Journal Article

Etiology of Bloody Diarrhea among Patients Presenting to United States Emergency Departments: Prevalence of <i>Escherichia coli</i> O157:H7 and Other Enteropathogens

David A. Talan, Gregory J. Moran, Michael Newdow, Samuel Ong, William R. Mower, Janet Y. Nakase, Robert W. Pinner and Laurence Slutsker

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 32, issue 4, pages 573-580
Published in print February 2001 | ISSN: 1058-4838
Published online February 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/318718
Etiology of Bloody Diarrhea among Patients Presenting to United States Emergency Departments: Prevalence of Escherichia coli O157:H7 and Other Enteropathogens

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Escherichia coli O157:H7 and other Shiga toxin—producing E. coli (STEC) infections have been associated with bloody diarrhea. The prevalence of enteropathogens among patients with bloody diarrhea was determined by a prospective study at 11 US emergency departments. Eligible patients had bloody stools, ⩾3 loose stool samples per 24-h period, and an illness lasting <7 days. Among 873 patients with 877 episodes of bloody diarrhea, stool samples for culture were obtained in 549 episodes (62.6%). Stool cultures were more frequently ordered for patients with fever, >10 stools/day, and visibly bloody stools than for patients without these findings. Enteropathogens were identified in 168 episodes (30.6%): Shigella (15.3%), Campylobacter (6.2%), Salmonella (5.8%), STEC (2.6%), and other (1.6%). Enteropathogens were isolated during 12.5% of episodes that physicians thought were due to a noninfectious cause. The prevalence of STEC infection varied by site from 0% to 6.2%. Hospital admissions resulted from 195 episodes (23.4%). These data support recommendations that stool samples be cultured for patients with acute bloody diarrhea.

Journal Article.  5313 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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