Pina P, Le Huidoux P, Lefflot S, Araujo E, Bellaïche M, Harzig M, Allouch P Y, Foucaud P
Service d'hygiène hospitalière, centre hospitalier de Versailles, Le Chesnay, France.
Arch Pediatr. 2000 Oct;7(10):1050-8. doi: 10.1016/s0929-693x(00)00312-2.
Nosocomial rotavirus infections induce difficult problems for pediatric wards during winter epidemics. This prospective study was carried out to measure their incidence in a general pediatric ward by using epidemiological tools, clinical and molecular methods, and to examine the main factors increasing the risk of cross contamination.
The study was carried out on children, younger than three years old, hospitalized between 15 November 1996 and 1 March 1997. We examined the feces of all children for rotavirus on admission and during their hospital stay if they had developed diarrhea. The strains were typed by RNA electrophoresis. A cohort study was done to identify the factors of exposure to risk.
Three hundred twenty-six of the 415 hospitalized infants were studied. One hundred and five were hospitalized for gastroenteritis, including 39 (37.1%) with rotavirus infection. Among 221 infants admitted without diarrhea, 11 (5.0%) had an asymptomatic community infection and nine (4.3%) developed nosocomial gastroenteritis. The only significant predisposing factor (P = 0.003) for nosocomial infection was the distance between the hospital rooms and the nurses station. Despite the low level of typing (51%), the molecular study suggested a wide diversity of nosocomial and community strains.
The relatively low incidence of nosocomial infections found may be due to routine assignment to individual rooms, the isolation of infants admitted with acute diarrhea, and the policy of routine detection of asymptomatic carriers with the use of similar isolation measures for these children.
医院内轮状病毒感染在冬季流行期间给儿科病房带来了难题。本前瞻性研究旨在通过流行病学工具、临床和分子方法来测量普通儿科病房中此类感染的发生率，并研究增加交叉污染风险的主要因素。
本研究针对1996年11月15日至1997年3月1日期间住院的3岁以下儿童展开。我们在所有儿童入院时检查其粪便中的轮状病毒，若住院期间出现腹泻则再次检查。通过RNA电泳对毒株进行分型。开展队列研究以确定暴露于风险的因素。
对415名住院婴儿中的326名进行了研究。105名因肠胃炎住院，其中39名（37.1%）感染了轮状病毒。在221名入院时无腹泻的婴儿中，11名（5.0%）有无症状社区感染，9名（4.3%）发生了医院内肠胃炎。医院感染的唯一显著易感因素（P = 0.003）是病房与护士站之间的距离。尽管分型水平较低（51%），分子研究表明医院内毒株和社区毒株具有广泛的多样性。
所发现的医院感染发生率相对较低，可能归因于常规分配单人病房、对急性腹泻入院婴儿进行隔离，以及采用类似隔离措施对无症状携带者进行常规检测的政策。
