Táborská J, Pazdiora P
Infekcní klinika, FN Plzen.
Cas Lek Cesk. 1996 Aug 21;135(16):516-20.
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.
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.
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.
全球范围内，轮状病毒导致三分之一的幼儿腹泻疾病需住院治疗。轮状病毒也被认为是医院内腹泻感染最常见的病原体。本研究的目的是分析腹泻和医院感染的病因，特别是三岁以下儿童的轮状病毒病因。
1990 - 1994年，共有2002名三岁以下儿童入院，其中1480名（73.9%）因腹泻疾病入院。轮状病毒病因被证实的占25.4%，腺病毒病因占3.3%。至于细菌感染，沙门氏菌病最常见（24.4%），弯曲菌病（8.4%）、志贺氏菌病（1.7%）、大肠杆菌感染（1.3%）或耶尔森氏菌病（0.2%）较少见。36.4%的肠胃炎病例病因未明确。1480例腹泻患者中有59例（4.0%）被证实发生了医院内轮状病毒感染，在2002名患病儿童总数中占4.5%。医院感染最常发生在住院第4至6天；临床表现通常差异不大，一般为等渗性脱水，约50%的病例需要肠外补液。约四分之三的患者转氨酶暂时升高。就疾病的季节性特征而言，一年中以下月份发病率最高：1月、2月、3月、4月、10月和11月。然而，这种肠炎的两阶段轮状病毒发病率与医院感染的发病率并不相符。对症治疗是成功的。预后良好。医院内轮状病毒感染平均使住院时间延长了5天。
医院内轮状病毒肠胃炎是一个严重问题，特别是在有幼儿的科室。到目前为止，我们无法影响其发生。它们没有季节性，临床表现或病程也没有差异。幸运的是，它们预后良好。然而，它们延长了住院时间。
