Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, Netherlands.
Pediatrics. 2012 Apr;129(4):e1011-9. doi: 10.1542/peds.2011-2779. Epub 2012 Mar 5.
Nosocomial rotavirus (nRV) infections represent an important part of rotavirus (RV)-associated morbidity. The incidence of nRV influences the estimated total RV disease burden, an important determinant of cost-effectiveness of RV vaccination programs. Our aim is to summarize the existing evidence and produce reliable estimates of nRV incidence, in pediatric settings in Europe and North America.
We searched electronic databases for studies on nRV incidence among pediatric inpatients. To ascertain complete case reporting, only studies describing active nRV surveillance in their methodology were included. Random effects meta-analysis was performed. Meta-regression was used to obtain results adjusted for important study characteristics.
Twenty surveillance studies met the quality criteria for inclusion. The pooled unadjusted nRV incidence was 2.9 per 100 hospitalizations (95% confidence interval [CI]: 1.6-4.4). Incidence was significantly influenced by studies' seasonality-months (RV epidemic season only or year-round) and the age range of included patients. Highest nRV incidence was found for children <2 years of age, hospitalized during the epidemic months (8.1/100 hospitalizations; 95% CI: 6.4-9.9). The adjusted year-round nRV incidence estimate without age restriction was 0.4/100 hospitalizations (95% CI: 0.1-2.1) and 0.7 (95% CI: 0.0-1.8) for children <5 years of age.
This is the first meta-analysis to summarize results of surveillance studies on nRV incidence. nRV is an important problem among hospitalized infants during the winter months. The lower season and age-adjusted nRV incidence estimate seems more appropriate for application in population-based burden of disease analysis.
医院获得性轮状病毒（nRV）感染是轮状病毒（RV）相关发病率的重要组成部分。nRV 的发病率影响 RV 疾病总负担的估计，这是 RV 疫苗接种计划成本效益的一个重要决定因素。我们的目的是总结现有的证据，并对欧洲和北美的儿科环境中 nRV 发病率进行可靠的估计。
我们检索了电子数据库中关于儿科住院患者 nRV 发病率的研究。为了确保完全报告病例，只纳入了在方法学中描述了主动 nRV 监测的研究。进行随机效应荟萃分析。使用元回归来获得调整重要研究特征后的结果。
20 项监测研究符合纳入标准。未调整的 nRV 发病率为每 100 例住院患者 2.9 例（95%置信区间：1.6-4.4）。发病率受到研究季节性（仅 RV 流行季节或全年）和纳入患者年龄范围的显著影响。年龄<2 岁、在流行季节住院的儿童 nRV 发病率最高（8.1/100 例住院患者；95%置信区间：6.4-9.9）。无年龄限制的全年 nRV 发病率估计值为 0.4/100 例住院患者（95%置信区间：0.1-2.1），年龄<5 岁的儿童为 0.7（95%置信区间：0.0-1.8）。
这是第一项总结关于 nRV 发病率监测研究结果的荟萃分析。nRV 是冬季住院婴儿的一个重要问题。较低的季节性和年龄调整后的 nRV 发病率估计值似乎更适合应用于基于人群的疾病负担分析。
