Wildi-Runge Stefanie, Allemann Simone, Schaad Urs B, Heininger Ulrich
University Children's Hospital (UKBB), P.O. Box, 4005 Basel, Switzerland.
Eur J Pediatr. 2009 Nov;168(11):1343-8. doi: 10.1007/s00431-009-0934-z. Epub 2009 Feb 11.
Rotavirus (RV) is a frequent cause of severe gastroenteritis (GE) in children. With the licensure of new RV vaccines, data on the burden of disease are important regarding immunization strategies. We reviewed the medical records of children hospitalized with RV infection in our institution between July 2002 and March 2006. Relevant data were extracted in a standardized fashion from records of hospitalized children with a positive RV antigen test in a stool sample. Severity of disease was graded by the 20-point Vesikari score. Population data were obtained from the Federal Office of Statistics. Six hundred eighty-six RVGE were identified and records of 608 hospitalizations (in 607 children) were available. In 539 (89%) cases, RVGE was the primary reason for hospitalization and 69 (11%) were nosocomial infections; yearly peaks occurred between February and May. Cumulative incidence of RVGE was 26.7/1,000 children <3 years of age. Median age of 539 children (55.6% male) with primary RVGE was 1.4 years and median stay in the hospital for both community acquired and nosocomial RVGE was 4 days (interquartile range 3-5). Thirtypercent and 94% of RV hospitalizations were in children <1 and <3 years of age, respectively. Mean Vesikari score was 15 (range 6-20; 96% >11). Intravenous fluids were administered in 378 (70%) patients, 130 (24%) patients were rehydrated via nasogastral tube, and 31 (5.7%) received rehydration by mouth. RVGE causes a substantial burden in children with an estimated risk for hospitalization due to RVGE of one in 37 children <3 years of age.
轮状病毒(RV)是儿童严重胃肠炎(GE)的常见病因。随着新型RV疫苗的获批,关于疾病负担的数据对于免疫策略至关重要。我们回顾了2002年7月至2006年3月间在我院因RV感染住院的儿童的病历。从粪便样本RV抗原检测呈阳性的住院儿童记录中以标准化方式提取相关数据。疾病严重程度采用20分的维西卡里评分进行分级。人口数据来自联邦统计局。共识别出686例RVGE病例,获得了608例住院记录(涉及607名儿童)。在539例(89%)病例中,RVGE是住院的主要原因,69例(11%)为医院感染;每年的发病高峰出现在2月至5月之间。RVGE在<3岁儿童中的累积发病率为26.7/1000。539例原发性RVGE儿童(55.6%为男性)的中位年龄为1.4岁,社区获得性和医院获得性RVGE的中位住院时间均为4天(四分位间距3 - 5天)。RV住院病例中,分别有30%和94%发生在<1岁和<3岁的儿童中。平均维西卡里评分为15分(范围6 - 20分;96%>11分)。378例(70%)患者接受了静脉补液,130例(24%)患者通过鼻胃管补液,31例(5.7%)患者经口补液。RVGE给儿童带来了沉重负担,估计<3岁儿童因RVGE住院的风险为1/37。