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Prospective study of nosocomial rotavirus infection in a paediatric hospital
M L Ringenbergs1, G P Davidson, J Spence
1Gastroenterology Unit, Adelaide Children's Hospital, Australia.
Insights
Rotavirus infections are a significant cause of hospital cross-infection in young children. Following patients post-discharge is crucial for accurately assessing illness incidence and developing prevention strategies.
Area of Science:
- Pediatric Infectious Diseases
- Hospital Epidemiology
- Virology
Background:
- Hospital-acquired enteric infections pose a risk to vulnerable pediatric populations.
- Rotavirus is a common pathogen causing gastroenteritis in young children.
Purpose of the Study:
- To investigate the incidence and characteristics of rotavirus hospital-acquired infections in young children.
- To assess the importance of post-discharge surveillance in determining true infection rates.
Main Methods:
- Prospective study of 220 pediatric patients under 3 years admitted without gastroenteritis.
- Daily fecal specimen collection during hospitalization and post-discharge follow-up for 2 days.
- Rotavirus detection in fecal samples.
Main Results:
- 14% of patients acquired rotavirus infection during hospitalization.
- 23% of infected patients excreted rotavirus only after discharge, highlighting the need for post-discharge monitoring.
- Asymptomatic rotavirus infection occurred in 29% of cases.
- Rotavirus acquisition was most common from May to August.
- Hospitalization was significantly prolonged in patients who acquired rotavirus (11.1 vs. 8.0 days).
Conclusions:
- Rotavirus is a significant cause of hospital cross-infection in young children.
- Post-discharge surveillance is essential for accurate incidence assessment of hospital-acquired illness.
- Preventive measures are needed to reduce rotavirus transmission in healthcare settings.
Abstract:
Hospital-acquired enteric infections, particularly those due to rotavirus, were investigated by studying 220 patients under 3 years of age who were admitted without gastroenteritis to two paediatric general medical wards during a 10 month period. Faecal specimens were collected within 48 h of admission and then daily until the patients were discharged. Samples were also collected after discharge if patients developed enteric symptoms within 2 days of discharge. Fourteen per cent (31 of 220) of patients acquired rotavirus infections while in hospital, 23% (seven of 30) excreted rotavirus only after discharge; 29% of patients infected with rotavirus were asymptomatic (nine of 31). Acquisition of rotavirus infection was most prevalent during the months May-August, with a prevalence of 34% (12 of 35) in May. Hospitalization was prolonged in those patients who acquired rotavirus (11.1 days compared with 8.0 days, P less than 0.05). This study highlights the importance of rotavirus as a cause of hospital cross-infection, particularly in the very young patient, and emphasizes the need for further assessment of factors involved in its acquisition. In order to determine correctly the incidence of hospital-acquired illness, it is essential to follow patients after discharge from hospital. This study reinforces the importance of developing preventive measures in order to reduce the frequency of this illness.