TY - JOUR
T1 - Clinical manifestations of a cluster of rotavirus infection in young infants hospitalized in neonatal care units
AU - Tai, I. Chen
AU - Huang, Yhu Chering
AU - Lien, Rey In
AU - Huang, Chung Guei
AU - Tsao, Kuo Chien
AU - Lin, Tzou Yien
PY - 2012/2
Y1 - 2012/2
N2 - Purpose: To define the clinical manifestations of rotavirus (RV) infection in neonates and young infants hospitalized in neonatal care units, which are rarely reported. Materials and Methods: From October 2008 to September 2010, a total of 153 stool specimens positive for RV were detected from 100 neonates and young infants hospitalized in neonatal care units of our hospital. Four infants had two episodes of RV infection. Demographics and clinical presentations of these infants were collected and analyzed. The infants were further classified as having hospital-acquired (HA) or community-acquired (CA) RV infection. Results: Of the 104 episodes from 100 patients, 76 (73%) were classified as HA. Fifty-six infants were male. The mean age of onset was 2 days. The most common presentations were loose stool passages (52.9%), abdominal distension (51.9%), blood or mucus in stool (42.3%), and unstable vital signs (32.7%). Watery character in stool passage was identified in 13.5% of the infants and vomiting in 21.2%. A picture suggestive of necrotizing enterocolitis (NEC) was identified in 22 episodes (21.1%), and 12 of these were stage II or above. The average number of hospitalization days from the onset of HA-RV infection was 23 days. Compared with those in the CA group, the infants in the HA group had a significantly higher rate of blood or mucus in stools (52.6% vs. 14.3%, p<0.01) and unstable vital signs (39.5% vs. 14.3%, p=0.02), but a lower rate of watery diarrhea (9.2% vs. 28.6%, p=0.04) and fever (13.8% vs. 42.9%, p<0.01). Overall, there were five deaths, but all of these infants had major diseases. Conclusion: Bloody, mucoid stools and unstable vital signs, instead of fever with watery diarrhea, are commonly seen in neonates and young infants with RV infection. A substantial proportion of these infants may present as NEC. Once introduced, RV appears to become a troublesome problem of HA infections in neonatal care settings.
AB - Purpose: To define the clinical manifestations of rotavirus (RV) infection in neonates and young infants hospitalized in neonatal care units, which are rarely reported. Materials and Methods: From October 2008 to September 2010, a total of 153 stool specimens positive for RV were detected from 100 neonates and young infants hospitalized in neonatal care units of our hospital. Four infants had two episodes of RV infection. Demographics and clinical presentations of these infants were collected and analyzed. The infants were further classified as having hospital-acquired (HA) or community-acquired (CA) RV infection. Results: Of the 104 episodes from 100 patients, 76 (73%) were classified as HA. Fifty-six infants were male. The mean age of onset was 2 days. The most common presentations were loose stool passages (52.9%), abdominal distension (51.9%), blood or mucus in stool (42.3%), and unstable vital signs (32.7%). Watery character in stool passage was identified in 13.5% of the infants and vomiting in 21.2%. A picture suggestive of necrotizing enterocolitis (NEC) was identified in 22 episodes (21.1%), and 12 of these were stage II or above. The average number of hospitalization days from the onset of HA-RV infection was 23 days. Compared with those in the CA group, the infants in the HA group had a significantly higher rate of blood or mucus in stools (52.6% vs. 14.3%, p<0.01) and unstable vital signs (39.5% vs. 14.3%, p=0.02), but a lower rate of watery diarrhea (9.2% vs. 28.6%, p=0.04) and fever (13.8% vs. 42.9%, p<0.01). Overall, there were five deaths, but all of these infants had major diseases. Conclusion: Bloody, mucoid stools and unstable vital signs, instead of fever with watery diarrhea, are commonly seen in neonates and young infants with RV infection. A substantial proportion of these infants may present as NEC. Once introduced, RV appears to become a troublesome problem of HA infections in neonatal care settings.
KW - Necrotizing enterocolitis
KW - Neonatal care unit
KW - Neonate
KW - Rotavirus
KW - Young infant
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U2 - 10.1016/j.jmii.2011.09.023
DO - 10.1016/j.jmii.2011.09.023
M3 - Article
C2 - 22154991
AN - SCOPUS:84856305976
SN - 0253-2662
VL - 45
SP - 15
EP - 21
JO - Journal of Microbiology, Immunology and Infection
JF - Journal of Microbiology, Immunology and Infection
IS - 1
ER -
