title: A retrospective cohort study of nosocomial diarrhea as a risk factor for nosocomial infection.
abstract: 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.
authors.affiliation: Department of Medicine, University of Virginia School of Medicine, Charlottesville.
authors.forename: N L
authors.initials: NL
authors.lastname: Lima
authors.forename: R L
authors.initials: RL
authors.lastname: Guerrant
authors.forename: D L
authors.initials: DL
authors.lastname: Kaiser
authors.forename: T
authors.initials: T
authors.lastname: Germanson
authors.forename: B M
authors.initials: BM
authors.lastname: Farr
mesh_terms: 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*