Med. Virol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1002\/jmv.25005","article-title":"Enterovirus detection in patients with acute gastroenteritis in switzerland","volume":"90","author":"Gosert","year":"2018","journal-title":"J. Med. Virol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1093\/cid\/cix500","article-title":"Rapid clearance and frequent reinfection with enteric pathogens among children with acute diarrhea in zanzibar","volume":"65","author":"Andersson","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Hassan, F., Kanwar, N., Harrison, C.J., Halasa, N.B., Chappell, J.D., Englund, J.A., Klein, E.J., Weinberg, G.A., Szilagyi, P.G., and Moffatt, M.E. (2018). Viral etiology of acute gastroenteritis in <2-year-old us children in the post-rotavirus vaccine era. J. Pediatric Infect. Dis. Soc.","DOI":"10.1093\/jpids\/piy077"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Diez-Domingo, J., Garces-Sanchez, M., Gimenez-Sanchez, F., Colomina-Rodriguez, J., and Martinon-Torres, F. (2019). [what have we learnt about rotavirus in spain in the last 10 years?]. An. Pediatr. (Barc.).","DOI":"10.1016\/j.anpede.2019.01.010"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1002\/jmv.20419","article-title":"A 5-year study of the prevalence and genetic diversity of human caliciviruses associated with sporadic cases of acute gastroenteritis in young children admitted to hospital in melbourne, australia (1998\u20132002)","volume":"77","author":"Kirkwood","year":"2005","journal-title":"J. Med. Virol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1002\/jmv.25308","article-title":"Epidemiology of human astroviruses among children younger than 5 years: Prospective hospital-based sentinel surveillance in south africa, 2009-2014","volume":"91","author":"Nadan","year":"2019","journal-title":"J. Med Virol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1097\/INF.0000000000001899","article-title":"Molecular detection of human astrovirus in children with gastroenteritis, northern italy","volume":"37","author":"Bergallo","year":"2018","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e20171326","DOI":"10.1542\/peds.2017-1326","article-title":"Astrovirus infection and diarrhea in 8 countries","volume":"141","author":"Olortegui","year":"2018","journal-title":"Pediatrics"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.jcv.2018.09.007","article-title":"PCR assays for detection of human astroviruses: In silico evaluation and design, and in vitro application to samples collected from patients in the netherlands","volume":"108","author":"Nijhuis","year":"2018","journal-title":"J. Clin. Virol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Garc\u00eda-Basteiro, A.L., Bosch, A., Sicuri, E., Bayas, J.M., Trilla, A., and Hayes, E.B. (2011). Hospitalizations due to rotavirus gastroenteritis in catalonia, Spain, 2003\u20132008. BMC Res. Notes, 4.","DOI":"10.1186\/1756-0500-4-429"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1038\/s41564-019-0416-7","article-title":"Viral complementation of immunodeficiency confers protection against enteric pathogens via interferon-lambda","volume":"4","author":"Ingle","year":"2019","journal-title":"Nat. Microbiol."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/11\/7\/585\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:01:49Z","timestamp":1760187709000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/11\/7\/585"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,27]]},"references-count":38,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2019,7]]}},"alternative-id":["v11070585"],"URL":"https:\/\/doi.org\/10.3390\/v11070585","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6,27]]}}}