Survey of physician diagnostic practices for patients with acute diarrhea: clinical and public health implications.
To understand physician practices regarding the diagnosis of acute diarrheal diseases, we conducted a survey, in 1996, of 2839 physicians in Connecticut, Georgia, Minnesota, Oregon, and California. Bacterial stool culture was requested for samples from the last patient seen for acute diarrhea by 784 (44%; 95% confidence interval, 42%-46%) of 1783 physicians. Physicians were more likely to request a culture for persons with acquired immune deficiency syndrome, bloody stools, travel to a developing country, diarrhea for >3 days, intravenous rehydration, or fever. Substantial geographic and specialty differences in culture-request practices were observed. Twenty-eight percent of physicians did not know whether stool culture included testing for Escherichia coli O157:H7; 40% did not know whether Yersinia or Vibrio species were included. These variabilities suggest a need for clinical diagnostic guidelines for diarrhea. Many physicians could benefit from education to improve their knowledge about tests included in routine stool examinations.
Hennessy
Thomas W
TW
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. tbh0@cdc.gov
Marcus
Ruthanne
R
Deneen
Valerie
V
Reddy
Sudha
S
Vugia
Duc
D
Townes
John
J
Bardsley
Molly
M
Swerdlow
David
D
Angulo
Frederick J
FJ
D000208:Acute Disease; D019411:Clinical Laboratory Techniques; D003967:Diarrhea / Q000175:diagnosis* / Q000382:microbiology; D004501:Education, Medical; D019453:Escherichia coli O157 / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology*; D006801:Humans; D010820:Physicians; D010818:Practice Patterns, Physicians'