Prevalence of diarrhea at a university hospital and association with modifiable risk factors.
OBJECTIVE
To assess the prevalence of diarrhea at a university-affiliated medical center and the presence of modifiable risk factors.


METHODS
A point prevalence survey was conducted. All patients hospitalized for more than 24 hours were asked if they were experiencing diarrhea. Stools of patients not previously tested were assessed for Clostridium difficile (CD) toxins A and B. Univariate analysis and multivariate logistic regression analyses were used to identify modifiable variables associated with diarrhea (significance defined as p < 0.05).


RESULTS
Four hundred eighty-five hospitalized patients were interviewed, of whom 60 (12.4%) reported 2 or more loose, unformed stools in the last 24 hours. Six of 81 (7.4%) patients tested positive for CD toxin. Three (50%) of the CD toxin-positive patients had not previously been tested during the current admission. Patients with diarrhea were more likely to have tested CD toxin-positive (OR 10.6; p = 0.01), received antibiotics (OR 1.79; p = 0.04), or been hospitalized for a longer period of time (p = 0.04).


CONCLUSIONS
Diarrhea was prevalent in 12.4% of hospitalized patients at a large university hospital at one point in time. Patients with diarrhea were more likely to have CD infection, receive antibiotics, or experience a longer hospitalization. Half of the CD diarrhea cases occurring in the hospital had been previously unidentified. Hospitalized patients should be evaluated for diarrhea on an ongoing basis with appropriate interventions instituted.
Garey
Kevin W
KW
College of Pharmacy, Department of Clinical Sciences and Administration, University of Houston, and St. Luke's Episcopal Hospital, TX 77030, USA. kgarey@uh.edu
Graham
Gail
G
Gerard
Laura
L
Dao
Thanh
T
Jiang
Zhi Dong
ZD
Price
Margaret
M
Dupont
Herbert L
HL