Incidence of and risk factors for hospital-acquired diarrhea in three tertiary care public hospitals in Bangladesh

• Published in: The American journal of tropical medicine and hygiene Vol. 91; no. 1; pp. 165 - 172
• Main Authors: Bhuiyan, Mejbah Uddin, Luby, Stephen P, Zaman, Rashid Uz, Rahman, M Waliur, Sharker, M A Yushuf, Hossain, M Jahangir, Rasul, Choudhury H, Ekram, A R M Saifuddin, Rahman, Mahmudur, Sturm-Ramirez, Katharine, Azziz-Baumgartner, Eduardo, Gurley, Emily S
• Format: Journal Article
• Language: English
• Published: United States The American Society of Tropical Medicine and Hygiene 01-07-2014
• Subjects: Adolescent; Adult; Aged; Bangladesh - epidemiology; Child; Child, Preschool; Cross Infection; Diarrhea - epidemiology; Diarrhea - pathology; Disease Outbreaks; Female; Hospitals, Public; Humans; Incidence; Infant; Length of Stay; Male; Middle Aged; Risk Factors; Survival Analysis; Tertiary Healthcare - statistics & numerical data; Bangladesh
• ISSN: 0002-9637; 1476-1645
• DOI: 10.4269/ajtmh.13-0484

During April 2007-April 2010, surveillance physicians in adult and pediatric medicine wards of three tertiary public hospitals in Bangladesh identified patients who developed hospital-acquired diarrhea. We calculated incidence of hospital-acquired diarrhea. To identify risk factors, we compared these patients to randomly selected patients from the same wards who were admitted > 72 hours without having diarrhea. The incidence of hospital-acquired diarrhea was 4.8 cases per 1,000 patient-days. Children < 1 year of age were more likely to develop hospital-acquired diarrhea than older children. The risk of developing hospital-acquired diarrhea increased for each additional day of hospitalization beyond 72 hours, whereas exposure to antibiotics within 72 hours of admission decreased the risk. There were three deaths among case-patients; all were infants. Patients, particularly young children, are at risk for hospital-acquired diarrhea and associated deaths in Bangladeshi hospitals. Further research to identify the responsible organisms and transmission routes could inform prevention strategies.