Korean J Pediatr Infect Dis.  2007 Nov;14(2):145-154. 10.14776/kjpid.2007.14.2.145.

Study of nosocomial rotavirus infection in neonates admitted to a postpartum-care center

• Park JY
• Kim DH
• Bae SY
• Choi CH
• Cho EY
• Choi JH
• Kim SM

• KMID: 2439947
• DOI: http://doi.org/10.14776/kjpid.2007.14.2.145

Abstract

PURPOSE
Rotavirus is one of the most important etiologic agents of nosocomial infections among the neonates. This study was designed to investigate nosocomial rotavirus infection in neonates who were admitted to a postpartum-care center after birth.
METHODS
From March 2005 to September 2006, 957 healthy neonates were examined for rotavirus antigen in stool by immunochromatographic method and 216 neonates were rotavirus antigen positive within 24 hours after admitted to a postpartum-care center. We reviewed the nursing charts retrospectively such as characteristics, monthly distribution, birth hospitals, delivery methods, feeding types and clinical manifestations.
RESULTS
Among 957 neonates, 216 neonates (22.6%) were rotavirus antigen positive and there were no differences in sex, birth weight, gestational age. Monthly positive rate of rotavirus antigen showed diversity from 10% to 36%. According to birth hospitals, positive rate showed diversity from 3.5% to 53.6%. Out of 957 neonates, 655 cases (68.4%) were born of vaginal delivery and mean hospitalized duration was 2.4 days, 302 cases (31.6%) were born of cesarean section and mean hospitalized duration was 5.7 days. 17.6% of vaginal delivery and 33.4% of cesarean section were rotavirus antigen positive. The positive rate was higher in neonates by cesarean section than vaginal delivery (P < 0.001). According to feeding types, positive rate of rotavirus antigen was lower in breast-fed group than formula- fed group (P < 0.001). Proportion of symptomatic case among rotavirus antigen positive was 34.7%. Most common clinical manifestation was diarrhea (61.3%), following poor feeding (45.3%), fever (40.0%), vomiting (25.3%), delayed weight gain (12.0%), and decreased urine amount (5.3%).
CONCLUSION
Some neonates were already infected before admission to a postpartum-care center. Without meticulous management, nosocomial rotavirus infection would transmit rapidly in a postpartum-care center spreading to the community. Recommendation of breastfeeding, routine rotavirus screeing test with or without symptom, and isolation of all rotavirus antigen positive neonates in a postpartum-care center seem to be necessary. Also attentive hygiene education and further investigations of rotavirus infection in a postpartum- care center would be needed.

Keyword

Rotavirus; Neonate; Nosocomial infection; Postpartum-care center

MeSH Terms

Birth Weight
Breast Feeding
Cesarean Section
Cross Infection
Diarrhea
Education
Feeding Methods
Female
Fever
Gestational Age
Humans
Hygiene
Infant, Newborn*
Methods
Nursing
Parturition
Pregnancy
Retrospective Studies
Rotavirus Infections*
Rotavirus*
Vomiting
Weight Gain