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首页> 外文期刊>Journal of epidemiology / >Etiology and Risk Factors of Acute Gastroenteritis in a Taipei Emergency Department: Clinical Features for Bacterial Gastroenteritis
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Etiology and Risk Factors of Acute Gastroenteritis in a Taipei Emergency Department: Clinical Features for Bacterial Gastroenteritis

机译：台北市急诊科急性胃肠炎的病因和危险因素：细菌性胃肠炎的临床特征

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Background: The causative pathogen is rarely identified in the emergency department (ED), since the results of cultures are usually unavailable. As a result, antimicrobial treatment may be overused. The aim of our study was to investigate the pathogens, risk factors of acute gastroenteritis, and predictors of acute bacterial gastroenteritis in the ED. Methods: We conducted a matched case-control study of 627 stool samples and 612 matched pairs. Results: Viruses (41.3%) were the leading cause of gastroenteritis, with noroviruses (32.2%) being the most prevalent, followed by bacteria (26.8%) and Giardia lamblia (12.4%). Taking antacids (adjusted odds ratio [aOR] 4.10; 95% confidence interval [CI], 2.57–6.53), household members/classmates with gastroenteritis (aOR 4.69; 95% CI, 2.76–7.96), attending a banquet (aOR 2.29; 95% CI, 1.64–3.20), dining out (aOR 1.70; 95% CI, 1.13–2.54), and eating raw oysters (aOR 3.10; 95% CI, 1.61–5.94) were highly associated with gastroenteritis. Elders (aOR 1.04; 05% CI, 1.02–1.05), those with CRP >10 mg/L (aOR 2.04; 95% CI, 1.15–3.62), or those who were positive for fecal leukocytes (aOR 2.04; 95% CI, 1.15–3.62) or fecal occult blood (aOR 1.97; 95% CI, 1.03–3.77) were more likely to be hospitalized in ED. In addition, presence of fecal leukocytes (time ratio [TR] 1.22; 95% CI, 1.06–1.41), abdominal pain (TR 1.20; 95% CI, 1.07–1.41), and frequency of vomiting (TR 0.79; 95% CI, 0.64–0.98) were significantly associated with the duration of acute gastroenteritis. Presence of fecal leukocytes (aOR 2.08; 95% CI, 1.42–3.05), winter season (aOR 0.45; 95% CI, 0.28–0.74), frequency of diarrhea (aOR 1.69; 95% CI, 1.01–2.83), and eating shrimp or crab (aOR 1.53; 95% CI, 1.05–2.23) were highly associated with bacterial gastroenteritis. The area under the receiver operating characteristic curve of the final model was 0.68 (95% CI, 0.55–0.63). Conclusions: Acute bacterial gastroenteritis was highly associated with season, frequency of diarrhea, frequency of vomiting, and eating shrimp or crab.
机译：背景：急诊科（ED）很少发现病原体，因为通常无法获得培养结果。结果，可能会过度使用抗菌治疗。我们研究的目的是调查急诊室中急性胃肠炎的病原体，危险因素和急性细菌性胃肠炎的预测因子。方法：我们对627份粪便样本和612对配对样本进行了匹配的病例对照研究。结果：病毒（41.3％）是肠胃炎的主要原因，诺如病毒（32.2％）是最普遍的，其次是细菌（26.8％）和兰氏贾第鞭毛虫（12.4％）。服用抗酸药（调整比值比[aOR] 4.10; 95％置信区间[CI]，2.57–6.53），患有肠胃炎的家庭成员/同学（aOR 4.69; 95％CI，2.76-7.96），参加宴会（aOR 2.29; 95％CI，1.64-3.20），外出就餐（aOR 1.70; 95％CI，1.13-2.54）和进食生牡蛎（aOR 3.10; 95％CI，1.61-5.94）与胃肠炎高度相关。老年人（aOR 1.04; 05％CI，1.02-1.05），CRP> 10 mg / L的老年人（aOR 2.04; 95％CI，1.15–3.62），或粪便白细胞阳性的患者（aOR 2.04; 95％CI （1.15–3.62）或粪便潜血（aOR 1.97; 95％CI，1.03–3.77）更有可能在急诊室住院。此外，粪便白细胞的存在（时间比[TR] 1.22; 95％CI，1.06-1.41），腹痛（TR 1.20; 95％CI，1.07-1.41），呕吐频率（TR 0.79; 95％CI） ，0.64–0.98）与急性胃肠炎的持续时间显着相关。粪便白细胞的存在（aOR 2.08; 95％CI，1.42-3.05），冬季（aOR 0.45; 95％CI，0.28–0.74），腹泻的频率（aOR 1.69; 95％CI，1.01-2.83）和进食虾或蟹（aOR 1.53; 95％CI，1.05-2.23）与细菌性肠胃炎高度相关。最终模型的接收器工作特性曲线下的面积为0.68（95％CI，0.55-0.63）。结论：急性细菌性肠胃炎与季节，腹泻频率，呕吐频率以及食用虾或蟹高度相关。

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