Burden of Nosocomial and Community-Acquired Rotavirus Gastroenteritis in Children

Öz

Background: This study aimed to evaluate the demographic and clinical characteristics, seasonal distribution, vaccination status, and complications of rotavirus gastroenteritis (RVGE) in children, as well as the frequency and clinical features of nosocomial RVGE. Methods: This retrospective study included pediatric patients aged 1 month to 18 years who were diagnosed with RVGE at a tertiary university pediatric hospital in Türkiye over a five-year period. The diagnosis of RVGE was based on the detection of rotavirus antigen in stool samples. Data on demographics, hospitalization, nosocomial status, complications, seasonal distribution, and vaccination status were obtained from hospital records, and vaccination status was confirmed via caregiver interviews. Nosocomial RVGE was defined as symptom onset ≥48 hours after admission or within 72 hours of discharge. Results: A total of 391 children were diagnosed with RVGE; 227 (58.1%) were outpatients and 164 (41.9%) were hospitalized. Nosocomial infection occurred in 60 (15.3%) of all RVGE cases, corresponding to 36.6% of hospitalized RVGE cases. The median age was 11 months (1–52) for outpatients, 10 months (1–61) for inpatients, and 5 months (1–40) for nosocomial cases. RVGE was most frequently observed in winter (36.6%). Complications occurred in 123 (31.5%) patients, the most common was dehydration, followed by bacteremia, pneumonia, seizures, and elevated liver enzymes. Only 8 children (2%) were vaccinated against rotavirus. Conclusion: Rotavirus remains a significant cause of gastroenteritis and hospitalization in children, particularly among the unvaccinated. The high rate of nosocomial transmission highlights the need for strengthened infection control practices and consideration of routine rotavirus vaccination in national immunization programs.

Anahtar Kelimeler

• Rotavirus
• gastroenteritis
• children
• vaccination
• nosocomial infection

Çocuklarda Nozokomiyal ve Toplum Kökenli Rotavirüs Gastroenteritinin Yükü

Öz

Giriş: Bu çalışmada, çocuklarda rotavirüs gastroenteritinin (RVGE) demografik ve klinik özellikleri, mevsimsel dağılımı, aşılanma durumu ve komplikasyonları ile hastane kökenli RVGE sıklığı ve klinik özelliklerinin değerlendirilmesi amaçlandı. Yöntemler: Bu retrospektif çalışmaya, beş yıllık bir süre boyunca Türkiye’deki üçüncü basamak bir üniversite çocuk hastanesinde RVGE tanısı alan, 1 ay ile 18 yaş aras pediatrik hastalar dâhil edildi. RVGE tanısı, dışkı örneklerinde rotavirüs antijeninin saptanmasına dayandırıldı. Demografik veriler, hastaneye yatış durumu, nozokomiyal durum, komplikasyonlar, mevsimsel dağılım ve aşılama durumu ile ilgili veriler hastane kayıtlarından elde edildi ve aşılama durumu, bakım verenlerle yapılan görüşmeler yoluyla doğrulandı. Nosokomiyal RVGE, semptomların yatıştan sonraki ≥48 saat içinde veya taburcu olduktan sonraki 72 saat içinde başlaması olarak tanımlandı. Bulgular: Toplam 391 çocukta RVGE saptandı; bunların 227’si (%58,1) ayaktan, 164’ü (%41,9) yatarak tedavi edildi. Tüm RVGE olgularının 60’ında (%15,3) nozokomiyal enfeksiyon vardı; bu, yatan RVGE olgularının %36,6’sına karşılık gelmekteydi. Ortanca yaş, ayaktan hastalarda 11 ay (1–52), yatanlarda 10 ay (1–61) ve nozokomiyal olgularda 5 ay (1–40) idi. En sık kış mevsiminde (%36,6) görüldü. Toplam 123 hastada (%31,5) komplikasyon gelişti; en yaygın komplikasyon dehidratasyondu, bunu bakteriyemi, pnömoni, nöbet ve karaciğer enzim yüksekliği izlendi. Sadece 8 çocuk (%2) rotavirüs aşılıydı. Sonuç: Rotavirüs, özellikle aşısız çocuklarda, gastroenterit ve hastaneye yatışların önemli bir nedenidir. Nozokomiyal bulaşın yüksek oranı, enfeksiyon kontrol önlemlerinin güçlendirilmesi ve rotavirüs aşısının ulusal bağışıklama programına dahil edilmesinin önemini vurgulamaktadır.

Anahtar Kelimeler

• Rotavirüs
• gastroenterit
• çocuk
• aşılama
• nozokomiyal enfeksiyon

Kaynakça

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