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Hospital-Acquired Diarrhea in Adults: A Prospective Case-Controlled Study in Mexico

Published online by Cambridge University Press:  21 March 2023

Mussaret Zaidi ,
Samuel Ponce de Leon ,
Rosa Maria Ortiz ,
Sergio Ponce de Leon ,
Juan J. Calva ,
Guillermo Ruiz-Palacios ,
Margarita Camorlinga ,
Luz Elena Cervantes  and
Francisco Ojeda
Mussaret Zaidi
Affiliation:
Department of Infectious Diseases, Instituto Nacional de la Nutrición, “Salvador Zubirán”
Samuel Ponce de Leon*
Affiliation:
Department of Infectious Diseases, Instituto Nacional de la Nutrición, “Salvador Zubirán”
Rosa Maria Ortiz
Affiliation:
Department of Infectious Diseases, Instituto Nacional de la Nutrición, “Salvador Zubirán”
Sergio Ponce de Leon
Affiliation:
Clinical Epidemiology Unit, Instituto Nacional de la Nutrición, “Salvador Zubirán”
Juan J. Calva
Affiliation:
Department of Infectious Diseases, Instituto Nacional de la Nutrición, “Salvador Zubirán”
Guillermo Ruiz-Palacios
Affiliation:
Department of Infectious Diseases, Instituto Nacional de la Nutrición, “Salvador Zubirán”
Margarita Camorlinga
Affiliation:
Clinical Investigation Unit Of Infectious and Parasitic Diseases, Centro Médico Nacional, Instituto Mexicano del Seguro Social, Mexico City, Mexico
Luz Elena Cervantes
Affiliation:
Department of Infectious Diseases, Instituto Nacional de la Nutrición, “Salvador Zubirán”
Francisco Ojeda
Affiliation:
Department of Infectious Diseases, Instituto Nacional de la Nutrición, “Salvador Zubirán”
*
Depto. de Infectologia, Instituto Nacional de la Nutrición, Vasco de Quiroga #15, Deleg. Tlalpan, Mex. D.E C.P. 14000, Mexico
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Abstract

Objective:

To know the incidence, etiology, risk factors, morbidity, and mortality of nosocomial diarrhea in adults.

Design:

Nested case-control study, matched by service, length of stay, date of admission, and presence of leukopenia and/or the acquired immunodeficiency syndrome (AIDS). Cases were those who developed nosocomial diarrhea. Controls were those who did not develop nosocomial diarrhea during a comparative period nor during the next ten days. Stool samples were processed in search for parasites, yeasts, bacteria, and rotavirus.

Setting:

Third-level referral center, in Mexico City, Mexico, for general internal medicine and surgical problems.

Patients:

Eligible subjects were all new admissions to the hospital from November 1987 to September 1988. Reasons for exclusion were presence of chronic diarrheal disease or melena. There were 115 cases and 111 controls.

Results:

Overall risk of acquiring nosocomial diarrhea was 5.5%, or 1.8 episodes per 100 patient-weeks. A potential pathogen was found in 59%. Yeasts and Entamoeba histolytica were the most frequently isolated pathogens. Mortality in cases was 18%, as compared with 5% in controls (p<.01). Multivariate analysis showed enteral feeding, recent enemas, presence of Candida species, use of antacids/Hz-blockers, and presence of nasogastric tubes as significant risk factors for nosocomial diarrhea.

Conclusions:

Diarrhea is a common complication in hospitalized patients. It occurs more often than previously suspected and is linked with a substantial mortality, The spectrum of etiologic agents is different from that reported in pediatric hospitals. Given that nosocomial diarrhea may constitute, at least, a marker of severity of illness, it should receive more attention in general hospitals.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 12 , Issue 6 , June 1991 , pp. 349 - 355
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1991

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