526 RISK FACTORS ASSOCIATED WITH NOSOCOMIAL ROTAVIRUS INFECTION (RVI) ON AN INFANT WARD

Abstract

In a prospective study of a single ward for 0-2 yr. old children, 3X/wk stool specimens were obtained during hospitalization from all children admitted for one month in the winter of 1984, and tested for RV by ELISA. In those children who were RV-negative at discharge, a single stool specimen was obtained from those developing symptoms within 1 week. Of 110 children, RVI occurred in 28 (25.1%), 17 of whom were hospital-acquired (HA) occurring ≥ 72 hrs. after admission. RVI developed in 2 of 17 cases after discharge. Nine of 11 community-acquired (CA) and 15 of 17 HA cases manifested symptoms; and in no case did RV positive stools precede the onset of symptoms. Risk factors for HA of RVI included the following: 1) Room contact. RV patients were in contact with other RV cases for 3.8 d in comparison to 1.4 d for controls (72 RV-negative children) (p < .02); 11/17 (65%) patients with RVI in comparison to 23/72 (32%) controls (p < .03) were in multibed rooms. 2) Inadequate isolation of RVI. In spite of hospital policy, enteric precautions were not implemented in 5/11 CA and 11/15 HA cases. 3) Prolonged hospitalization. Whereas the mean duration of hospitalization for controls was 4.7 d, the mean time of RV acquisition for HA cases was 8.1 d. These findings indicate that control of HA RVI necessitates prompt identification and isolation of not only CA but also HA patients with RVI.