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[Nosocomial dyspepsia in newborn and young infants. A 15-month prospective study with continuous Rotavirus
Insights
Rotavirus was a common cause of gastroenteritis in hospitalized infants, particularly premature babies. Early tachypnoea preceded Rotavirus illness, and hand hygiene is crucial for prevention.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Gastroenteritis is a significant cause of hospitalization in newborns and infants.
- Understanding the causative agents and risk factors is crucial for effective management and prevention.
Purpose of the Study:
- To conduct a prospective surveillance of gastroenteritis in hospitalized infants.
- To identify infectious agents, with a focus on Rotavirus, and analyze their distribution and clinical impact.
- To evaluate risk factors and preventive measures for Rotavirus-induced gastroenteritis.
Main Methods:
- A 15-month prospective study involving 201 hospitalized newborns and infants.
- Weekly stool specimen investigation using complement fixation test (CFT).
- Surveillance for Rotavirus and other infectious agents in 320 gastroenteritis patients.
Main Results:
- An infectious agent was detected in 41% of gastroenteritis patients: Rotavirus (54), Staph. aureus (22), E. coli (4), other bacteria (25), Candida albicans (17), Echovirus 11 (1).
- Candida albicans was most frequent in premature infants; Rotavirus incidence was highest in premature small-for-date babies.
- Rotavirus caused milder illness compared to bacterial infections; severe cases often had no detectable cause. Tachypnoea preceded Rotavirus gastroenteritis in newborns/infants.
Conclusions:
- Rotavirus is a significant pathogen in infant gastroenteritis, with specific risk groups identified.
- Meticulous hand disinfection and separate patient care are vital for controlling Rotavirus spread.
- Early tachypnoea may indicate impending Rotavirus gastroenteritis in infants.
Abstract:
A 15 months prospective study of gastroenteritis in hospitalized newborns and infants (N = 201) was combined with a Rotavirus infection surveillance. Stool specimens were investigated weekly (CFT). From patients with gastroenteritis (N = 320) an infectious agent could be detected on average in 41% of each patient group: Rotavirus N = 54, Staph. aureus N = 22, toxin producing E. coli N = 4, other bacteria N = 25, Candida albicans N = 17, Echovirus 11 N = 1. With certain exceptions, the pathogens were distributed equally within the patient groups. However, Candida albicans appeared most frequently in premature children and the highest incidence of Rotavirus infections was observed in premature small for date babies. Rotavirus caused the mildest illness. The severest forms had usually no detectable cause. Bacteria took up an intermediate position. 68% of patients with detectable Rotavirus in the faeces had symptoms. However, treatment was required in only 25% of premature and small for date babies and 40% of normal newborns. In newborns and infants an isolated tachypnoea was observed 3 days prior to onset of a Rotavirus induced gastroenteritis. Breast fed infants showed no evidence of increased protection. Rotavirus antibodies were detectable in 58% of children prior to infection. The study presents evidence for the value of separate of patient care and meticulous hand disinfection, especially in the case of Rotavirus induced gastroenteritis.