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Assays for the Specific Growth Rate and Cell-binding Ability of Rotavirus
Published on: January 28, 2019
Ancillary testing in children with rotavirus gastroenteritis
Peter A Rowinsky1, Andrew P Steenhoff, Shiang-Ju Kung
1Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.
Insights
In children with rotavirus gastroenteritis (RGE), serious bacterial infections (SBI) were not observed, questioning the need for costly tests. Younger children (≤6 months) faced longer hospital stays.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Microbiology
Background:
- Rotavirus gastroenteritis (RGE) is a common childhood illness.
- Microbiological assays are often used to rule out serious bacterial infections (SBI) in RGE patients.
- The incidence of concurrent SBI in RGE is largely unknown.
Purpose of the Study:
- To determine the incidence of SBI in children with RGE.
- To identify risk factors associated with prolonged hospitalization in this cohort.
Main Methods:
- Retrospective cohort study of children under 18 with laboratory-confirmed RGE.
- Data collected over a 4-year period at a community hospital.
- Prolonged length of stay (LOS) defined as hospitalization for ≥3 days.
Main Results:
- Ninety-four RGE cases were identified; 88.3% required admission.
- No cases of concurrent SBI were found.
- Age ≤6 months and peripheral blood culture collection were associated with prolonged LOS (≥3 days).
Conclusions:
- The absence of SBI in children with RGE suggests routine microbiological assays may be unnecessary.
- Younger children (≤6 months) are at higher risk for prolonged hospitalization.
- Findings may inform clinical practice regarding diagnostic testing and resource allocation.
Objectives:
Costly microbiological assays are frequently performed in patients with rotavirus gastroenteritis (RGE) to exclude concurrent serious bacterial infection (SBI). The incidence of concurrent SBI in this population is unknown but estimated to be low. The primary objective was to describe the incidence of SBI in children with RGE. The secondary objective was to elucidate risk factors for prolonged length of stay (LOS) in the cohort.
Methods:
All children < or =18 years seen at a community hospital for laboratory-confirmed RGE over a 4-year period were included in a retrospective cohort study to describe the incidence of concurrent SBI and to identify risk factors for prolonged LOS. Prolonged LOS was defined as hospitalization for > or =3 days.
Results:
Ninety-four cases of RGE were identified; 58 (61.7%) males and 80 (85.1%) African Americans. The median age was 8 months (interquartile range [IQR], 1 month to 16 years) and 83 patients (88.3%) required admission. There were no cases of SBI. The median LOS was 2 days. Age < or = 6 months (adjusted odds ratio [OR], 3.0; 95% confidence interval [CI], 1.2-7.7; P = 0.022) and collection of a peripheral blood culture (adjusted OR, 2.7; 95% CI, 1.0-7.1; P = 0.043) were associated with LOS > or = 3 days.
Conclusions:
In children evaluated at a community hospital with laboratory-confirmed RGE, no episodes of SBI occurred. This finding challenges the need to perform invasive, costly, microbiological assays to exclude concurrent SBI in this population. Children 6 months and younger were at increased risk of prolonged hospitalization from RGE.
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