Healthcare-associated Viral Gastroenteritis among Children in a Large Pediatric Hospital, United Kingdom

Nigel A Cunliffe,Sharon J Lowe,C Anthony Hart,Will Sopwith,Martyn Regan,Claire Elliot,Nick Kitchin,Toyoko Nakagomi,J Angela Booth,Osamu Nakagomi

doi:10.3201/eid1601.090401

Abstract

Viruses are the major pathogens of community-acquired (CA) acute gastroenteritis (AGE) in children, but their role in healthcare-associated (HA) AGE is poorly understood. Children with AGE hospitalized at Alder Hey Children's Hospital, Liverpool, UK, were enrolled over a 2-year period. AGE was classified as HA if diarrhea developed > or =48 hours after admission. Rotavirus, norovirus, adenovirus 40/41, astrovirus, and sapovirus were detected by PCR. A total of 225 children with HA-AGE and 351 with CA-AGE were enrolled in the study. HA viral gastroenteritis constituted one fifth of the diarrheal diseases among hospitalized children and commonly occurred in critical care areas. We detected > or =1 virus in 120 (53%) of HA-AGE cases; rotavirus (31%), norovirus (16%), and adenovirus 40/41 (15%) were the predominant viruses identified. Molecular evidence indicated rotaviruses and noroviruses were frequently introduced into the hospital from the community. Rotavirus vaccines could substantially reduce the incidence of HA-AGE in children.

Highlights

Viruses are the major pathogens of community-acquired (CA) acute gastroenteritis (AGE) in children, but their role in healthcare-associated (HA) AGE is poorly understood
In a 2-year prospective study in a large pediatric hospital, we examined the contribution to HA-AGE and CA-AGE of rotavirus and 4 additional enteric viruses using the most sensitive molecular detection methods available
In our study, one fifth of AGE among children within a large pediatric hospital was of viral origin and acquired within the healthcare setting

Summary

Introduction

Viruses are the major pathogens of community-acquired (CA) acute gastroenteritis (AGE) in children, but their role in healthcare-associated (HA) AGE is poorly understood. Rotavirus was detected in 70 (58%) of 120 children with HA-AGE in whom a virus was identified. In 98 (17%) of 576 children with AGE, >1 virus was detected; this proportion did not significantly differ between CA (65/351 cases, 19%) and HA (33/225, 15%) infection.

Results

Conclusion