Open Access Highly Accessed Research article

Nosocomial Rotavirus Gastroenteritis in pediatric patients: a multi-center prospective cohort study

Filippo Festini1*, Priscilla Cocchi1, Daniela Mambretti2, Bruna Tagliabue3, Milena Carotti4, Daniele Ciofi1, Klaus P Biermann5, Roberto Schiatti5, Franco M Ruggeri6, Fernando Maria De Benedictis4, Alessandro Plebani3, Alfredo Guarino2 and Maurizio de Martino1

Author Affiliations

1 Department of Pediatrics, University of Florence, Florence, Italy

2 Department of Pediatrics, University of Naples "Federico II", Naples, Italy

3 Department of Pediatrics, University of Brescia, Brescia, Italy

4 Department of Pediatrics, "Salesi" Children's Hospital, Ancona, Italy

5 Infection Control Unit, "Meyer" Children's Hospital, Florence, Italy

6 Department of Veterinary Public Health & Food Safety, National Institute of Health-Istituto Superire di Sanità, Rome, Italy

For all author emails, please log on.

BMC Infectious Diseases 2010, 10:235  doi:10.1186/1471-2334-10-235

Published: 9 August 2010



Few data are available on the incidence of nosocomial Rotavirus infections (NRVI) in pediatric hospitals and on their economic impact. The goals of this study were: to evaluate the incidence of NRVI in various Italian pediatric wards during the course of two peak RV seasons; to investigate possible risk factors for NRVI; to estimate the costs caused by NRVI.


prospective cohort study. Population: all the children under 30 months of age who were admitted without any symptom or diagnosis of gastroenteritis in the pediatric hospitals of Florence, Naples, Brescia and Ancona, Italy, during the winter-spring periods 2006-2007 and 2007-2008. Serial RV rapid tests and clinical monitoring were carried out on the cohort. Telephone interviews were performed from 3 to 5 days after discharge.


520 out of 608 children completed the study (85.6%). The overall incidence of NRVI was 5.3% (CI95% 3.6-7.5), (7.9 per 1,000 days of hospital stay, CI 95% 5.3-11.3). The average duration of hospital stay was significantly longer for children who had NRVI (8.1 days, SD 5.4) than for non-infected children (6.4 days, SD 5.8, difference 1.7 days, p = 0.004). The risk of contracting NRVI increased significantly if the child stayed in hospital more than 5 days, RR = 2.8 (CI95% 1.3-6), p = 0.006. In Italy the costs caused by NRVI can be estimated at 8,019,155.44 Euro per year. 2.7% of the children hospitalized with no gastroenteritis symptoms tested positive for RV.


Our study showed a relevant incidence of NRVI, which can increase the length of the children's stay in hospital. Limiting the number of nosocomial RV infections is important to improve patients' safety as well as to avoid additional health costs.