Infectious gastroenteritis and the need for strict contact precaution procedures in adults presenting to the emergency department

a Danish Register-based Study

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Resumé

Background: Acute infectious gastroenteritis requires contact precautions to prevent spread. On acute admission, the cause of diarrhoea is unknown, so the decision regarding which patients to isolate has to be made on clinical information with a risk of inexpedient use of contact precautions. Aim: To investigate how often gastroenteritis occurs (and therefore how often the need for isolation has to be assessed) in Danish emergency departments, and how often patients have to remain on contact precautions according to the results of faecal samples. Methods: This Danish register-based retrospective cohort study on adults in Danish emergency departments used three data sources: discharge diagnoses from the Danish National Patient Register; microbiological results from faecal samples provided in the emergency department; and the causes of hospital admission based on the chief complaint. Findings: Among 66,885 acute admissions, 4.3% of patients had at least one feature of gastroenteritis: admission with diarrhoea as the chief complaint (1.6%); microbiological examination of faecal sample (2.8%); and discharged with a diagnosis of gastroenteritis (1.7%). Nineteen percent of those who had a faecal sample tested were found to have norovirus or Clostridium difficile, and needed to remain on strict contact precautions. Conclusion: The initiation of contact precautions has to be assessed for 4.3% of all emergency department patients; 19% of the patients who had a faecal sample tested had highly contagious gastroenteritis and required strict contact precautions. Further studies are needed to develop tools to determine which patients to isolate.

OriginalsprogEngelsk
TidsskriftJournal of Hospital Infection
Vol/bind98
Udgave nummer4
Sider (fra-til)391-397
ISSN0195-6701
DOI
StatusUdgivet - apr. 2018

Fingeraftryk

Gastroenteritis
Hospital Emergency Service
Clostridium difficile
Information Storage and Retrieval
Patient Admission
Cohort Studies
Retrospective Studies

Citer dette

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title = "Infectious gastroenteritis and the need for strict contact precaution procedures in adults presenting to the emergency department: a Danish Register-based Study",
abstract = "Background: Acute infectious gastroenteritis requires contact precautions to prevent spread. On acute admission, the cause of diarrhoea is unknown, so the decision regarding which patients to isolate has to be made on clinical information with a risk of inexpedient use of contact precautions. Aim: To investigate how often gastroenteritis occurs (and therefore how often the need for isolation has to be assessed) in Danish emergency departments, and how often patients have to remain on contact precautions according to the results of faecal samples. Methods: This Danish register-based retrospective cohort study on adults in Danish emergency departments used three data sources: discharge diagnoses from the Danish National Patient Register; microbiological results from faecal samples provided in the emergency department; and the causes of hospital admission based on the chief complaint. Findings: Among 66,885 acute admissions, 4.3{\%} of patients had at least one feature of gastroenteritis: admission with diarrhoea as the chief complaint (1.6{\%}); microbiological examination of faecal sample (2.8{\%}); and discharged with a diagnosis of gastroenteritis (1.7{\%}). Nineteen percent of those who had a faecal sample tested were found to have norovirus or Clostridium difficile, and needed to remain on strict contact precautions. Conclusion: The initiation of contact precautions has to be assessed for 4.3{\%} of all emergency department patients; 19{\%} of the patients who had a faecal sample tested had highly contagious gastroenteritis and required strict contact precautions. Further studies are needed to develop tools to determine which patients to isolate.",
keywords = "Journal Article, Contact precautions, Norovirus, Clostridium difficile, Infectious gastroenteritis, Emergency Service, Hospital, Humans, Middle Aged, Male, Norovirus/isolation & purification, Gastroenteritis/epidemiology, Young Adult, Denmark/epidemiology, Feces/microbiology, Aged, 80 and over, Disease Transmission, Infectious/prevention & control, Patient Isolation/statistics & numerical data, Adult, Female, Aged, Clostridium difficile/isolation & purification, Retrospective Studies, Cross Infection/prevention & control, Infection Control/methods",
author = "Florence Skyum and Vibeke Andersen and Ming Chen and Court Pedersen and Mogensen, {Christian Backer}",
note = "Copyright {\circledC} 2017. Published by Elsevier Ltd.",
year = "2018",
month = "4",
doi = "10.1016/j.jhin.2017.11.001",
language = "English",
volume = "98",
pages = "391--397",
journal = "Journal of Hospital Infection",
issn = "0195-6701",
publisher = "W.B.Saunders Co. Ltd.",
number = "4",

}

TY - JOUR

T1 - Infectious gastroenteritis and the need for strict contact precaution procedures in adults presenting to the emergency department

T2 - a Danish Register-based Study

AU - Skyum, Florence

AU - Andersen, Vibeke

AU - Chen, Ming

AU - Pedersen, Court

AU - Mogensen, Christian Backer

N1 - Copyright © 2017. Published by Elsevier Ltd.

