title: The Sustained Rotavirus Vaccination Impact on Nosocomial Infection, Duration of Hospital Stay, and Age: The RotaBIS Study (2005-2012).
abstract: BACKGROUND
  The benefits of rotavirus (RV) vaccination in developed countries have focused on reductions in mortality, hospitalization and medical visits, and herd protection. We investigated other aspects related to RV-induced nosocomial infection, duration of hospital stay, age shift, and sustained vaccine impact (VI) over time.
  
  
  METHODS
  RotaBIS (Rotavirus Belgian Impact Study; ClinicalTrials.gov identifier, NCT01563146) annually collects retrospective data on hospitalization linked to RV testing in children up to 5 years old from 11 pediatric wards located all over Belgium. Data from 2005 to 2012 have been split in pre- (2005-2006) and post-vaccination (2007-2012) period. Information was collected on age, gender, RV test result, nosocomial infection caused by RV and duration of hospital stay.
  
  
  RESULTS
  Over the 6-year period after the introduction of the RV vaccine, an 85% reduction in nosocomial infections was observed (221 in 2005 to 33 in 2012, p < 0.001). A significant reduction of almost 2 days in average duration of hospital stay per event was observed overall (7.62 days in 2005 to 5.77 days in 2012, p < 0.001). The difference is mainly explained by the higher reduction in number of nosocomial infections. A pronounced age shift (+24%, p < 0.01) of RV nosocomial infection to infants ≤2 months old was observed, increasing with length of post-vaccination period. VI was maintained over the follow-up (±79% VI per birth cohort). A decrease was seen depending on age, 85% (95% CI 76-91%) in the youngest to 63% (95% CI 22-92%) in the oldest age group.
  
  
  CONCLUSIONS
  The higher reduction in nosocomial infection may affect the overall average duration of hospital stay for RV infection. No change in VI by birth cohort, but a reduction by age group was observed. These findings could be important for decision-makers considering the introduction of universal mass RV vaccination programs.
  
  
  BACKGROUND
  ClinicalTrials.gov identifier, NCT01563146.
  
  
  BACKGROUND
  GlaxoSmithKline Biologicals SA (Rixensart, Belgium).
authors.affiliation: GSK Vaccines, Wavre, Belgium. baudouin.a.standaert@gsk.com.
authors.forename: Baudouin
authors.initials: B
authors.lastname: Standaert
authors.affiliation: Realidad, Grimbergen, Belgium.
authors.forename: Danielle
authors.initials: D
authors.lastname: Strens
authors.affiliation: GSK Vaccines, Wavre, Belgium.
authors.forename: Xiao
authors.initials: X
authors.lastname: Li
authors.affiliation: Keyrus Biopharma (c/o GSK Vaccines, Wavre, Belgium), Lasne, Belgium.
authors.forename: Nadia
authors.initials: N
authors.lastname: Schecroun
authors.affiliation: Pediatrics, Jessa Hospital, Hasselt, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Raes
keywords: Age shift; Bed occupancy; Duration of hospital stay; Hospitalization; Nosocomial infection; Quality of care; Rotavirus; Vaccination; Vaccine impact