A prospective study of nosocomial enteric pathogen acquisition in hospitalized children in South India

Abstract

Screening for enteric pathogens in stool samples from 249 children under the age of 36 months, admitted to hospital for non-gastrointestinal disorders, was positive at admission in 41 (16.4 per cent) in a prospective study of enteric pathogen acquisition and diarrhoea in hospitalized children. Infection with multiple organisms was found in 31/41 (75.6 per cent) children who were positive when screened at admission. Of 194 children who had no enteric pathogens on admission and could be followed up for 3 days after discharge, clinical or laboratory data showed nosocomial enteric infections in 39 (20.1 per cent). Presumed nosocomial infection with more than one organism was seen in only two patients and no pathogens were isolated in 14 (35.8 per cent). Children presenting to hospital may asymptomatically carry enteric pathogens and potentially act as a source of nosocomial infections. One in five children admitted into hospital without an enteric infection is at risk of developing a nosocomial gastrointestinal infection, with rotavirus being the most common aetiological agent.

Incidence of and Risk Factors for Hospital-Acquired Diarrhea in Three Tertiary Care Public Hospitals in Bangladesh

“…Infants (children < 1 year of age) were at highest risk for hospital-acquired diarrhea during their hospitalization, a finding consistent with previous studies5,12,27,28; all three deaths in this study occurred among infants, suggesting that new onset of diarrhea during hospitalization could lead to particularly poor health outcomes in very young children. The proportion of patients who developed hospital-acquired diarrhea in this study was similar to other studies from middle- and low-income countries 2,3,8.…”

Diarrhoeagenic Escherichia coli as a predominant cause of paediatric nosocomial diarrhoea in India

“…Thus, our study led to the institution of proper antibiotic prescription and management of diarrhoea. Studies have shown that patients with ND have a prolonged duration of hospital stay (Kamalaratnam et al, 2001). In our study, the mean duration of hospital stay was 27.4 days compared with 19.3 days in the controls (P,0.002).…”

“…The incidence of ND due to E. coli is thought to be low, as routine testing for such microorganisms is beyond the capability of many clinical laboratories. A study from south India (Kamalaratnam et al, 2001) showed rotavirus, adenovirus, Salmonella and Cryptosporidium as the common organisms identified in children who acquired ND, with low detection rates of EPEC and ETEC. Clusters of ND were recorded in our study on three occasions and the agent was EAEC.…”

Prevalence and etiology of nosocomial diarrhoea in children < 5 years in Tikrit teaching hospital

“…In our study, the prevalence was as high at 32.4%. A study in northern Brazil reported a higher prevalence of nosocomial diarrhoea among children (about 40%) [5], while in south India the prevalence was reported to be 20% among hospitalized children aged < 36 months [6]. The difference in the prevalence is related to many factors such as hygiene practices, type of microorganisms endemic in the area and sanitation level of the hospitals.…”