Ford-Jones E L, Mindorff C M, Gold R, Petric M
Division of Infectious Diseases, Hospital for Sick Children, Toronto, Ontario, Canada.
Am J Epidemiol. 1990 Apr;131(4):711-8. doi: 10.1093/oxfordjournals.aje.a115555.
For determination of the incidence of viral-associated diarrhea after admission to a pediatric hospital, all patients admitted to general pediatrics, cardiology, and neurosurgery wards without diarrhea between January 1 and July 31, 1985 were followed 5 days per week for presence of diarrhea, etiologic agent, and possible risk factors. A total of 1,530 patients were followed for 3,642 days. Of these patients, 69 developed 80 nosocomial diarrhea episodes after 72 hours in hospital for a nosocomial diarrhea rate of 4.5 infected children per 100 admissions. Of 358 patients with an infected roommate, 37 (10.3%) developed nosocomial diarrhea. Etiologic agents recognized included rotavirus (43%), calicivirus (16%), astrovirus (14%), minreovirus (12%), adenovirus (8%), Salmonella sp. (4%), and parvo/picornavirus (3%). The nosocomial 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 roommates/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 less than 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). Nosocomial 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.
为确定儿科医院住院后病毒相关性腹泻的发病率，对1985年1月1日至7月31日期间入住普通儿科、心脏病科和神经外科病房且无腹泻的所有患者，每周随访5天，观察腹泻情况、病原体及可能的危险因素。共对1530例患者进行了3642天的随访。在这些患者中，69例在住院72小时后发生了80次医院内腹泻发作，医院内腹泻发生率为每100例入院患者中有4.5例感染儿童。在358例有感染室友的患者中，37例（10.3%）发生了医院内腹泻。确认的病原体包括轮状病毒（43%）、杯状病毒（16%）、星状病毒（14%）、微小呼肠孤病毒（12%）、腺病毒（8%）、沙门氏菌属（4%）以及细小病毒/微小核糖核酸病毒（3%）。按年龄划分的医院内腹泻发生率为：0至11个月，8.8%；12至35个月，3.6%；36个月及以上，0.6%。按住院时间划分的发生率为：3至7天，8.4%；8至14天，10.4%；15至21天，7.9%；22天及以上，8.8%；按每1000患者日的室友数量划分的发生率为：0至1人，15.7；2至3人，27.7；4人及以上，45.2。发生腹泻的患者更有可能使用尿布（9.6%对1.8%，p<0.001）。两组在使用游戏室方面无显著差异。共有64例患者在入院72小时内发生腹泻（社区腹泻率=4.2）。医院内病毒相关性腹泻几乎完全是36个月以下使用尿布儿童所患的疾病，且在住院期间任何时间都可能发生。在多人病房中更常见，但在单人病房中也确实会发生。
