American Journal of Epidemiology Vol. 131, No. 4: 711-718
Copyright © 1990 by The Johns Hopkins University School of Hygiene and Public Health
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THE INCIDENCE OF VIRAL-ASSOCIATED DIARRHEA AFTER ADMISSION TO A PEDIATRIC HOSPITAL
1Division of Infectious Diseases, The Hospital for Sick Children and the Department of Pediatrics, University of Toronto Toronto, Ontario, Canada
2Division of Infectious Diseases, The Hospital for Sick Children and the Department of Microbiolo University of Toronto Toronto, Ontario, Canada
For determination of the incidence of viral-associated diarrhea after admission to a pediatric hospital, all patients admitted to general pediatrics, cardioiogy, and neurosurgery wards without diarrhea between January 1 and July 31, 1985 were followed 5 days per week for presence of diarrhea, etlologic agent, and possible risk factors. A total of 1,530 patients were followed for 3,642 days. Of these patients, 69 developed 80 nosocomlal dIarrhea episodes after 72 hours In hospital for a nosocomlal diarrhea rate of 4.5 Infected children per 100 admissIons. Of 358 patIents with an infected roommate, 37 (10.3%) developed nosocomlal diarrhea. Etlologic agents recognized included rotavirus (43%), calicivlrus (16%), astrovirus (14%), minreovirus (12%), adenovlrus (8%), Salmonella sp. (4%), and parvo/picomavirus (3%). The nosoconiial diarrhea rate by age was: 0–11 months, 8.8%; 12–35 months, 3.6%; and 36 months or more, 0.6%. The rate by length of stay was: 3–7 days, 8.4%; 8–14 days, 10.4%; 15–21 days, 7.9%; and 22 days or more, 8.8%, and by number of roonimates/1,000 patient-days it was: 0–1, 15.7; 2 to 3, 27.7; and 4 or more, 45.2. Patients who acquired diarrhea were more likely to be diapered (9.6% vs. 1.8%, p >0.001). Playroom use was not significantly different in the two groups. A total of 64 patients developed diarrhea within 72 hours of admission (community diarrhea rate=4.2). Nosocomlal viral-associated diarrhea is almost exclusively a disease of diapered children less than age 36 months and occurs at any time during hospital stay. It is more common in multibed rooms, but does occur In single-bed rooms.
cross infection; diarrhea, infantile; pediatrics
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