Incidence of and risk factors for hospital-acquired diarrhea in three tertiary care public hospitals in Bangladesh.
During April 2007-April 2010, surveillance physicians in adult and pediatric medicine wards of three tertiary public hospitals in Bangladesh identified patients who developed hospital-acquired diarrhea. We calculated incidence of hospital-acquired diarrhea. To identify risk factors, we compared these patients to randomly selected patients from the same wards who were admitted > 72 hours without having diarrhea. The incidence of hospital-acquired diarrhea was 4.8 cases per 1,000 patient-days. Children < 1 year of age were more likely to develop hospital-acquired diarrhea than older children. The risk of developing hospital-acquired diarrhea increased for each additional day of hospitalization beyond 72 hours, whereas exposure to antibiotics within 72 hours of admission decreased the risk. There were three deaths among case-patients; all were infants. Patients, particularly young children, are at risk for hospital-acquired diarrhea and associated deaths in Bangladeshi hospitals. Further research to identify the responsible organisms and transmission routes could inform prevention strategies.
Mejbah Uddin
MU
Bhuiyan
Stephen P
SP
Luby
Rashid Uz
RU
Zaman
M Waliur
MW
Rahman
M A Yushuf
MAY
Sharker
M Jahangir
MJ
Hossain
Choudhury H
CH
Rasul
A R M Saifuddin
ARMS
Ekram
Mahmudur
M
Rahman
Katharine
K
Sturm-Ramirez
Eduardo
E
Azziz-Baumgartner
Emily S
ES
Gurley
D000293:Adolescent; D000328:Adult; D000368:Aged; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection; D003967:Diarrhea / Q000453:epidemiology* / Q000473:pathology; D004196:Disease Outbreaks; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D015994:Incidence; D007223:Infant; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016019:Survival Analysis; D063128:Tertiary Health Care / Q000706:statistics & numerical data*