PATIENT SAFETY

Journal Analysis : Effect of Lactobacillus GG and Breast-feeding in the

Prevention of Rotavirus Nosocomial Infection

BY 6th GROUP

Marissa Ulkhair

1311311089

Rahmi Auliya

1311312020

Sindy Rahmawati

1311311004

UNDERGRADUATE OF NURSING
ANDALAS UNIVERSITY
2015

FOREWORD

Praise and thankfulness stated to Almighty Allah SWT, has given the great chance and
opportunity to the writer team for finishing this paper well. The title of this paper is about
Nosocomial Infection
The purpose of this paper to make students understand having a good knowledge and skill.
Then, students can practice to the patients at all.
The writer team also say thanks to Miss. Vetty Priscilla and all of our family had given us
many support and contribution for writing this paper.
The writer team really realizes this paper not written maximally and perfectly, Therefore the
team really hopes some improving suggestions and critics from all the readers, the writer
team really appreciate it.

Padang, Mei 19th 2015

The writer team

Chapter I
Introduction
1. Background
Nosocomial infection also called hospital acquired infection can be defined as: An
infection acquired in hospital by a patient who was admitted for a reason other than that
infection. An infection occurring in a patient in a hospital or other health care facility in
whom the infection was not present or incubating at the time of admission. This includes
infections acquired in the hospital but appearing after discharge, and also occupational
infections among staff of the facility.
2. Purpose
To analysis journal that related to IPSG 5

Chapter II

Journal Analysis
1. Abstrack
Rotavirus is one of the leading etiologic agents of nosocomial infections among
children. The development of preventive measures is therefore important. The
efficacy of Lactobacillus GG in the treatment of rotavirus infection has been reported
in literature, but there is only one recent study about its effectiveness in prevention of
infection. The role of breast-feeding in the prevention of rotavirus infection is still
debated. The aim of our study was to assess the efficacy of Lactobacillus GG and
breast-feeding in the prevention of nosocomial rotavirus infections.
Rotavirus is one of the most important etiologic agents of nosocomial infections in
childhood. Prevent nosocomial shedding of the virus have been unsuccessful so far.
Despite the adoption of norms regarding enteric isolation , the incidence of
nosocomial rotavirus infections is still high, ranging from 8 to 33 cases per 100
hospitalized children, depending on the age range of patients and the season of the
year. As the vaccine is not available in Italy, the development of other preventive
measures is important.
2. Method
The study was conducted in children aged 1 to 18 months, admitted for common
diseases to the infant section of the Department of Paediatrics, University of Turin,
between December 1, 1999, and May 31, 2000. Informed written consent was
obtained from the parents before enrollment of their children.
On admission, each patient was randomly assigned, using odd and even random
sampling numbers (31), to receive two capsules of 1010 colony-forming unites of
LGG on admission and one capsule of 1010 colony-forming units of LGG once daily
for the duration of hospitalization (treated group), or a comparable placebo made of
inert oligosaccharides with indistinguishable organoleptic properties from the
probiotic (placebo group). Both LGG and the placebo were manufactured and
supplied by Dicofarm SpA (Rome, Italy). The capsules of LGG and placebo were
opened and dissolved in water and administered before meals. A case of nosocomial
diarrhea was defined as the occurrence of three or more loose stools per day at least
24 hours after admission.

3. Result
Our study demonstrates a high incidence of nosocomial rotavirus infections (27.7%)
for several reasons. The study was performed during the seasonal peak of rotavirus
infections, from December to May, and because the age range studied was at the
highest risk of contracting rotavirus infection. The data collected concerned both
symptomatic and asymptomatic infections. Although the latter is less harmful for the
individual patient, but are responsible for virus shedding, both in hospitals and in
child communities (kindergarten, nursery schools, etc.). Stool samples were collected
not only during hospitalization, but also within 72 hours after discharge, allowing us
to identify 35 of 61 nosocomial
infections (57.4%).
Our data show that LGG is ineffective in the prevention of nosocomial rotavirus
infections or in protecting against the onset of diarrhea symptoms in infected patients.
LGG is resistant to the most widely used antibiotics to a group of antibiotics,
including cefoxitin, aztreonam, amikacin, gentamicin, kanamycin, streptomycin,
norfloxacin, nalidixic acid, sulphametoxazole, trimethoprim, cotrimoxazole,
metronidazole, polymixin, and colistin sulphate. Finally, LGG has proved to be
effective in the prevention of antibiotic-associated diarrhea
The efficacy of breast-feeding in the prevention of rotavirus infections is still under
discussion in literature. In our study, breast-feeding was associated with a reduced
incidence of diarrhea symptoms in the infected patients and a reduced incidence of
rotavirus nosocomial infections. It has been recently reported that lactadherin, a
glycoprotein found in different concentrations in human milk, may bind rotavirus and
inhibits its replication, reducing the symptoms of the infection (39). We speculate that
this protein is implicated in preventing infection in our breast fed patients. In
conclusion, our findings fail to support the efficacy of LGG in the prevention of
rotavirus infections and in preventing diarrhea symptoms, whereas breast-feeding
proved to be effective.

Chapter III
Conclusion

In conclusion, our findings fail to support the efficacy of LGG in the

prevention of rotavirus infections and in preventing diarrhea symptoms,
whereas breast-feeding proved to be effective.

References

Berner R, Schumacher RF, Hameister S, Forster J. Occurrence and impact of

community-acquired and nosocomial rotavirus infection: A hospital-based study over 10
years. Acta Paediatr Suppl 1999; 426:4852.
Dennehy PH, Tente WE, Fischer DJ, Veloudis BA, Peter G. Lack of impact of rapid
identification of rotavirus infected patients on nosocomial rotavirus infection. Pediatr Infect
Dis J 1989;8:2906.
Garner JS. Guidelines for isolation precautions in hospitals. The Hospital Infection
Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1996;17:5380.
Haffejee IE. The epidemiology of rotavirus infections: A global perspective. J Pediatr
Gastroenterol Nutr 1995;20:27586.