Frost F, Craun G F, Calderon R L
Southwest Center for Managed Care Research, Albuquerque, New Mexico 87108, USA.
Emerg Infect Dis. 1998 Oct-Dec;4(4):619-25. doi: 10.3201/eid0404.980412.
This study calculated yearly estimated national hospital discharge (1985 to 1994) and age-adjusted death rates (1980 to 1992) due to bacterial, viral, protozoal, and ill-defined enteric pathogens. Infant and young child hospitalization (but not death) rates in each category increased more than 50% during 1990 to 1994. Age-adjusted death and hospitalization rates due to enteric bacterial infections and hospitalizations due to enteric viral infections have increased since 1988. The increases in hospitalization and death rates from enteric bacterial infections were due to a more than eightfold increase in rates for specified enteric bacterial infections that were uncoded during this period (ICD9 00849). To identify bacterial agents responsible for most of these infections, hospital discharges and outpatient claims (coded with more detail after 1992) were examined for New Mexico's Lovelace Health Systems for 1993 to 1996. Of diseases due to uncoded enteric pathogens, 73% were due to Clostridium difficile infection. Also, 88% of Washington State death certificates (1985 to 1996) coded to unspecified enteric pathogen infections (ICD0084) listed C. difficile infection.
本研究计算了1985年至1994年全国医院出院人数的年度估计值以及1980年至1992年因细菌、病毒、原生动物和病因不明的肠道病原体导致的年龄调整死亡率。1990年至1994年期间,每类疾病中婴幼儿的住院率(而非死亡率)增长超过50%。自1988年以来,因肠道细菌感染导致的年龄调整死亡率和住院率以及因肠道病毒感染导致的住院率均有所上升。肠道细菌感染导致的住院率和死亡率上升是由于在此期间未编码的特定肠道细菌感染(ICD9 00849)的发病率增加了八倍多。为了确定导致这些感染的主要细菌病原体,对新墨西哥州洛夫莱斯医疗系统1993年至1996年的医院出院记录和门诊索赔(1992年后编码更详细)进行了检查。在病因不明的肠道病原体导致的疾病中,73%是由艰难梭菌感染引起的。此外,华盛顿州1985年至1996年编码为未指定肠道病原体感染(ICD0084)的死亡证明中,88%列出了艰难梭菌感染。