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J Infect. 2017 Nov;75(5):448-454. doi: 10.1016/j.jinf.2017.08.006. Epub 2017 Aug 13.

Rotavirus disease course among immunocompromised patients; 5-year observations from a tertiary care medical centre.

Author information

1
Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Huispostnummer STR.6.131, Postbus 85500, 3508 GA Utrecht, The Netherlands. Electronic address: P.Bruijning@umcutrecht.nl.
2
Department of Medical Microbiology, University Medical Centre Utrecht, Huispostnummer STR.6.131, Postbus 85500, 3508 GA Utrecht, The Netherlands.
3
NIHR Clinical Research Facility Southampton, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, United Kingdom.
4
Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Huispostnummer STR.6.131, Postbus 85500, 3508 GA Utrecht, The Netherlands; Department of Medical Microbiology, University Medical Centre Utrecht, Huispostnummer STR.6.131, Postbus 85500, 3508 GA Utrecht, The Netherlands.

Abstract

Rotavirus (RV) is highly endemic inside and outside hospital-settings. Immunocompromised children and adults are at risk of complicated rotavirus gastroenteritis (RVGE), but general rotavirus disease severity in this group remains poorly described and rotavirus testing is not routinely performed beyond infancy. We assessed rotavirus disease among immunocompromised hospitalized patients.

METHODS:

Rotavirus infections at a Dutch tertiary-care centre were identified from 5-year laboratory records. Rotavirus disease course was evaluated by chart review for each immunocompromised patient. In a matched case-control analysis, we assessed whether being immunocompromised predisposed to RVGE. Rotavirus testing practice for suspected infectious gastroenteritis in our hospital was determined over a 3-years period.

RESULTS:

Out of 4584 RV tests performed, 294 were positive among hospitalized patients. Immunocompromised patients represented 57% (N = 20) of adult, and 12% (N = 32) of paediatric RVGE. A complicated disease course occurred in 81% of them and 33% required adaptations in underlying disease management. Immunocompromised adults were 7.4 times more likely todevelop RVGE compared to non-immunocompromised matched hospital-controls. Rotavirus testing in adult patients with suspected infectious gastroenteritis was uncommon (12% tested).

CONCLUSIONS:

In our hospital, most adults with RVGE are immunocompromised compared to a much smaller proportion in children. RVGE in immunocompromised patients is associated with significant morbidity. Routine rotavirus testing beyond infancy should be recommended for immunocompromised patients with suspected infectious gastroenteritis.

KEYWORDS:

Complications; Hospital; Immunocompromised; Infectious gastroenteritis; Nosocomial; Rotavirus; Vaccination

PMID:
28813644
DOI:
10.1016/j.jinf.2017.08.006
[Indexed for MEDLINE]

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