Etiology and Risk Factors of Acute Gastroenteritis in a Taipei Emergency Department: Clinical Features for Bacterial Gastroenteritis

Autor: Fang Tzy Wu, Dar Der Ji, Ho Sheng Wu, Wen Yun Lin, Donald Dah-Shyong Jiang, Jung Jung Mu, Chao Chih Lai, Wei Ting Chen, Ji Rong Yang, Muh Yong Yen, Tony Hsiu Hsi Chen
Rok vydání: 2016
Předmět:
Male
0301 basic medicine
Abdominal pain
Epidemiology
fecal occult blood
medicine.disease_cause
Patient Admission
Risk Factors
acute gastroenteritis
Aged
80 and over
lcsh:R5-920
receiver operating characteristic
Antiinfective agent
Bacterial Infections
General Medicine
Middle Aged
Gastroenteritis
Diarrhea
Acute Disease
Female
Original Article
medicine.symptom
lcsh:Medicine (General)
Emergency Service
Hospital
Adult
medicine.medical_specialty
Bacterial Gastroenteritis
Adolescent
salmonella
030106 microbiology
Taiwan
norovirus
Infectious Disease
C-reactive protein
Young Adult
03 medical and health sciences
Internal medicine
medicine
Humans
Aged
Diagnostic Tests
Routine
business.industry
Fecal occult blood
Odds ratio
fecal leukocytes
Surgery
Case-Control Studies
Norovirus
Etiology
Giardia lamblia
business
Zdroj: Journal of Epidemiology
Journal of Epidemiology, Vol 26, Iss 4, Pp 216-223 (2016)
ISSN: 1349-9092
0917-5040
DOI: 10.2188/jea.je20150061
Popis: Background The causative pathogen is rarely identified in the emergency department (ED), since the results of cultures are usually unavailable. As a result, antimicrobial treatment may be overused. The aim of our study was to investigate the pathogens, risk factors of acute gastroenteritis, and predictors of acute bacterial gastroenteritis in the ED. Methods We conducted a matched case-control study of 627 stool samples and 612 matched pairs. Results Viruses (41.3%) were the leading cause of gastroenteritis, with noroviruses (32.2%) being the most prevalent, followed by bacteria (26.8%) and Giardia lamblia (12.4%). Taking antacids (adjusted odds ratio [aOR] 4.10; 95% confidence interval [CI], 2.57-6.53), household members/classmates with gastroenteritis (aOR 4.69; 95% CI, 2.76-7.96), attending a banquet (aOR 2.29; 95% CI, 1.64-3.20), dining out (aOR 1.70; 95% CI, 1.13-2.54), and eating raw oysters (aOR 3.10; 95% CI, 1.61-5.94) were highly associated with gastroenteritis. Elders (aOR 1.04; 05% CI, 1.02-1.05), those with CRP >10 mg/L (aOR 2.04; 95% CI, 1.15-3.62), or those who were positive for fecal leukocytes (aOR 2.04; 95% CI, 1.15-3.62) or fecal occult blood (aOR 1.97; 95% CI, 1.03-3.77) were more likely to be hospitalized in ED. In addition, presence of fecal leukocytes (time ratio [TR] 1.22; 95% CI, 1.06-1.41), abdominal pain (TR 1.20; 95% CI, 1.07-1.41), and frequency of vomiting (TR 0.79; 95% CI, 0.64-0.98) were significantly associated with the duration of acute gastroenteritis. Presence of fecal leukocytes (aOR 2.08; 95% CI, 1.42-3.05), winter season (aOR 0.45; 95% CI, 0.28-0.74), frequency of diarrhea (aOR 1.69; 95% CI, 1.01-2.83), and eating shrimp or crab (aOR 1.53; 95% CI, 1.05-2.23) were highly associated with bacterial gastroenteritis. The area under the receiver operating characteristic curve of the final model was 0.68 (95% CI, 0.55-0.63). Conclusions Acute bacterial gastroenteritis was highly associated with season, frequency of diarrhea, frequency of vomiting, and eating shrimp or crab.
Databáze: OpenAIRE
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