Pinto Jamie M, Petrova Anna
Department of Pediatrics, Jersey Shore University Medical Center, Neptune, New Jersey; and.
Department of Pediatrics, Jersey Shore University Medical Center, Neptune, New Jersey; and
Hosp Pediatr. 2017 Sep;7(9):536-541. doi: 10.1542/hpeds.2016-0180. Epub 2017 Aug 8.
The decision to test for the etiology of diarrhea is a challenging question for practicing pediatricians.
The main goal of this retrospective cohort study was to identify factors associated with testing for and diagnosis of rotavirus, , or other bacterial infections, as well as the length of stay (LOS) for children with acute gastroenteritis who were hospitalized at a single institution. Patients aged 6 to 60 months with acute diarrhea (<14 days) and no underlying gastrointestinal conditions were included. Data were analyzed by using multivariate logistic and linear regression models.
Stool testing was performed in 73.1% of the 331 patients studied. The majority were tested for multiple pathogens, including rotavirus (65.9%), (30.8%), and other bacteria (63.4%), with recovery rates of 33.0%, 9.8%, and 6.7%, respectively. Rotavirus was more often identified in older patients with dehydration and vomiting. Although testing for was more likely with prolonged diarrhea, no vomiting, and recent antibiotic use, no factors were associated with recovery. Patients who were diagnosed with were more likely to receive probiotics than those who received negative test results. LOS was not associated with stool testing or recovery of any tested pathogens.
Although children with acute gastroenteritis underwent frequent stool testing for diarrheal etiology, detection of a pathogen was uncommon and not associated with a change in LOS. Experimental research will be needed to make additional conclusions about the efficacy of testing for diarrheal etiology in the inpatient practice of acute pediatric diarrhea.
对于执业儿科医生而言，决定对腹泻病因进行检测是一个具有挑战性的问题。
这项回顾性队列研究的主要目标是确定与轮状病毒、 或其他细菌感染检测及诊断相关的因素，以及在单一机构住院的急性胃肠炎患儿的住院时间（LOS）。纳入年龄在6至60个月、患有急性腹泻（<14天）且无潜在胃肠道疾病的患者。使用多变量逻辑回归和线性回归模型分析数据。
在331名研究患者中，73.1%进行了粪便检测。大多数患者针对多种病原体进行检测，包括轮状病毒（65.9%）、 （30.8%）和其他细菌（63.4%），回收率分别为33.0%、9.8%和6.7%。轮状病毒在有脱水和呕吐症状的年长患者中更常被检出。虽然腹泻时间延长、无呕吐且近期使用过抗生素时更有可能检测 ，但没有因素与 恢复相关。被诊断为 的患者比检测结果为阴性的患者更有可能接受益生菌治疗。住院时间与粪便检测或任何检测病原体的恢复无关。
尽管患有急性胃肠炎的儿童频繁进行腹泻病因的粪便检测，但病原体的检出并不常见，且与住院时间的变化无关。需要进行实验研究，以就急性小儿腹泻住院治疗中腹泻病因检测的疗效得出更多结论。
