HELIOS Klinikum Krefeld, Zentrum für Kinder- und Jugendmedizin, Lutherplatz 40, 47805 Krefeld, Germany.
Pediatr Infect Dis J. 2013 Feb;32(2):e62-7. doi: 10.1097/INF.0b013e31826f602b.
Rotavirus (RV) gastroenteritis is a notifiable disease in Germany. The reports to the authorities contain few data concerning the severity of disease. The aims of this study were to determine incidence and outcome of very severe cases of RV disease.
Cases of very severe RV disease were collected by the German Paediatric Surveillance Unit for rare diseases (Erhebungseinheit für seltene pädiatrische Erkrankungen in Deutschland) using anonymous questionnaires based on hospitalized patients between April 2009 and March 2011. Inclusion criteria were detection of RV antigen in feces, patient aged 0-16 years and 1 or more of the following criteria: intensive care treatment, hypernatremia or hyponatremia (>155 mmol/L or <125 mmol/L), clinical signs of encephalopathy (somnolence, seizures, apnea) and RV-associated death.
During 2 years, 130 cases of very severe RV disease were reported, 101 of 130 were verified. Seventeen patients had nosocomial infection, of whom 14 were neonates in intensive care. Among those, 12 infants had verified or suspected necrotizing enterocolitis. Eighty-four community-acquired cases were reported, median age was 10.5 months (0-108 months). The median hospital stay was 6 days, and 48 patients needed intensive care treatment. Among children less than 5 years of age, the yearly incidence of community-acquired very severe RV disease was 1.2 of 100,000 (95% confidence interval: 0.9-1.4/100,000). A total of 26 of 84 and 10 of 84 patients had severe hypernatremia or hyponatremia, respectively, and 58 of 84 patients had signs of encephalopathy. Three deaths were reported (1 nosocomial and 2 community acquired).
RV infection in Germany can have a life-threatening course. A substantial number are nosocomial infections.
轮状病毒（RV）胃肠炎在德国是一种应报告疾病。向当局报告的疾病数据很少涉及疾病的严重程度。本研究的目的是确定非常严重的 RV 疾病病例的发病率和结果。
德国儿科罕见疾病监测单位（Erhebungseinheit für seltene pädiatrische Erkrankungen in Deutschland）通过匿名问卷收集非常严重 RV 疾病病例，这些问卷基于 2009 年 4 月至 2011 年 3 月住院患者。纳入标准为粪便中检测到 RV 抗原、患者年龄为 0-16 岁以及以下 1 个或多个标准：重症监护治疗、高钠血症或低钠血症（>155mmol/L 或<125mmol/L）、脑病临床症状（嗜睡、癫痫发作、呼吸暂停）和 RV 相关死亡。
在 2 年期间，报告了 130 例非常严重的 RV 疾病病例，其中 130 例中有 101 例得到证实。17 例患者发生医院感染，其中 14 例为重症监护的新生儿。其中，12 例婴儿患有确诊或疑似坏死性小肠结肠炎。报告了 84 例社区获得性病例，中位年龄为 10.5 个月（0-108 个月）。中位住院时间为 6 天，48 例患者需要重症监护治疗。在 5 岁以下儿童中，社区获得性非常严重 RV 疾病的年发病率为 1.2/100,000（95%置信区间：0.9-1.4/100,000）。84 例患者中，26 例有严重高钠血症或低钠血症，分别为 84 例患者中有 10 例有脑病症状，58 例患者有脑病症状。报告了 3 例死亡（1 例院内感染和 2 例社区获得性感染）。
德国的 RV 感染可能会危及生命。相当数量的感染是医院获得性感染。
