Department of Paediatrics, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom.
Department of Virology, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom.
PLoS One. 2018 Mar 22;13(3):e0194009. doi: 10.1371/journal.pone.0194009. eCollection 2018.
Rotavirus is the leading cause of acute gastroenteritis in children and is associated with neurological complications such as seizures and encephalopathy. The aim of this study was to investigate the presentation and complications of rotavirus compared to non-rotavirus gastroenteritis in UK children.
This was a retrospective, case-control, hospital-based study conducted at three sites in east London, UK. Cases were children aged 1 month to 16 years diagnosed with acute gastroenteritis between 1 June 2011 and 31 December 2013, in whom stool virology investigations confirmed presence of rotavirus by PCR. They were matched by age, gender and month of presentation to controls with rotavirus-negative gastroenteritis.
Data were collected from 116 children (50 cases and 66 controls). Children with rotavirus gastroenteritis tended to present more frequently with metabolic acidosis (pH 7.30 vs 7.37, P = 0.011) and fever (74% versus 46%; P = 0.005) and were more likely to require hospitalisation compared to children with non-rotavirus gastroenteritis (93% versus 73%; P = 0.019). Neurological complications were the most common extra-intestinal manifestations, but did not differ significantly between children with rotavirus-positive gastroenteritis (RPG) and rotavirus-negative gastroenteritis (RNG) (24% versus 15%, respectively; P = 0.24). Encephalopathy occurred only in children with rotavirus infection (n = 3, 6%).
Rotavirus causes longer and more severe disease compared to other viral pathogens. Seizures and milder neurological signs were surprisingly common and associated with multiple pathogens, but encephalopathy occurred only in children with rotavirus gastroenteritis. Rotavirus vaccination may reduce seizures and presentation to hospital, but vaccines against other pathogens causing gastroenteritis are required.
轮状病毒是导致儿童急性肠胃炎的主要原因，并与癫痫发作和脑病等神经系统并发症相关。本研究旨在调查轮状病毒与英国儿童中其他非轮状病毒肠胃炎相比的表现和并发症。
这是一项在英国伦敦东部三个地点进行的回顾性病例对照医院为基础的研究。病例为 2011 年 6 月 1 日至 2013 年 12 月 31 日期间被诊断为急性肠胃炎的年龄在 1 个月至 16 岁的儿童，粪便病毒学检测通过 PCR 确认轮状病毒阳性。根据年龄、性别和就诊月份，与轮状病毒阴性肠胃炎的对照组进行匹配。
共收集了 116 名儿童（50 例病例和 66 例对照组）的数据。轮状病毒肠胃炎患儿更常出现代谢性酸中毒（pH7.30 比 7.37，P=0.011）和发热（74%比 46%；P=0.005），与非轮状病毒肠胃炎患儿相比，更有可能需要住院治疗（93%比 73%；P=0.019）。神经系统并发症是最常见的肠道外表现，但在轮状病毒阳性肠胃炎（RPG）和轮状病毒阴性肠胃炎（RNG）患儿之间无显著差异（分别为 24%和 15%；P=0.24）。脑病仅发生在轮状病毒感染患儿（n=3，6%）中。
与其他病毒病原体相比，轮状病毒引起的疾病持续时间更长，病情更严重。癫痫发作和较轻的神经系统症状令人惊讶地常见，与多种病原体相关，但脑病仅发生在轮状病毒肠胃炎患儿中。轮状病毒疫苗接种可能会减少癫痫发作和住院率，但仍需要针对导致肠胃炎的其他病原体的疫苗。
