Document Detail

Clinical manifestations of rotavirus infection in the neonatal intensive care unit.
MedLine Citation:
PMID:  12488657     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: This report describes clinical signs of rotavirus infection (RVI) among neonates admitted to a neonatal intensive care unit (NICU), compares these signs between term and preterm neonates and assesses the seasonal distribution of RVI in the NICU with that of the community. METHODS: After an initial prevalence study of 28 days, a prospective longitudinal study in the NICU was conducted. During the next 48 months from December 1, 1991 to November 30, 1995, term and preterm NICU patients were evaluated daily for pre-defined deviations in their baseline gastrointestinal status. Fecal specimens of neonates who fulfilled the entry criteria were tested for rotavirus by a monoclonal antibody-based enzyme immunoassay and by immunoelectron microscopy. Demographic and outcome data for these neonates were collected. In addition data assessing RVI in the community were collected during this period. RESULTS: The prevalence of RVI among NICU patients was 18.4%. Of 194 neonates included in the longitudinal study, 95 had RVI. Neonates with RVI differed from those without RVI with respect to frequent stooling (P = 0.0005), higher percentage of bloody mucoid stools (P = 0.003) and higher percentage of watery stools (P = 0.023). The odds of these three clinical outcomes were approximately 2.5 times higher in neonates with RVI than in neonates without RVI. Among neonates included in the study advanced necrotizing enterocolitis occurred at the same rate (15%) among those with and without RVI. Comparisons between term and preterm neonates with RVI showed that frequent stooling (P = 0.003) and watery stools (P = 0.0001) occurred more often among term neonates, whereas bloody mucoid stools (P = 0.001), abdominal distention (P = 0.03) and intestinal dilatation (P = 0.016) were more common in preterm neonates. The seasonal distribution of RVI in NICU paralleled its distribution in the community. CONCLUSION: RVI appears prevalent in the NICU setting. An absence of watery stools in a neonate should not preclude consideration of RVI when evaluating gastrointestinal signs among neonates. The clinical spectrum of RVI differs in term and preterm infants.
Renu Sharma; Mark L Hudak; Bangalore R Premachandra; Gary Stevens; Carmela B Monteiro; James A Bradshaw; Andrew M Kaunitz; Robert A Hollister
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  21     ISSN:  0891-3668     ISO Abbreviation:  Pediatr. Infect. Dis. J.     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-12-18     Completed Date:  2003-01-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1099-105     Citation Subset:  IM    
Department of Pediatrics, University of Florida Health Science Center, Jacksonville, USA.
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MeSH Terms
Analysis of Variance
Cross Infection / epidemiology*,  virology
Enteritis / epidemiology*,  virology
Feces / virology
Florida / epidemiology
Follow-Up Studies
Gestational Age
Infant, Newborn
Infant, Premature*
Intensive Care Units, Neonatal*
Logistic Models
Longitudinal Studies
Prospective Studies
Risk Factors
Rotavirus Infections / diagnosis*,  epidemiology*
Sampling Studies
Sex Distribution

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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