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Published on: July 22, 2012
[Nosocomial rotavirus infections in children]
1Infekcní klinika, FN Plzen.
Insights
Rotavirus gastroenteritis is a frequent cause of hospitalizations in young children. Nosocomial rotavirus infections prolong hospital stays but have a favorable prognosis and are not seasonal.
Area of Science:
- Pediatrics
- Infectious Diseases
- Gastroenterology
Context:
- Rotaviruses are a leading cause of severe diarrheal diseases in children globally, accounting for a significant proportion of hospital admissions.
- They are also a primary etiological agent of nosocomial (hospital-acquired) diarrheal infections.
Purpose:
- To analyze the etiology of diarrhea in children under three years of age, with a specific focus on rotavirus as a cause of nosocomial infection.
- To understand the incidence, clinical presentation, and outcomes of rotavirus-related nosocomial infections in hospitalized children.
Summary:
- A study of 2002 children under three found rotavirus in 25.4% of diarrheal cases. Nosocomial rotavirus infection occurred in 4.0% of diarrheal patients, typically between days 4-6 of hospitalization.
- While rotavirus infections show seasonal peaks, nosocomial cases did not follow this pattern. Clinical presentation, often with isoosmolal dehydration, was similar to community-acquired cases.
- Elevated aminotransferases were observed in most patients. Symptomatic treatment was effective, and the prognosis was favorable, though nosocomial infections extended hospitalization by an average of five days.
Impact:
- Nosocomial rotavirus gastroenteritis presents a significant challenge in pediatric hospital settings, particularly affecting young children.
- Current understanding does not provide means to prevent these infections, which lack seasonal patterns and distinct clinical features.
- Despite a favorable prognosis, nosocomial rotavirus infections contribute to prolonged hospital stays, highlighting the need for effective control strategies.
Background:
Worldwide rotaviruses cause in young children one third of diarrhoeal diseases which call for hospital admission. Rotaviruses are also considered the most frequent etiological agent of nosocomial diarrhoeal infections. The objective of the present work was an analysis of the etiology of diarrhoea and nosocomial infection, in particular of rotavirus etiology in children under three years of age.
Methods And Results:
In 1990-1994 a total of 2002 children under three years were admitted to hospital, incl. 1480 (73.9%) on account of diarrhoeal diseases. A rotavirus etiology was proved in 25.4%, adenovirus etiology in 3.3%. As to bacterial infections, salmonellosis was most frequent (24.4%), less frequent campylobacteriosis (8.4%), shigellosis (1.7%), colibacillary infection (1.3%) or yersiniosis (0.2%). In 36.4% cases of gastroenteritis the etiology was not elucidated. Nosocomial infection with rotaviruses was proved in 59 of 1480 patients with diarrhoea (4.0%) and in 4.5% of the total number of 2002 sick children resp. Nesocomial infection developed most frequently between the 4th and 6th day of hospitalization; the clinical picture is not very different, as a rule isoosmolal dehydration which in cca 50% called for parenteral rehydration. About three quarters of the patients have temporarily elevated aminotransferases. As far as the seasonal character of the disease is concerned, the highest incidence was recorded in the following months of the year: I, II, III, IV, X and XI. This two-phase rotaviral incidence of enteritis does, however, not correspond with the incidence of nosocomial infections. Symptomatic treatment is successful. The prognosis is favourable. Nosocomial rotavirus infection protracted hospitalization on average by five days.
Conclusions:
Nosocomial rotavirus gastroenteritis is a serious problem in particular in departments with young children. So far we are unable to influence their occurrence. They are not seasonal, they do not have a different clinical picture or course. Luckily they have a favourable prognosis. However, they prolong the period of hospitalization.
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