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[法国5岁以下儿童中因轮状病毒肠胃炎需住院治疗或前往急诊室就诊的影响]

[Impact of Rotavirus gastroenteritis requiring hospitalization or presenting to emergency room among children less than 5 years in France].

作者信息

Parez N, Mory O, Pozzetto B, Garbag-Chenon A, Pillet S, Texier N, Téhard B

机构信息

Hôpital Louis-Mourier, 178, rue des Renouillers, 92701 Colombes cedex, France.

出版信息

Pathol Biol (Paris). 2012 Oct;60(5):275-81. doi: 10.1016/j.patbio.2011.04.002. Epub 2011 Jul 31.

Abstract

BACKGROUND

In France, Rotavirus infections are responsible for approximately 300,000 cases of acute gastroenteritis (AGE) in children less than 5 years every year, 138,000 outpatient consultations and 18,000 hospitalizations. Surveillance for Rotavirus Infections in Hospitalized Kids (SHRIK) is a European prospective observational study conducted to assess the burden related to Rotavirus gastroenteritis (RVGE) in these children.

METHODS

Patients less than 5 years visiting emergency rooms for AGE (U-AGE), who were hospitalized (H-AGE) or who developed RVGE 48 hours after hospitalization (N-AGE) were included in the study over a year. A stool sample was collected for every child and analyzed by ELISA.

RESULTS

Results are presented for patients enrolled in France. A total of 755 eligible patients with AGE were included (357 for U-AGE, 372 for H-AGE and 26 for N-AGE). Among them, the proportion of RVGE was 49.1% (n=114) for U-AGE and 64.4% (n=186) for H-AGE. Most cases of RVGE (89%) involved children less than 2 years. GERV were frequently more severe than GEA non related to Rotavirus (NRVGE), according to the Vesikari scale, (68.4% against 41.9%, P<0.0001). Oral rehydration was performed for nearly 50% of RVGE patients before coming to hospital, versus 36.2% for NRVGE (P<0.002). All RV-positive strains were genotyped: the most frequent strains were G1P[8] (U-AGE, 42%; H-AGE, 46%) and G9P[8] (U-AGE, 38%; H-AGE, 31%).

CONCLUSION

SHRIK study followed up all GEA visiting emergency room or requiring hospitalization for one year and showed that the burden of Rotavirus disease is high with a ratio over 70% of all hospital GEA during the winter peak.

摘要

背景

在法国,轮状病毒感染每年导致约30万例5岁以下儿童急性胃肠炎(AGE),13.8万人次门诊就诊及1.8万次住院治疗。住院儿童轮状病毒感染监测(SHRIK)是一项欧洲前瞻性观察性研究,旨在评估这些儿童中与轮状病毒胃肠炎(RVGE)相关的负担。

方法

在一年时间里,纳入因AGE到急诊室就诊(U-AGE)、住院(H-AGE)或住院48小时后发生RVGE(N-AGE)的5岁以下患者。为每个儿童采集粪便样本并通过酶联免疫吸附测定法进行分析。

结果

呈现了法国入组患者的结果。共纳入755例符合条件的AGE患者(U-AGE组357例,H-AGE组372例,N-AGE组26例)。其中,U-AGE组RVGE比例为49.1%(n = 114),H-AGE组为64.4%(n = 186)。大多数RVGE病例(89%)涉及2岁以下儿童。根据韦西卡里量表,RVGE通常比非轮状病毒相关的GEA(NRVGE)更严重(68.4%对41.9%,P < 0.0001)。近50%的RVGE患者在入院前接受了口服补液,而NRVGE患者为36.2%(P < 0.002)。对所有RV阳性菌株进行了基因分型:最常见的菌株是G1P[8](U-AGE组,42%;H-AGE组,46%)和G9P[8](U-AGE组,38%;H-AGE组,31%)。

结论

SHRIK研究对所有到急诊室就诊或需要住院治疗的GEA进行了为期一年的随访,结果显示轮状病毒疾病负担较高,在冬季高峰期间占所有住院GEA的比例超过70%。

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