Abstract
BackgroundFew data are available on the incidence of nosocomial Rotavirus infections (NRVI) in pediatric hospitals and on their economic impact. The goals of this study were: to evaluate the incidence of NRVI in various Italian pediatric wards during the course of two peak RV seasons; to investigate possible risk factors for NRVI; to estimate the costs caused by NRVI.Methodsprospective cohort study. Population: all the children under 30 months of age who were admitted without any symptom or diagnosis of gastroenteritis in the pediatric hospitals of Florence, Naples, Brescia and Ancona, Italy, during the winter-spring periods 2006-2007 and 2007-2008. Serial RV rapid tests and clinical monitoring were carried out on the cohort. Telephone interviews were performed from 3 to 5 days after discharge.Results520 out of 608 children completed the study (85.6%). The overall incidence of NRVI was 5.3% (CI95% 3.6-7.5), (7.9 per 1,000 days of hospital stay, CI 95% 5.3-11.3). The average duration of hospital stay was significantly longer for children who had NRVI (8.1 days, SD 5.4) than for non-infected children (6.4 days, SD 5.8, difference 1.7 days, p = 0.004). The risk of contracting NRVI increased significantly if the child stayed in hospital more than 5 days, RR = 2.8 (CI95% 1.3-6), p = 0.006. In Italy the costs caused by NRVI can be estimated at 8,019,155.44 Euro per year. 2.7% of the children hospitalized with no gastroenteritis symptoms tested positive for RV.ConclusionsOur study showed a relevant incidence of NRVI, which can increase the length of the children's stay in hospital. Limiting the number of nosocomial RV infections is important to improve patients' safety as well as to avoid additional health costs.
Highlights
Few data are available on the incidence of nosocomial Rotavirus infections (NRVI) in pediatric hospitals and on their economic impact
The RV genus of the Reoviridae family is very diverse, as it consists of different groups (A-G) and of different types based on the characteristics of the surface proteins
The primary objective of our study was to evaluate the incidence of NRVI in various pediatric wards throughout Italy during the course of two peak RV infection periods
Summary
Few data are available on the incidence of nosocomial Rotavirus infections (NRVI) in pediatric hospitals and on their economic impact. Rotavirus (RV) is the most frequent cause of viral gastroenteritis in children under 5 years of age. Acute gastroenteritis due to RV infection (RV AGE) causes the death of approximately 440,000 children every year [1,2]. In the USA, RV is responsible for the hospitalization of 58,000 to 70,000 children every year [3]. The RV genus of the Reoviridae family is very diverse, as it consists of different groups (A-G) and of different types based on the characteristics of the surface proteins. VP7 (G = glycoprotein) and VP4 (P = protease-sensitive protein). At least 23 G types and 31 P types of group A RVs, the group which most commonly infects humans, have been differentiated [4,5]
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