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Nosocomial gastroenteritis in paediatric patients
Insights
Nosocomial rotavirus gastroenteritis is a significant problem in pediatric isolation wards, occurring 3.4 times more frequently than bacterial infections. Current isolation protocols require modification to reduce rotavirus transmission among young children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hospital Epidemiology
Background:
- Acute gastroenteritis is common in children under 5 years.
- Identifying causative agents is crucial for effective treatment and prevention.
- Nosocomial infections pose a significant challenge in healthcare settings.
Purpose of the Study:
- To investigate the incidence and causative agents of acute gastroenteritis in a pediatric isolation ward.
- To determine the rate and common pathogens responsible for nosocomial infections.
- To evaluate the effectiveness of existing isolation procedures in preventing rotavirus transmission.
Main Methods:
- Retrospective analysis of 2228 children under 5 admitted with acute gastroenteritis between November 1982 and April 1985.
- Identification of causative agents including rotavirus and common bacteria (Salmonella, Campylobacter, Shigella, Escherichia coli).
- Review of isolation procedures: cohort nursing, barrier gowns, and chlorhexidine handwashing.
Main Results:
- Rotavirus was identified in 56.2% of cases.
- 13.4% of positive cases were nosocomial infections.
- Rotavirus accounted for 128 nosocomial infections (20% of all rotavirus cases), significantly more than bacterial pathogens (35 cases, 7%).
- Nosocomial rotavirus gastroenteritis was 3.4 times more frequent than bacterial nosocomial gastroenteritis.
Conclusions:
- Current isolation procedures are insufficient to prevent rotavirus nosocomial infections.
- Rotavirus gastroenteritis represents a substantial nosocomial risk in pediatric settings.
- Modifications to isolation protocols are necessary to reduce rotavirus transmission.
Abstract:
Between November 1982 and April 1985, 2228 children under the age of 5 years with acute gastroenteritis were admitted to the paediatric isolation ward of Queen Mary Hospital, Department of Paediatrics, University of Hong Kong. In 56.2% the causative agent was identified as rotavirus, Salmonella, Campylobacter, Shigella, Escherichia coli or a combination of these pathogens. Our isolation procedures included cohort nursing of all diarrhoeal patients in two separate rooms (each accommodating 6 patients), barrier gowns and stringent handwashing with chlorhexidine. A total of 163 cases (13.4% of all positive cases) were identified as nosocomial infections. Rotavirus was the responsible agent for nosocomial infection in 128 cases (20% of all rotavirus infection). There were 35 patients with bacterial nosocomial infection, (7% of all the bacterial positive cases). Nosocomial rotavirus gastroenteritis was 3.4 times more frequent than nosocomial gastroenteritis due to bacterial pathogens. We conclude that modification of our present isolation procedures is necessary in order to reduce rotavirus nosocomial infection.