title: The impact of Rotavirus mass vaccination on hospitalization rates, nosocomial Rotavirus gastroenteritis and secondary blood stream infections.
abstract: BACKGROUND
  The aim of the study was to evaluate the effects of universal mass vaccination (UMV) against rotavirus (RV) on the hospitalization rates, nosocomial RV infections and RV-gastroenteritis (GE)-associated secondary blood stream infections (BSI).
  
  
  METHODS
  The retrospective evaluation (2002-2009) by chart analysis included all clinically diagnosed and microbiologically confirmed RV-GE cases in a large tertiary care hospital in Austria. The pre-vaccination period (2002-2005) was compared with the recommended and early funded (2006-2007) and the funded (2008-2009) vaccination periods. Primary outcomes were RV-GE-associated hospitalizations, secondary outcomes nosocomial RV disease, secondary BSI and direct hospitalization costs for children and their accompanying persons.
  
  
  RESULTS
  In 1,532 children with RV-GE, a significant reduction by 73.9% of hospitalized RV-GE cases per year could be observed between the pre-vaccination and the funded vaccination period, which was most pronounced in the age groups 0-11 months (by 87.8%), 6-10 years (by 84.2%) and 11-18 years (88.9%). In the funded vaccination period, a reduction by 71.9% of nosocomial RV-GE cases per year was found compared to the pre-vaccination period. Fatalities due to nosocomial RV-GE were only observed in the pre-vaccination period (3 cases). Direct costs of hospitalized, community-acquired RV-GE cases per year were reduced by 72.7% in the funded vaccination period. The reduction of direct costs for patients (by 86.9%) and accompanying persons (86.2%) was most pronounced in the age group 0-11 months.
  
  
  CONCLUSIONS
  UMV may have contributed to the significant decrease of RV-GE-associated hospitalizations, to a reduction in nosocomial RV infections and RV-associated morbidity due to secondary BSI and reduced direct hospitalization costs. The reduction in nosocomial cases is an important aspect considering severe disease courses in hospitalized patients with co-morbidities and death due to nosocomial RV-GE.
authors: Department of Pediatrics, Pediatrics I, Innsbruck Medical University, Anichstr, 35, 6020, Innsbruck, Austria.
authors: Manuela
authors: M
authors: Zlamy
authors: Sabine
authors: S
authors: Kofler
authors: Dorothea
authors: D
authors: Orth
authors: Reinhard
authors: R
authors: Würzner
authors: Peter
authors: P
authors: Heinz-Erian
authors: Andrea
authors: A
authors: Streng
authors: Martina
authors: M
authors: Prelog
mesh_terms: D000293:Adolescent; D001317:Austria / Q000453:epidemiology; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control / Q000821:virology; D003428:Cross Infection / Q000097:blood / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D032541:Mass Vaccination / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012400:Rotavirus Infections / Q000097:blood / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control; D022243:Rotavirus Vaccines / Q000008:administration & dosage*
chemical_list: D022243:Rotavirus Vaccines