| Titre : | Derivation and validation of guidelines for stool cultures for enteropathogenic bacteria other than Clostridium difficile in hospitalized adults. (2001) |
| Auteurs : | Tilman-M BAUER ; John-J APONTE ; I.A.N. BOWLER ; Jürgen FEHRENBACH ; Reno FREI ; Manfred KIST ; Ajit LALVANI ; Gabi PHILIPPCZIK ; Roberto SEGOVIA ; Ingrid Steffen ; Bernhard STEINBRUCKNER ; Jordi VILA ; Bacteriological Laboratory. University Hospital Basel. Basel. CHE ; Department of Internal Medicine Ii. University Hospital. Freiburg. DEU ; Institute of Medical Microbiology and Hygiene. University Hospital. Freiburg. DEU |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (vol. 285, n° 3, 2001) |
| Pagination : | 313-319 |
| Langues: | Anglais |
| Mots-clés : | ECONOMIE ; Recommandation ; Culture microorganisme ; Bactérie ; Hospitalisation ; Malade ; Coût ; Etude prospective ; Homme |
| Résumé : | [BDSP. Notice produite par INIST Cvq0IR0x. Diffusion soumise à autorisation]. Context The yield of in-hospital stool cultures performed more than 72 hours after admission is low, and a commonly used policy dictates that laboratories reject these cultures to save costs. However, enteropathogenic bacteria other than Clostridium difficile (EPB) may cause nosocomial illness that would be missed by use of such a "3-day rule." Objective To develop guidelines for hospital use of stool cultures that are sensitive to clinically relevant cases of sporadic and epidemic nosocomial diarrhea. Design Five-part study that incorporated a derivation sample based on retrospective chart review and a prospective cohort study (including cost savings analysis), and a validation sample based on retrospective chart review. Setting Four European academic health care centers. Patients Derivation sample : 1735 adult inpatients from whom 3416 stool cultures were obtained during a 19-month period (1995-1997) and 68 adult inpatients for whom EPB were grown from stool cultures during a 10-year period (1988-1998) ; validation sample : 65 patients with sporadic isolation of EPB (1993-1998), 56 patients involved in 2 nosocomial Salmonella outbreaks (1992 and 1997), and 330 patients who had stool cultures performed (1998). Main Outcome Measure Performance of derived criteria in detecting pathogenic bacteria and outbreaks and reducing total number of stool cultures performed. Results Stool cultures grew EPB in 3.3% of samples obtained <=72 hours after admission and 0. (...) |
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