Maille L, Beby-Defaux A, Bourgoin A, Koulmann L, Eucher V, Cardona J, Oriot D, Agius G
Laboratoire de virologie, Centre hospitalier universitaire, Hôpital Jean-Bernard, BP 577, 86021 Poitiers Cedex, France.
Ann Biol Clin (Paris). 2000 Sep-Oct;58(5):601-6.
Rotavirus and respiratory syncytial virus (RSV) infections represent up to 30% of the totality of nosocomial infections in paediatric wards. We studied the importance of these infections in the paediatric wards of the University Hospital Center of Poitiers, France, from October 1996 to September 1998. We defined as nosocomial an infection acquired after 3 days of hospitalization for rotavirus and after 7 days for RSV. The 274 cases of children presenting rotavirus gastroenteritis or RSV infection within this period were studied. Rotavirus was detected in stools by using an agglutination test and RSV was diagnosed in nasopharyngeal aspirations by direct examination with an immunofluorescence assay (IFA), cell culture and serotyping with IFA. We noted 50 rotavirus and 224 RSV infections, with a first epidemic of RSV subgroup B (49.5%) and a second epidemic of subgroup A (44.9%). 19 (38%) were rotavirus nosocomial infections and 5 (2.2%) were RSV nosocomial infections. The majority of the nosocomial infections occurred before the age of one year and particularly before the age of 6 months (42.2% for rotavirus, 60% for RSV). In comparison to community-acquired infections, children with rotavirus nosocomial infections were younger (9 months versus 12.5 months) which was the opposite for RSV nosocomial infections (10.8 months versus 6.5 months). The sex-ratio of children with community-acquired infections was 2.1 that was not reported in nosocomial infections. The length of stay in hospital was always longer in nosocomial infections (11.7 days versus 3.6 days for rotavirus; 38.8 days versus 4.8 days for RSV). Diarrhea (p = 0.007) and vomiting (p = 0.013) for enteric infections and wheezing (p = 0.02) for respiratory infections were more often observed in community-acquired infections. This study emphasizes the frequency and the consequences of rotavirus and RSV nosocomial infections in paediatric wards and the importance of the hygienic rules to prevent these infections.
轮状病毒和呼吸道合胞病毒（RSV）感染占儿科病房医院感染总数的30%。我们于1996年10月至1998年9月在法国普瓦捷大学医院中心的儿科病房研究了这些感染的重要性。我们将住院3天后感染的轮状病毒和7天后感染的RSV定义为医院感染。在此期间，对274例出现轮状病毒胃肠炎或RSV感染的儿童病例进行了研究。通过凝集试验在粪便中检测轮状病毒，通过免疫荧光测定法（IFA）直接检查、细胞培养以及IFA血清分型在鼻咽抽吸物中诊断RSV。我们记录了50例轮状病毒感染和224例RSV感染，其中首次出现RSV B亚组流行（49.5%），第二次出现A亚组流行（44.9%）。19例（38%）为轮状病毒医院感染，5例（2.2%）为RSV医院感染。大多数医院感染发生在1岁之前，尤其是6个月之前（轮状病毒感染为42.2%，RSV感染为60%）。与社区获得性感染相比，轮状病毒医院感染的儿童年龄更小（9个月对12.5个月），而RSV医院感染的情况则相反（10.8个月对6.5个月）。社区获得性感染儿童的性别比为2.1，而医院感染中未报告这一比例。医院感染的住院时间总是更长（轮状病毒感染为11.7天对3.6天；RSV感染为38.8天对4.8天）。在社区获得性感染中，肠道感染的腹泻（p = 0.007）和呕吐（p = 0.013）以及呼吸道感染的喘息（p = 0.02）更为常见。这项研究强调了儿科病房中轮状病毒和RSV医院感染的频率及后果，以及预防这些感染的卫生规则的重要性。
