Hospital‐acquired rotavirus and norovirus acute gastroenteritis in a pediatric unit, in 2014‐2015

Abstract

The occurrence of hospital-acquired acute gastroenteritis (AGE) is a major concern for public health. RotavirusA (RVA) and norovirus (NoV) are common causes of viral AGE in the pediatric population, and their role in nosocomial infections has been proven, remaining poorly investigated. To investigate RVA and NoV in hospital-acquired AGE, 55 stool samples from children with nosocomial AGE were collected between May 2014 and May 2015. To evaluate virus spreading routes, 51 environmental swabs were collected from staff and patients' rooms. Stools were tested for both RVA and NoV RNA by reverse-transcription-PCR. Nucleotide sequencing and phylogenetic analysis were performed to characterize the viruses. Forty-seven of 55 cases analyzed resulted positive for RVA. The predominant genotype was G4P[8] (18/55) followed by G1P[8] (14/55). Mixed RVA infections were also detected (7/55). Twenty-two samples were positive for NoV, and GII.4 was revealed to be the predominant genotype. Seventeen samples were positive for both RVA and NoV. This study aimed to evaluate the burden of norovirus and rotavirus nosocomial AGE, contributing to identify the environment source of infections and to activate effective strategies for intervention. The reduction in nosocomial AGE cases is an important aspect, considered the worsened disease course in transplant, cancer, and intensive care unit inpatients.

Development of a novel prevention bundle for pediatric healthcare-associated viral infections

“…Like others, 4 – 8 , 11 , 12 we observed that patients with HAVIs often experienced adverse outcomes, including escalation of respiratory support, delayed discharge, and transfer to ICU. Nevertheless, there remains a lack of awareness and urgency around the potential severity of HAVIs in the pediatric setting, suggesting the need for additional efforts to emphasize these adverse events similarly to other well-established patient safety initiatives.…”

“…Escalation of care 134 (37) Delay of discharge 71 (19) Transfer to ICU 42 (11) Other interventions 26 (7) Required readmission 22 (6) Required intubation 19 (5) Delay of procedure/surgery/imaging 15 (4) NOTE. ICU, intensive care unit.…”

“…[1][2][3] Hospitalized children who develop a HAVI often experience prolonged hospitalization, higher readmission rates, and increased morbidity such as escalation of respiratory support. [4][5][6][7][8][9][10] Neonates and immunocompromised children may experience significant clinical deterioration and even death. 8,11,12 Also, HAVIs result in increased healthcare costs through their associated morbidity, initiation of response measures to outbreaks, and potential loss of working days for parents and/or furloughed employees.…”

“…8,11,12 Also, HAVIs result in increased healthcare costs through their associated morbidity, initiation of response measures to outbreaks, and potential loss of working days for parents and/or furloughed employees. 4 The prevention of HAVIs is challenging. Unlike other healthcare-associated infections (HAIs), viral pathogens can affect patients regardless of presence of indwelling devices.…”

Healthcare-associated infections: potential for prevention through vaccination

“…4 HAIs encompass both bacterial and viral infections. Examples of the latter are rotavirus and norovirus acute gastroenteritis acquired in a pediatric unit, 5 and respiratory viruses such as influenza and rhinovirus in the intensive care unit. 6 The rates of healthcare-associated respiratory viral infections may be high: of 7772 laboratory-confirmed cases of respiratory viral infection in a Korean tertiary-care hospital, 22.8% were categorized as having been acquired in hospital, with an overall incidence of 3.9 cases per 1000 admitted.…”