Clinical and microbiological features of suspect sporadic food poisoning cases presenting to an accident and emergency department.
During a five-month period all patients presenting to an inner-city accident and emergency department with suspected food poisoning were assessed for relevant clinical and microbiological features. There were 102 patients in the study period (0.3% of all attendances). Fifty-two stool samples were processed and 11 were culture positive (21% of those sampled, 11% of all cases). The two commonest organisms were Campylobacter (6) and Salmonella (4). A logistic regression analysis showed that, of the continuous variables, a higher temperature (odds ratio [OR] 2.72, 95% confidence interval [CI] 1.36 to 5.46) was predictive of stool culture positivity, and age was negatively predictive (OR 0.88, 95% CI 0.78 to 0.98). Of the dichotomous variables only a history of fever (OR 3.94, 95% CI 1.07 to 14.5) was predictive of stool culture positivity. The presence of nausea (OR 0.11, 95% CI 0.03 to 0.43) or vomiting (OR 0.22, 95% CI 0.06 to 0.80), and the absence of abdominal tenderness, had a negative predictive value for stool culture positivity. No patient without a history of abdominal pain and diarrhoea had a positive stool culture.
Leman
P
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Accident & Emergency Department, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH. peter.leman@gstt.sthames.nhs.uk
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000818:Animals; D001794:Blood Pressure; D001831:Body Temperature; D002167:Campylobacter / Q000302:isolation & purification; D003967:Diarrhea / Q000382:microbiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005243:Feces / Q000382:microbiology; D005260:Female; D005334:Fever / Q000382:microbiology; D005517:Foodborne Diseases / Q000175:diagnosis* / Q000382:microbiology*; D005872:Giardia / Q000302:isolation & purification; D006801:Humans; D016015:Logistic Models; D008131:London; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000382:microbiology; D011237:Predictive Value of Tests; D011674:Pulse; D012475:Salmonella / Q000302:isolation & purification; D017678:Sex Distribution; D014195:Travel; D014839:Vomiting / Q000382:microbiology