title: The role of torovirus in nosocomial viral gastroenteritis at a large tertiary pediatric centre.
abstract: OBJECTIVE
  To describe the viral etiology and epidemiology of nosocomial viral gastroenteritis (NVG) at a tertiary care pediatric hospital and identify any changes over the past two decades.
  
  
  METHODS
  Retrospective review of all patients with laboratory-confirmed NVG at The Hospital for Sick Children (Toronto, Ontario), from January 1, 2004, to December 31, 2005.
  
  
  RESULTS
  One hundred forty-two episodes of NVG were found among 133 patients, occurring in 0.48 of 100 admissions. The median age was two years; 42% were <1 year of age and 41% were immunocompromised. The most commonly detected pathogen was torovirus (67% of episodes), followed by rotavirus (19%) and adenovirus (9%). Seventy-five cases (53%) were epidemiologically linked in 32 separate clusters (median cluster size two, range two to four). The NVG rate fell from 0.63 of 100 to 0.22 of 100 admissions after March 2005 (P<0.001) when enhanced infection control precautions were instituted in response to an outbreak of vancomycin-resistant Enterococcus.
  
  
  CONCLUSIONS
  Torovirus remains the most commonly identified cause of NVG at The Hospital for Sick Children. Most NVG cases were epidemiologically linked, and a significant reduction in cases occurred after the institution of enhanced infection control practices following an outbreak of vancomycin-resistant Enterococcus. Improved education and surveillance for NVG should lead to further reduction in this problem.
authors.affiliation: Department of Paediatrics, The Hospital for Sick Children and University of Toronto; ; Department of Laboratory Medicine and Pathobiology, University of Toronto; ; Division of Microbiology, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario Dr Gubbay and Dr Al-Rezqi are co-first authors.
authors.forename: Jb
authors.initials: J
authors.lastname: Gubbay
authors.forename: A
authors.initials: A
authors.lastname: Al-Rezqi
authors.forename: M
authors.initials: M
authors.lastname: Hawkes
authors.forename: L
authors.initials: L
authors.lastname: Williams
authors.forename: Se
authors.initials: S
authors.lastname: Richardson
authors.forename: A
authors.initials: A
authors.lastname: Matlow
keywords: Gastroenteritis; Nosocomial infections; Pediatrics; Rotavirus; Torovirus