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Nosocomial rotaviral diarrhea: pattern of spread on wards in a children's hospital
D L Pacini1, M T Brady, C T Budde
1Department of Pediatrics, Ohio State University, Columbus.
Insights
Nosocomial gastroenteritis, primarily caused by rotavirus, was studied in a children's hospital. Strict infection control measures, like hand washing, significantly reduced rotavirus incidence on isolation wards.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hospital Epidemiology
Background:
- Nosocomial gastroenteritis is a significant concern in pediatric healthcare settings.
- Rotavirus is a common cause of infectious diarrhea in hospitalized children.
- Understanding transmission patterns is crucial for effective control.
Purpose of the Study:
- To prospectively investigate the incidence and patterns of nosocomial gastroenteritis in a children's hospital.
- To identify the role of rotavirus in hospital-acquired infections.
- To evaluate the impact of ward structure and infection control practices on disease incidence.
Main Methods:
- Prospective observational study conducted over a 5-month period in a 315-bed children's hospital.
- Identification and tracking of 85 cases of nosocomial diarrhea across 13 hospital wards.
- Laboratory confirmation of rotavirus in stool samples from affected patients.
- Comparison of rotavirus incidence rates between different ward types, including infectious disease isolation wards.
Main Results:
- Rotavirus was identified in 40% of the 85 nosocomial gastroenteritis cases.
- Higher incidence of nosocomial rotavirus occurred on wards with a younger patient population (under 2 years).
- The infectious diseases (isolation) ward demonstrated a significantly lower incidence of rotavirus (0.24 cases per 100 admissions) compared to other wards (2.30 cases per 100 admissions), despite higher exposure potential.
Conclusions:
- Effective infection control measures, particularly hand hygiene and ward design, play a critical role in reducing nosocomial rotavirus transmission.
- Pediatric isolation wards, when properly managed, can significantly mitigate the spread of infectious gastroenteritis.
- Further research into specific infection control strategies is warranted to minimize hospital-acquired rotavirus infections.
Abstract:
Nosocomial gastroenteritis in a 315-bed hospital for children was examined prospectively from January 11 through May 31, 1985. There were 85 cases of nosocomial diarrhea during the study period, and these were identified on each of the 13 hospital wards. Rotavirus was identified in 40% of cases. Incidence of nosocomial rotavirus was highest on wards where most children were less than 2 years of age, except for the infectious diseases (isolation) ward (0.24 versus 2.30 cases per 100 admissions, p = 1.70 x 10(-4), Fisher exact test). The lower incidence on the infectious diseases ward occurred despite the greater potential for exposure to rotavirus, since 70% of children admitted with community-acquired rotavirus diarrhea were placed on the infectious diseases ward. Better infection control, especially hand washing, aided by the structure of the infectious diseases ward, may have been responsible for this difference.