Your browser doesn't support javascript.
loading
Risk factors for contagious gastroenteritis in adult patients with diarrhoea in the emergency department - a prospective observational multicentre study.
Skyum, Florence; Pedersen, Court; Andersen, Vibeke; Chen, Ming; Franke, Andreas; Petersen, Detlev; Ries, Wolfgang; Mogensen, Christian Backer.
Afiliación
  • Skyum F; Focused Research Unit in Emergency Medicine, Hospital of Southern Denmark, Kresten Philipsens Vej 15, DK-6200, Aabenraa, Denmark. Florence.Skyum@rsyd.dk.
  • Pedersen C; Institute for Regional Health Research, University of Southern Denmark, JB Winsløw Vej 25, DK-5000, Odense, Denmark. Florence.Skyum@rsyd.dk.
  • Andersen V; Focused Research Unit in Emergency Medicine, Hospital of Southern Jutland, Kresten Philipsens Vej 15, DK-6200, Aabenraa, Denmark. Florence.Skyum@rsyd.dk.
  • Chen M; Department of Infectious Disease, Odense University Hospital, JB Winsløws vej 4, DK-5000, Odense, Denmark.
  • Franke A; Focused Research Unit for Molecular Diagnostic and Clinical Research, Hospital of Southern Jutland, Kresten Philipsens Vej 15, DK-6200, Aabenraa, Denmark.
  • Petersen D; Institute of Molecular Medicine, University of Southern Denmark, JB Winsløw vej 25, DK-5000, Odense, Denmark.
  • Ries W; Focused Research Unit for Molecular Diagnostic and Clinical Research, Hospital of Southern Jutland, Kresten Philipsens Vej 15, DK-6200, Aabenraa, Denmark.
  • Mogensen CB; Department of Clinical Microbiology, Hospital of Southern Jutland, Sydvang 1, 6400, Sønderborg, DK, Denmark.
BMC Infect Dis ; 19(1): 133, 2019 Feb 11.
Article en En | MEDLINE | ID: mdl-30744568
ABSTRACT

BACKGROUND:

Infectious gastroenteritis is common in the emergency department (ED). Patients infected with either Norovirus or toxigenic Clostridium difficile require special isolation procedures. The aims were to describe the aetiology of infectious gastroenteritis in the ED, evaluate whether current isolation procedures, based on clinical judgement are sufficient, and to identify information that might be used to identify patients requiring isolation.

METHODS:

Prospective, observational, multicentre study. We collected information on symptoms, vital signs, travel history, the recent use of antibiotics, and infectious contacts and tested faecal samples for Norovirus, C. difficile, and enteropathogenic bacteria.

RESULTS:

The study enrolled 227 patients, of whom 163 (71%) delivered a faecal sample for Norovirus analysis (13% positive), 171 (74%) for C. difficile (13% positive), and 173 (76%) for enteropathogenic bacteria (16% positive). In total 71% of the patients were isolated using strict precautions, 29% of the isolated patient and 14% of the patients who were not isolated had had a highly contagious GE. Risk factors for Norovirus included frequent vomiting (OR 5.5), recent admission of another patient with Norovirus (OR 2.6), and a short duration of diarrhoea. Risk factors for C. difficile infections included older age (OR 6.0), longer duration of diarrhoea (OR 5.2), mucus in stool (OR 3.5), and previous antibiotic use (OR 23.4).

CONCLUSION:

Highly contagious GE occurs in » of the GE patients in the EDs, isolation based on clinical judgement is not very efficient. Several risk factors can predict the presence of Norovirus or toxigenic Clostridium difficile. It is uncertain whether this knowledge can improve isolation practices in ED settings. TRIAL REGISTRATION This study was retrospectively registered in the Clinical Trials Data Base ( NCT02685527 ) and prospectively approved by the Regional Committees on Health Research Ethics for Southern Denmark (project ID S20140200) and Ethics Committee at the Medical Association of Schleswig-Holstein ["Ethikkommission bei der Ärztekammer Schleswig-Holstein", project ID 120/15(I)] and registered with the Danish Data Protection Agency (project ID nr. 2008-58-0035/ 1608).
Asunto(s)
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 2_ODS3 / 3_ND / 4_TD Problema de salud: 2_enfermedades_transmissibles / 3_diarrhea / 3_neglected_diseases / 4_diarrhoeal_infections Asunto principal: Enterocolitis Seudomembranosa / Infecciones por Caliciviridae / Norovirus / Servicio de Urgencia en Hospital / Gastroenteritis Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Ethics Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: BMC Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2019 Tipo del documento: Article País de afiliación: Dinamarca

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 2_ODS3 / 3_ND / 4_TD Problema de salud: 2_enfermedades_transmissibles / 3_diarrhea / 3_neglected_diseases / 4_diarrhoeal_infections Asunto principal: Enterocolitis Seudomembranosa / Infecciones por Caliciviridae / Norovirus / Servicio de Urgencia en Hospital / Gastroenteritis Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Ethics Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: BMC Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2019 Tipo del documento: Article País de afiliación: Dinamarca
...