title: Healthcare-associated viral gastroenteritis among children in a large pediatric hospital, United Kingdom.
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.
authors.affiliation: Division of Medical Microbiology, University of Liverpool, Daulby St, Liverpool L69 3GA, UK. n.a.cunliffe@liv.ac.uk
authors.forename: Nigel A
authors.initials: NA
authors.lastname: Cunliffe
authors.forename: J Angela
authors.initials: JA
authors.lastname: Booth
authors.forename: Claire
authors.initials: C
authors.lastname: Elliot
authors.forename: Sharon J
authors.initials: SJ
authors.lastname: Lowe
authors.forename: Will
authors.initials: W
authors.lastname: Sopwith
authors.forename: Nick
authors.initials: N
authors.lastname: Kitchin
authors.forename: Osamu
authors.initials: O
authors.lastname: Nakagomi
authors.forename: Toyoko
authors.initials: T
authors.lastname: Nakagomi
authors.forename: C Anthony
authors.initials: CA
authors.lastname: Hart
authors.forename: Martyn
authors.initials: M
authors.lastname: Regan
mesh_terms: D017250:Caliciviridae Infections / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000821:virology; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology; D005838:Genotype; D006745:Hospital Bed Capacity, 300 to 499; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D029322:Norovirus / Q000235:genetics; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D012401:Rotavirus / Q000235:genetics; D012400:Rotavirus Infections / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology