Ancillary testing in children with rotavirus gastroenteritis.
OBJECTIVE
Costly microbiological assays are frequently performed in patients with rotavirus gastroenteritis (RGE) to exclude concurrent serious bacterial infection (SBI). The incidence of concurrent SBI in this population is unknown but estimated to be low. The primary objective was to describe the incidence of SBI in children with RGE. The secondary objective was to elucidate risk factors for prolonged length of stay (LOS) in the cohort.


METHODS
All children < or =18 years seen at a community hospital for laboratory-confirmed RGE over a 4-year period were included in a retrospective cohort study to describe the incidence of concurrent SBI and to identify risk factors for prolonged LOS. Prolonged LOS was defined as hospitalization for > or =3 days.


RESULTS
Ninety-four cases of RGE were identified; 58 (61.7%) males and 80 (85.1%) African Americans. The median age was 8 months (interquartile range [IQR], 1 month to 16 years) and 83 patients (88.3%) required admission. There were no cases of SBI. The median LOS was 2 days. Age < or = 6 months (adjusted odds ratio [OR], 3.0; 95% confidence interval [CI], 1.2-7.7; P = 0.022) and collection of a peripheral blood culture (adjusted OR, 2.7; 95% CI, 1.0-7.1; P = 0.043) were associated with LOS > or = 3 days.


CONCLUSIONS
In children evaluated at a community hospital with laboratory-confirmed RGE, no episodes of SBI occurred. This finding challenges the need to perform invasive, costly, microbiological assays to exclude concurrent SBI in this population. Children 6 months and younger were at increased risk of prolonged hospitalization from RGE.
Rowinsky
Peter A
PA
Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.
Steenhoff
Andrew P
AP
Kung
Shiang-Ju
SJ
Arbeter
Allan
A
Shah
Samir S
SS
D001424:Bacterial Infections / Q000175:diagnosis* / Q000453:epidemiology*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006764:Hospitals, Community; D006801:Humans; D015994:Incidence; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012400:Rotavirus Infections / Q000453:epidemiology*