PY - 2018/4

Y1 - 2018/4

N2 - Background: Acute infectious gastroenteritis requires contact precautions to prevent spread. On acute admission, the cause of diarrhoea is unknown, so the decision regarding which patients to isolate has to be made on clinical information with a risk of inexpedient use of contact precautions. Aim: To investigate how often gastroenteritis occurs (and therefore how often the need for isolation has to be assessed) in Danish emergency departments, and how often patients have to remain on contact precautions according to the results of faecal samples. Methods: This Danish register-based retrospective cohort study on adults in Danish emergency departments used three data sources: discharge diagnoses from the Danish National Patient Register; microbiological results from faecal samples provided in the emergency department; and the causes of hospital admission based on the chief complaint. Findings: Among 66,885 acute admissions, 4.3% of patients had at least one feature of gastroenteritis: admission with diarrhoea as the chief complaint (1.6%); microbiological examination of faecal sample (2.8%); and discharged with a diagnosis of gastroenteritis (1.7%). Nineteen percent of those who had a faecal sample tested were found to have norovirus or Clostridium difficile, and needed to remain on strict contact precautions. Conclusion: The initiation of contact precautions has to be assessed for 4.3% of all emergency department patients; 19% of the patients who had a faecal sample tested had highly contagious gastroenteritis and required strict contact precautions. Further studies are needed to develop tools to determine which patients to isolate.

AB - Background: Acute infectious gastroenteritis requires contact precautions to prevent spread. On acute admission, the cause of diarrhoea is unknown, so the decision regarding which patients to isolate has to be made on clinical information with a risk of inexpedient use of contact precautions. Aim: To investigate how often gastroenteritis occurs (and therefore how often the need for isolation has to be assessed) in Danish emergency departments, and how often patients have to remain on contact precautions according to the results of faecal samples. Methods: This Danish register-based retrospective cohort study on adults in Danish emergency departments used three data sources: discharge diagnoses from the Danish National Patient Register; microbiological results from faecal samples provided in the emergency department; and the causes of hospital admission based on the chief complaint. Findings: Among 66,885 acute admissions, 4.3% of patients had at least one feature of gastroenteritis: admission with diarrhoea as the chief complaint (1.6%); microbiological examination of faecal sample (2.8%); and discharged with a diagnosis of gastroenteritis (1.7%). Nineteen percent of those who had a faecal sample tested were found to have norovirus or Clostridium difficile, and needed to remain on strict contact precautions. Conclusion: The initiation of contact precautions has to be assessed for 4.3% of all emergency department patients; 19% of the patients who had a faecal sample tested had highly contagious gastroenteritis and required strict contact precautions. Further studies are needed to develop tools to determine which patients to isolate.

KW - Journal Article

KW - Contact precautions

KW - Norovirus

KW - Clostridium difficile

KW - Infectious gastroenteritis

KW - Emergency Service, Hospital

KW - Humans

KW - Middle Aged

KW - Male

KW - Norovirus/isolation & purification

KW - Gastroenteritis/epidemiology

KW - Young Adult

KW - Denmark/epidemiology

KW - Feces/microbiology

KW - Aged, 80 and over

KW - Disease Transmission, Infectious/prevention & control

KW - Patient Isolation/statistics & numerical data

KW - Adult

KW - Female

KW - Aged

KW - Clostridium difficile/isolation & purification

KW - Retrospective Studies

KW - Cross Infection/prevention & control

KW - Infection Control/methods

U2 - 10.1016/j.jhin.2017.11.001

DO - 10.1016/j.jhin.2017.11.001

M3 - Journal article

VL - 98

SP - 391

EP - 397

JO - Journal of Hospital Infection

JF - Journal of Hospital Infection

SN - 0195-6701

IS - 4

ER -