A retrospective cohort study of nosocomial diarrhea as a risk factor for nosocomial infection.
Because most nosocomial infections are caused by enteric flora, it was undertaken to determine whether diarrhea predisposes to nosocomial infections by conducting a retrospective cohort study involving patients with and without nosocomial diarrhea who were hospitalized during a 12-month period. The rate of urinary tract infection per person-day after onset of diarrhea was significantly greater in patients with diarrhea (relative risk = 10.3; 95% confidence interval = 1.7-63.1, P = .006). When indwelling bladder catheter and duration of catheter placement were considered, diarrhea remained an independent risk factor for urinary tract infection in logistic regression analysis (P = .009). These data suggest that diarrhea and consequent urethral meatal contamination may be a cause of nosocomial urinary tract infection, especially in patients with a catheter, and that removal of the catheter should be considered whenever possible in patients with diarrhea.
Lima
N L
NL
Department of Medicine, University of Virginia School of Medicine, Charlottesville.
Guerrant
R L
RL
Kaiser
D L
DL
Germanson
T
T
Farr
B M
BM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003428:Cross Infection / Q000209:etiology*; D003967:Diarrhea / Q000150:complications*; D005260:Female; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D014552:Urinary Tract Infections / Q000209:etiology*