Detection of Acute Gastroenteritis Etiology in Hospitalized Young Children: Associated Factors and Outcomes.

BACKGROUND: The decision to test for the etiology of diarrhea is a challenging question for practicing pediatricians.

METHODS: The main goal of this retrospective cohort study was to identify factors associated with testing for and diagnosis of rotavirus, Clostridium difficile , or other bacterial infections, as well as the length of stay (LOS) for children with acute gastroenteritis who were hospitalized at a single institution. Patients aged 6 to 60 months with acute diarrhea (<14 days) and no underlying gastrointestinal conditions were included. Data were analyzed by using multivariate logistic and linear regression models.

RESULTS: Stool testing was performed in 73.1% of the 331 patients studied. The majority were tested for multiple pathogens, including rotavirus (65.9%), C difficile (30.8%), and other bacteria (63.4%), with recovery rates of 33.0%, 9.8%, and 6.7%, respectively. Rotavirus was more often identified in older patients with dehydration and vomiting. Although testing for C difficile was more likely with prolonged diarrhea, no vomiting, and recent antibiotic use, no factors were associated with C difficile recovery. Patients who were diagnosed with C difficile were more likely to receive probiotics than those who received negative test results. LOS was not associated with stool testing or recovery of any tested pathogens.

CONCLUSIONS: Although children with acute gastroenteritis underwent frequent stool testing for diarrheal etiology, detection of a pathogen was uncommon and not associated with a change in LOS. Experimental research will be needed to make additional conclusions about the efficacy of testing for diarrheal etiology in the inpatient practice of acute pediatric diarrhea.