Infectious Gastroenteritis and the Need for Strict Contact Precaution Procedures in Adults Presenting in the Emergency Department – a Danish Register-based Study.

Link to article at PubMed

Infectious Gastroenteritis and the Need for Strict Contact Precaution Procedures in Adults Presenting in the Emergency Department - a Danish Register-based Study.

J Hosp Infect. 2017 Nov 08;:

Authors: Skyum F, Andersen V, Chen M, Pedersen C, Mogensen CB

Abstract
BACKGROUND: Acute infectious gastroenteritis requires contact precautions to prevent spreading. On acute admission the cause of diarrhoea is unknown, so the decision of whom to isolate has to be made on clinical information with a risk of inexpedient use of contact precautions.
AIM: The aims of the study were to investigate how often gastroenteritis occurs, and thus the isolation indication has to be assessed, in Danish emergency departments, and how often patients have to remain on contact precaution according to the results of the faecal samples.
METHODS: This Danish register based retrospective cohort study on adults in Danish emergency departments linked three data sources: discharge diagnoses from the Danish National Patient Register; microbiologically results from faecal samples delivered in the emergency department; and the causes of hospital admission based on the chief complaint.
FINDINGS: Among 66,885 acute admissions 4.3% patients had at least one feature of gastroenteritis: admission with a chief complaint of diarrhoea (1.6%); faecal sample microbiology examination (2.8%); discharged with a gastroenteritis diagnosis (1.7%). 19% of those who had a faecal sample tested were norovirus or Clostridium difficile cases, who should remain on strict contact precautions.
CONCLUSION: The initiation of contact precaution has to be assessed for 4.3% of all emergency department patients; 19% of the patients who had a sample tested had highly contagious gastroenteritis and required strict contact precautions. Further studies for developing tools to determine whom to isolate are needed.

PMID: 29128345 [PubMed - as supplied by publisher]

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