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Published on: February 17, 2023
A prospective study of nosocomial enteric pathogen acquisition in hospitalized children in South India
C N Kamalaratnam1, G Kang, C Kirubakaran
1Department of Child Health, Christian Medical College and Hospital, Vellore, India.
Insights
Many hospitalized children asymptomatically carry enteric pathogens, posing a risk for nosocomial infections. Nearly one in five children admitted without infection develop gastrointestinal issues, with rotavirus being a common cause.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hospital Epidemiology
Background:
- Hospitalized children, particularly those under 36 months, are susceptible to enteric pathogen acquisition.
- Non-gastrointestinal admissions do not preclude the presence of asymptomatic enteric pathogens.
Purpose of the Study:
- To investigate the incidence and impact of enteric pathogen acquisition in hospitalized children.
- To determine the rate of nosocomial enteric infections in children admitted for non-gastrointestinal disorders.
Main Methods:
- Prospective study involving 249 children under 36 months admitted for non-gastrointestinal disorders.
- Stool sample screening at admission and follow-up for nosocomial infections post-discharge.
- Clinical and laboratory data analysis to identify enteric pathogens and infection sources.
Main Results:
- 16.4% of children screened positive for enteric pathogens at admission, with 75.6% carrying multiple organisms.
- 20.1% of initially uninfected children developed nosocomial enteric infections within 3 days of discharge.
- Rotavirus was identified as the most frequent cause of nosocomial gastrointestinal infections.
Conclusions:
- Children admitted to hospitals can be asymptomatic carriers of enteric pathogens, serving as sources for nosocomial spread.
- A significant proportion of hospitalized children are at risk of developing nosocomial gastrointestinal infections.
- Effective infection control measures are crucial to prevent pathogen transmission in pediatric hospital settings.
Abstract:
Screening for enteric pathogens in stool samples from 249 children under the age of 36 months, admitted to hospital for non-gastrointestinal disorders, was positive at admission in 41 (16.4 per cent) in a prospective study of enteric pathogen acquisition and diarrhoea in hospitalized children. Infection with multiple organisms was found in 31/41 (75.6 per cent) children who were positive when screened at admission. Of 194 children who had no enteric pathogens on admission and could be followed up for 3 days after discharge, clinical or laboratory data showed nosocomial enteric infections in 39 (20.1 per cent). Presumed nosocomial infection with more than one organism was seen in only two patients and no pathogens were isolated in 14 (35.8 per cent). Children presenting to hospital may asymptomatically carry enteric pathogens and potentially act as a source of nosocomial infections. One in five children admitted into hospital without an enteric infection is at risk of developing a nosocomial gastrointestinal infection, with rotavirus being the most common aetiological agent.
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