Focused Research Unit in Emergency Medicine, Hospital of Southern Jutland, Aabneraa, Denmark; Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark.
Focused Research Unit for Molecular Diagnostic and Clinical Research, Hospital of Southern Jutland, Aabenraa, Denmark; Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark.
J Hosp Infect. 2018 Apr;98(4):391-397. doi: 10.1016/j.jhin.2017.11.001. Epub 2017 Nov 8.
Acute infectious gastroenteritis requires contact precautions to prevent spread. On acute admission, the cause of diarrhoea is unknown, so the decision regarding which patients to isolate has to be made on clinical information with a risk of inexpedient use of contact precautions.
To investigate how often gastroenteritis occurs (and therefore how often the need for isolation has to be assessed) in Danish emergency departments, and how often patients have to remain on contact precautions according to the results of faecal samples.
This Danish register-based retrospective cohort study on adults in Danish emergency departments used three data sources: discharge diagnoses from the Danish National Patient Register; microbiological results from faecal samples provided in the emergency department; and the causes of hospital admission based on the chief complaint.
Among 66,885 acute admissions, 4.3% of patients had at least one feature of gastroenteritis: admission with diarrhoea as the chief complaint (1.6%); microbiological examination of faecal sample (2.8%); and discharged with a diagnosis of gastroenteritis (1.7%). Nineteen percent of those who had a faecal sample tested were found to have norovirus or Clostridium difficile, and needed to remain on strict contact precautions.
The initiation of contact precautions has to be assessed for 4.3% of all emergency department patients; 19% of the patients who had a faecal sample tested had highly contagious gastroenteritis and required strict contact precautions. Further studies are needed to develop tools to determine which patients to isolate.
急性感染性肠胃炎需要采取接触预防措施以防止传播。在急性入院时，腹泻的原因未知，因此必须根据临床信息做出隔离哪些患者的决定，存在接触预防措施使用不当的风险。
调查丹麦急诊科急性肠胃炎的发病频率（因此需要评估隔离的频率），以及根据粪便样本检测结果，有多少患者需要继续采取接触预防措施。
这项丹麦基于登记的回顾性队列研究纳入了丹麦急诊科的成年人，使用了三个数据源：丹麦国家患者登记处的出院诊断；急诊科提供的粪便样本的微生物学结果；以及基于主诉的入院原因。
在 66885 例急性入院患者中，有 4.3%的患者至少有一个肠胃炎的特征：以腹泻为主要症状入院（1.6%）；粪便样本的微生物学检查（2.8%）；出院时诊断为肠胃炎（1.7%）。19%接受粪便样本检测的患者检测出诺如病毒或艰难梭菌，需要严格的接触预防措施。
必须对所有急诊科患者中的 4.3%评估接触预防措施的启动情况；19%接受粪便样本检测的患者患有具有高度传染性的肠胃炎，需要严格的接触预防措施。需要进一步研究来开发工具以确定需要隔离的患者。
