Nosocomial Rotavirus Gastroenteritis in pediatric patients: a multi-center prospective cohort study.
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.


METHODS
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.
Festini
Filippo
F
Department of Pediatrics, University of Florence, Florence, Italy. filippo.festini@unifi.it
Cocchi
Priscilla
P
Mambretti
Daniela
D
Tagliabue
Bruna
B
Carotti
Milena
M
Ciofi
Daniele
D
Biermann
Klaus P
KP
Schiatti
Roberto
R
Ruggeri
Franco M
FM
De Benedictis
Fernando Maria
FM
Plebani
Alessandro
A
Guarino
Alfredo
A
de Martino
Maurizio
M
D015331:Cohort Studies; D003428:Cross Infection / Q000191:economics / Q000453:epidemiology* / Q000821:virology; D005759:Gastroenteritis / Q000191:economics / Q000453:epidemiology* / Q000821:virology; D017048:Health Care Costs; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D007223:Infant; D007407:Interviews as Topic; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012401:Rotavirus / Q000302:isolation & purification*; D012400:Rotavirus Infections / Q000191:economics / Q000453:epidemiology* / Q000821:virology