Management and Outcomes of Salmonella Gastroenteritis in the Era of Rapid Molecular Testing.
Hosp Pediatr
; 12(11): 1011-1019, 2022 11 01.
Article
in En
| MEDLINE
| ID: mdl-36263712
ABSTRACT
BACKGROUND AND OBJECTIVES:
Molecular diagnostics provide a rapid and sensitive diagnosis of gastroenteritis compared with a stool culture. In this study, we seek to describe the changes in medical management and outcomes of children with Salmonella gastroenteritis as our hospital system adopted molecular diagnostics.METHODS:
This study is a retrospective chart review of children <18 years of age diagnosed with nontyphoidal Salmonella gastroenteritis between 2008 and 2018 at a large pediatric health care system in the southeastern United States. Those with immunocompromising conditions and hemoglobinopathies were excluded. Patients diagnosed via molecular testing were compared with those diagnosed solely by stool culture for aspects of management including admission rates, blood culture obtainment, and antibiotic administration.RESULTS:
Of 965 eligible patients with Salmonella gastroenteritis, 264 (27%) had a stool molecular test and 701 (73%) only had a stool culture performed. Groups were similar in age and presentation. Those diagnosed by molecular methods had higher hospitalization rates (69% vs 50%, P <.001), more blood cultures obtained (54% vs 44%, P <.01), and received more antibiotics (49% vs 34%, P <.001) despite statistically similar rates of bacteremia (11% vs 19%, P = .05).CONCLUSIONS:
The rapid diagnosis of Salmonella gastroenteritis by molecular methods was associated with increased hospital admission rates, blood culture obtainment, and antibiotic use. This suggests possible overmedicalization of uncomplicated Salmonella gastroenteritis, and clinicians should remain cognizant of the possibility of providing low-value care for uncomplicated disease.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Salmonella
/
Gastroenteritis
Type of study:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Child
/
Humans
/
Infant
Language:
En
Journal:
Hosp Pediatr
Year:
2022
Document type:
Article
Affiliation country:
Georgia