THE INCIDENCE OF VIRAL-ASSOCIATED DIARRHEA AFTER ADMISSION TO A PEDIATRIC HOSPITAL

For determination of the incidence of viral-associated diarrhea after admission to a pediatric hospital, all patients admitted to general pediatrics, cardioiogy, and neurosurgery wards without diarrhea between January 1 and July 31, 1985 were followed 5 days per week for presence of diarrhea, etlologic agent, and possible risk factors. A total of 1,530 patients were followed for 3,642 days. Of these patients, 69 developed 80 nosocomlal dIarrhea episodes after 72 hours In hospital for a nosocomlal diarrhea rate of 4.5 Infected children per 100 admissIons. Of 358 patIents with an infected roommate, 37 (10.3%) developed nosocomlal diarrhea. Etlologic agents recognized included rotavirus (43%), calicivlrus (16%), astrovirus (14%), minreovirus (12%), adenovlrus (8%), Salmonella sp. (4%), and parvo/picomavirus (3%). The nosoconiial diarrhea rate by age was: 0-11 months, 8.8%; 12-35 months, 3.6%; and 36 months or more, 0.6%. The rate by length of stay was: 3-7 days, 8.4%; 8-14 days, 10.4%; 15-21 days, 7.9%; and 22 days or more, 8.8%, and by number of roonimates/1,000 patient-days it was: 0-1, 15.7; 2 to 3, 27.7; and 4 or more, 45.2. Patients who acquired diarrhea were more likely to be diapered (9.6% vs. 1.8%, p >0.001). Playroom use was not significantly different in the two groups. A total of 64 patients developed diarrhea within 72 hours of admission (community diarrhea rate=4.2). Nosocomlal viral-associated diarrhea is almost exclusively a disease of diapered children less than age 36 months and occurs at any time during hospital stay. It is more common in multibed rooms, but does occur In single-bed rooms. © 1990 by The Johns Hopkins University School of Hygiene and Public Health.