title: The incidence of viral-associated diarrhea after admission to a pediatric hospital.
abstract: For determination of the incidence of viral-associated diarrhea after admission to a pediatric hospital, all patients admitted to general pediatrics, cardiology, and neurosurgery wards without diarrhea between January 1 and July 31, 1985 were followed 5 days per week for presence of diarrhea, etiologic agent, and possible risk factors. A total of 1,530 patients were followed for 3,642 days. Of these patients, 69 developed 80 nosocomial diarrhea episodes after 72 hours in hospital for a nosocomial diarrhea rate of 4.5 infected children per 100 admissions. Of 358 patients with an infected roommate, 37 (10.3%) developed nosocomial diarrhea. Etiologic agents recognized included rotavirus (43%), calicivirus (16%), astrovirus (14%), minreovirus (12%), adenovirus (8%), Salmonella sp. (4%), and parvo/picornavirus (3%). The nosocomial diarrhea rate by age was: 0-11 months, 8.8%; 12-35 months, 3.6%; and 36 months or more, 0.6%. The rate by length of stay was: 3-7 days, 8.4%; 8-14 days, 10.4%; 15-21 days, 7.9%; and 22 days or more, 8.8%, and by number of roommates/1,000 patient-days it was: 0-1, 15.7; 2 to 3, 27.7; and 4 or more, 45.2. Patients who acquired diarrhea were more likely to be diapered (9.6% vs. 1.8%, p less than 0.001). Playroom use was not significantly different in the two groups. A total of 64 patients developed diarrhea within 72 hours of admission (community diarrhea rate = 4.2). Nosocomial viral-associated diarrhea is almost exclusively a disease of diapered children less than age 36 months and occurs at any time during hospital stay. It is more common in multibed rooms, but does occur in single-bed rooms.
authors.affiliation: Division of Infectious Diseases, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: E L
authors.initials: EL
authors.lastname: Ford-Jones
authors.forename: C M
authors.initials: CM
authors.lastname: Mindorff
authors.forename: R
authors.initials: R
authors.lastname: Gold
authors.forename: M
authors.initials: M
authors.lastname: Petric
mesh_terms: D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology; D003967:Diarrhea / Q000453:epidemiology* / Q000209:etiology; D003968:Diarrhea, Infantile / Q000453:epidemiology*; D005260:Female; D006776:Hospitals, Pediatric; D006782:Hospitals, Special; D006801:Humans; D015994:Incidence; D007223:Infant; D007224:Infant Care; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D009864:Ontario / Q000453:epidemiology; D012307:Risk Factors; D012400:Rotavirus Infections / Q000453:epidemiology / Q000209:etiology; D014777:Virus Diseases / Q000453:epidemiology* / Q000209:etiology