Román Riechmann E, Wilhelmi de Cal I, Cilleruelo Pascual Ma L, Calvo Rey C, García García Ma L, Sánchez-Fauquier A
Servicio de Pediatría, Hospital Severo Ochoa, Madrid, Spain.
An Pediatr (Barc). 2004 Apr;60(4):337-43. doi: 10.1016/s1695-4033(04)78280-6.
Nosocomial gastroenteritis is frequent in pediatric hospital wards. Between 20% and 50% of gastroenteritis cases caused by rotavirus and astrovirus are of nosocomial origin.
To determine the incidence of nosocomial rotavirus and astrovirus gastroenteritis in our environment, the incidence of asymptomatic infection with these viruses, and to identify the G serotypes of the rotaviruses detected.
We performed a prospective study of all children under 2 years of age admitted to a neonatology unit over a 1-year period who were followed-up for the presence of diarrhea and periodic study of feces to detect the presence of rotavirus and astrovirus antigens by enzyme immunoassay (EIA). Patients with gastroenteritis also underwent bacteria stool culture, adenovirus detection by EIA, calcivirus detection by polymerase chain reaction, and analysis of rotavirus G serotypes by EIA with monoclonal antibodies.
Of 666 children admitted without diarrhea, 60 presented nosocomial gastroenteritis (9 % of patients admitted and 1.75 per 100 days of hospital stay): 34 presented rotavirus (5 % of patients) and two presented astrovirus (0.3 % of patients). Of the 329 patients without diarrhea who were studied, viral elimination was detected in 27: rotavirus in 23 patients and astrovirus in four. Viral infection was detected on admission in 13 patients (4 %) and after 72 hours in 14 patients (4.2 %) (asymptomatic nosocomial infection). No differences in the distribution of rotavirus G serotypes were observed between community-acquired and nosocomial gastroenteritis.
These data confirm the importance of viral etiology in nosocomial gastroenteritis and allow us to evaluate asymptomatic fecal elimination of rotavirus as one of the factors in the transmission of this infection.
医院获得性肠胃炎在儿科病房很常见。由轮状病毒和星状病毒引起的肠胃炎病例中，20%至50%为医院获得性感染。
确定我们所在环境中医院获得性轮状病毒和星状病毒肠胃炎的发病率、这些病毒无症状感染的发病率，并鉴定所检测到的轮状病毒的G血清型。
我们对新生儿病房1年内收治的所有2岁以下儿童进行了一项前瞻性研究，对其进行腹泻随访，并定期检测粪便，通过酶免疫测定法（EIA）检测轮状病毒和星状病毒抗原。肠胃炎患者还进行了粪便细菌培养、通过EIA检测腺病毒、通过聚合酶链反应检测杯状病毒，以及使用单克隆抗体通过EIA分析轮状病毒G血清型。
666名无腹泻入院的儿童中，60名发生了医院获得性肠胃炎（占入院患者的9%，每100天住院时间中有1.75例）：34例为轮状病毒感染（占患者的5%），2例为星状病毒感染（占患者的0.3%）。在329名未腹泻且接受检测的患者中，27名检测到病毒清除：23名患者为轮状病毒，4名患者为星状病毒。13名患者（4%）入院时检测到病毒感染，14名患者（4.2%）在72小时后检测到病毒感染（无症状医院获得性感染）。社区获得性肠胃炎和医院获得性肠胃炎之间，轮状病毒G血清型分布没有差异。
这些数据证实了病毒病因在医院获得性肠胃炎中的重要性，并使我们能够将轮状病毒无症状粪便排出评估为该感染传播的因素之一。
