TY - JOUR
T1 - Rotaviral and bacterial gastroenteritis in children during winter
T2 - An evaluation of physician ordering patterns
AU - Chemaly, Roy F.
AU - Yen-Lieberman, Belinda
AU - Schindler, Sue A.
AU - Goldfarb, Johanna
AU - Hall, Gerri S.
AU - Procop, Gary W.
N1 - Funding Information:
This study was partly supported by Meridian Diagnostics, Inc. (Cincinnati, OH).
PY - 2003/9
Y1 - 2003/9
N2 - Background: Identification of the agents of infectious diarrhea may facilitate appropriate therapy and prevent inappropriate antibiotic use. Objectives: To better define the etiology of infectious diarrhea for children <12 years in our community and to study the ordering patterns of physicians. Study design: We reviewed test results of stool specimens from children <12 years old at our institution (CCF) and those submitted through our reference laboratory for rotavirus enzyme immunoassay (REIA) and stool cultures for a 7-month period (11/1/00-6/1/01). For CCF patients, REIA and stool cultures for usual bacterial enteric pathogens (BEP) were performed, regardless of the test ordered (i.e. REIA alone, stool culture alone or both). We compared the results with the orders placed to determine if requests for rotavirus alone or bacterial stool culture alone missed BEP or rotavirus, respectively. Results: Overall, REIAs were performed on 81% (538/661) of stool specimens, with 37% positive. Stool cultures were performed on 62% (408/661) of stool specimens, with 4.4% positive. Stool specimens (280) from CCF pediatric patients were evaluated for both rotavirus and BEP. Some 42% of REIA and 23% of stool cultures were ordered as single tests, while both tests were ordered for 35% of the patients. Of the REIA ordered alone, 34% were positive for rotavirus; however, 2.5% of these contained BEP that would have been missed. Of the stool cultures that were ordered alone, 8% were positive; however, 19% of these contained rotavirus that would have been missed. When both tests were ordered, 22% contained rotavirus and 2% contained BEP. Conclusion: Both rotavirus and bacterial enteric infections were missed with selective viral versus bacterial specific ordering patterns. A rotaviral screen prior to stool culture may be useful for children with diarrhea during the winter months.
AB - Background: Identification of the agents of infectious diarrhea may facilitate appropriate therapy and prevent inappropriate antibiotic use. Objectives: To better define the etiology of infectious diarrhea for children <12 years in our community and to study the ordering patterns of physicians. Study design: We reviewed test results of stool specimens from children <12 years old at our institution (CCF) and those submitted through our reference laboratory for rotavirus enzyme immunoassay (REIA) and stool cultures for a 7-month period (11/1/00-6/1/01). For CCF patients, REIA and stool cultures for usual bacterial enteric pathogens (BEP) were performed, regardless of the test ordered (i.e. REIA alone, stool culture alone or both). We compared the results with the orders placed to determine if requests for rotavirus alone or bacterial stool culture alone missed BEP or rotavirus, respectively. Results: Overall, REIAs were performed on 81% (538/661) of stool specimens, with 37% positive. Stool cultures were performed on 62% (408/661) of stool specimens, with 4.4% positive. Stool specimens (280) from CCF pediatric patients were evaluated for both rotavirus and BEP. Some 42% of REIA and 23% of stool cultures were ordered as single tests, while both tests were ordered for 35% of the patients. Of the REIA ordered alone, 34% were positive for rotavirus; however, 2.5% of these contained BEP that would have been missed. Of the stool cultures that were ordered alone, 8% were positive; however, 19% of these contained rotavirus that would have been missed. When both tests were ordered, 22% contained rotavirus and 2% contained BEP. Conclusion: Both rotavirus and bacterial enteric infections were missed with selective viral versus bacterial specific ordering patterns. A rotaviral screen prior to stool culture may be useful for children with diarrhea during the winter months.
KW - Diagnosis
KW - Diarrhea
KW - Enteric pathogens
KW - Incidence
KW - Rotavirus
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U2 - 10.1016/S1386-6532(02)00237-8
DO - 10.1016/S1386-6532(02)00237-8
M3 - Article
C2 - 12927750
AN - SCOPUS:0041589373
SN - 1386-6532
VL - 28
SP - 44
EP - 50
JO - Journal of Clinical Virology
JF - Journal of Clinical Virology
IS - 1
ER -