The role of Clostridium difficile and viruses as causes of nosocomial diarrhea in children
The role of Clostridium difficile and viruses as causes of nosocomial diarrhea in children
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DOI：
10.1086/501990
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发表时间：
2002-11-01
影响因子：
4.5
通讯作者：
Goloubeva, O
中科院分区：
文献类型：
--
作者：
Langley, JM;LeBlanc, JC;Goloubeva, O
目的：我们报告了在过去十年中在我们机构对儿童医院内腹泻的监测，并注意到由于病毒和艰难梭菌引起的腹泻的不同流行病学。设计：一项前瞻性队列研究。地点：一所大学附属儿科医院，有180张床位，服务于一个城市地区，并为加拿大的沿海省份提供转诊服务。参与者：18岁以下的儿童。从1991年到1999年，通过与工作人员的个人接触和微生物学和医疗记录的审查进行了监测。院内腹泻被定义为入院后48小时以上出现的稀便，12小时内至少有两次稀便，并且没有可能的非感染性caus.RESULTS：院内腹泻是第三大常见的院内感染（217 1,466; 15%），血液和呼吸道感染后，从0.5到1发作每1,000患者-天。在217例院内腹泻中，122例（56%）已确定病原体：C。艰难梭菌（39/122; 32%）、轮状病毒（38/122; 31%）、腺病毒（36/122; 30%）和其他病毒（9/122; 796）。中位年龄为1.3岁（范围11天至17.9岁），病毒性腹泻患儿为0.80岁，C型腹泻患儿为3.9岁。艰难梭菌感染的儿童为1.5年，未发现致病微生物的腹泻儿童为1.5年（P
OBJECTIVE: We report surveillance of nosocomial diarrhea in children at our institution during the past decade and note different epidemiology of diarrhea due to viruses and Clostridium difficile.DESIGN: A prospective cohort study.SETTING: A university-affiliated pediatric hospital with 180 beds serving an urban area and providing referral care for the Maritime Provinces of Canada.PARTICIPANTS: Children younger than 18 years.METHODS: Surveillance was conducted from 1991 to 1999 using personal contact with personnel and review of microbiology and medical records. Nosocomial diarrhea was defined as loose stools occurring more than 48 hours after admission, with at least two loose stools in 12 hours and no likely non-infectious cause.RESULTS: Nosocomial diarrhea was the third most common nosocomial infection (217 of 1,466; 15%), after bloodstream and respiratory infections, with from 0.5 to 1 episode per 1,000 patient-days. Of 217 nosocomial diarrhea episodes, 122 (56%) had identified pathogens: C. difficile (39 of 122; 32%), rotavirus (38 of 122; 31%), adenovirus (36 of 122; 30%), and other viral (9 of 122; 796). The median age was 1.3 years (range, 11 days to 17.9 years), 0.80 year for children with viral diarrhea, 3.9 years for children with C. difficile, and 1.5 years for children with diarrhea without a causative organism identified (P