Nosocomial Rotavirus Gastroenteritis in pediatric patients: a multi-center prospective cohort study
Nosocomial Rotavirus Gastroenteritis in pediatric patients: a multi-center prospective cohort study
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DOI：
10.1186/1471-2334-10-235
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发表时间：
2010-08-09
影响因子：
3.7
通讯作者：
de Martino, Maurizio
中科院分区：
文献类型：
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作者：
Festini, Filippo;Cocchi, Priscilla;de Martino, Maurizio
背景：关于儿科医院内轮状病毒感染（NRVI）的发生率及其经济影响的数据很少。本研究的目的是：评估NRVI的发病率在意大利儿科病房在两个高峰RV季节的过程中，调查可能的危险因素为NRVI，估计费用所造成的NRVI.Methods：前瞻性队列研究。人口：2006-2007年和2007-2008年冬春季期间，在佛罗伦萨、那不勒斯、布雷西亚和安科纳（意大利）儿科医院住院且无任何胃肠炎症状或诊断的所有30个月以下儿童。对该队列进行系列RV快速检测和临床监测。结果：608名儿童中有520名（85.6%）完成了研究。NRVI的总发生率为5.3%（CI 95% 3.6-7.5），（7.9/1000住院日，CI 95% 5.3-11.3）。NRVI患儿的平均住院时间（8.1天，SD 5.4）显著长于非感染患儿（6.4天，SD 5.8，差异1.7天，p = 0.004）。住院时间超过5天的患儿感染NRVI的风险显著增加，RR = 2.8（CI 95% 1.3-6），p = 0.006。在意大利，NRVI造成的费用估计为每年8，019，155.44欧元。2.7%的住院儿童没有胃肠炎症状检测RV阳性。结论：我们的研究表明，NRVI的相关发病率，这可以增加儿童的住院时间。限制院内RV感染的数量对于提高患者的安全性以及避免额外的健康成本非常重要。
Background: Few 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.Methods: prospective 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.Results: 520 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.Conclusions: Our 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.