[Nosocomial rotavirus infections in children].

BACKGROUND

Worldwide rotaviruses cause in young children one third of diarrhoeal diseases which call for hospital admission. Rotaviruses are also considered the most frequent etiological agent of nosocomial diarrhoeal infections. The objective of the present work was an analysis of the etiology of diarrhoea and nosocomial infection, in particular of rotavirus etiology in children under three years of age.

METHODS AND RESULTS

In 1990-1994 a total of 2002 children under three years were admitted to hospital, incl. 1480 (73.9%) on account of diarrhoeal diseases. A rotavirus etiology was proved in 25.4%, adenovirus etiology in 3.3%. As to bacterial infections, salmonellosis was most frequent (24.4%), less frequent campylobacteriosis (8.4%), shigellosis (1.7%), colibacillary infection (1.3%) or yersiniosis (0.2%). In 36.4% cases of gastroenteritis the etiology was not elucidated. Nosocomial infection with rotaviruses was proved in 59 of 1480 patients with diarrhoea (4.0%) and in 4.5% of the total number of 2002 sick children resp. Nesocomial infection developed most frequently between the 4th and 6th day of hospitalization; the clinical picture is not very different, as a rule isoosmolal dehydration which in cca 50% called for parenteral rehydration. About three quarters of the patients have temporarily elevated aminotransferases. As far as the seasonal character of the disease is concerned, the highest incidence was recorded in the following months of the year: I, II, III, IV, X and XI. This two-phase rotaviral incidence of enteritis does, however, not correspond with the incidence of nosocomial infections. Symptomatic treatment is successful. The prognosis is favourable. Nosocomial rotavirus infection protracted hospitalization on average by five days.

CONCLUSIONS

Nosocomial rotavirus gastroenteritis is a serious problem in particular in departments with young children. So far we are unable to influence their occurrence. They are not seasonal, they do not have a different clinical picture or course. Luckily they have a favourable prognosis. However, they prolong the period of hospitalization.