Montreal Children's Hospital, McGill University Health Centre, Montreal, Canada.
J Hosp Infect. 2011 Sep;79(1):59-63. doi: 10.1016/j.jhin.2011.04.020. Epub 2011 Jul 1.
Rotavirus is a well-recognised nosocomial pathogen in paediatric settings. Although rotavirus gastroenteritis is a vaccine-preventable disease, there is currently no publicly funded programme in Canada. The objective of this study was to inform rotavirus vaccination strategy by determining the incidence of nosocomial rotavirus gastroenteritis (NRVGE), estimating the burden of disease and characterising the patients affected. We performed a retrospective cohort study of all NRVGE cases over a period of 10 years in a Canadian tertiary-care paediatric hospital. Cases (N = 214) were identified by the hospital's prospective surveillance programme for nosocomial infections. The incidence was 0.5 per 1,000 patient-days (95% confidence interval: 0.43-0.57) with no significant decline over the 10-year period. The infection rate per hospital day was highest among patients with a hospital stay of > 5 days. A chronic underlying medical condition was present in 126 patients (59%), was often associated with previous hospitalisation, and was identifiable early in life for 95 patients (44%). Rehydration was required for 132 (62%) patients and was intravenous in 98 (46%). Twenty-six patients (12%) required readmission, for a median of four days, for NRVGE that occurred after discharge. Nosocomial rotavirus infection continues to be an important problem in paediatric hospitals, predominantly for children with underlying medical conditions requiring recurrent and prolonged hospitalisation. A rotavirus immunisation programme targeted at vulnerable patients, such as infants with congenital pathology and low birth weight, requires assessment in Canada and other countries that have not introduced universal rotavirus immunisation.
轮状病毒是儿科环境中一种公认的医院病原体。尽管轮状病毒胃肠炎是一种可通过疫苗预防的疾病，但加拿大目前没有公共资助的计划。本研究的目的是通过确定医院获得性轮状病毒胃肠炎（NRVGE）的发病率、估计疾病负担并描述受影响的患者，为轮状病毒疫苗接种策略提供信息。我们对加拿大一家三级儿科医院 10 年来所有 NRVGE 病例进行了回顾性队列研究。通过医院前瞻性医院感染监测计划确定病例（N=214）。发病率为每 1000 个患者日 0.5 例（95%置信区间：0.43-0.57），在 10 年期间没有明显下降。住院时间>5 天的患者的感染率最高。126 例（59%）患者存在慢性基础疾病，这些患者常与既往住院有关，95 例（44%）患者在生命早期即可识别。132 例（62%）患者需要补液，98 例（46%）患者需要静脉补液。26 例（12%）患者因出院后发生的 NRVGE 需要再次入院，中位时间为 4 天。医院获得性轮状病毒感染仍然是儿科医院的一个重要问题，主要发生在有基础疾病、需要反复和长时间住院的儿童中。在加拿大和其他尚未普及轮状病毒免疫接种的国家，需要评估针对有感染风险的患者（如患有先天性疾病和低出生体重的婴儿）的轮状病毒免疫接种计划。
