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Diarrhea in hospitalized patients
S A Yablon1, R Krotenberg, K Fruhmann
1Department of Physical Medicine and Rehabilitation, New Jersey Medical School/University of Medicine and Dentistry of New Jersey, Newark.
American Journal of Physical Medicine & Rehabilitation
|April 1, 1992
Summary
Clostridium difficile infection causes significant diarrhea and disrupts rehabilitation therapy in hospitalized patients. Early diagnosis and prompt treatment are crucial for better patient outcomes.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Hospital Epidemiology
Background:
- Clostridium difficile is a common cause of antibiotic-associated diarrhea in hospitalized patients.
- Rehabilitation hospital inpatients are at risk due to frequent antibiotic use.
- Limited data exists on Clostridium difficile epidemics in rehabilitation centers.
Purpose of the Study:
- To investigate the impact of Clostridium difficile-related disease in rehabilitation hospital inpatients.
- To determine the prevalence of Clostridium difficile as a cause of diarrhea in this population.
- To assess the effect of Clostridium difficile on patient's rehabilitation course.
Main Methods:
- Retrospective review of inpatients evaluated for diarrhea over 13 months in two rehabilitation hospitals.
- Identification of Clostridium difficile as the etiological agent for diarrhea.
- Analysis of therapy sessions altered or canceled due to symptomatic diarrhea.
Main Results:
- Clostridium difficile was identified as the cause of diarrhea in 36% of evaluated patients.
- No other causes of diarrhea were identified in the studied group.
- Significant disruption to rehabilitation therapy occurred, with 90% of altered/canceled sessions during symptomatic periods.
- Four patients required transfer to acute care due to severe symptoms.
Conclusions:
- Clostridium difficile infection adversely impacts the hospital course of rehabilitation patients.
- Physicians should maintain a high suspicion for C. difficile in patients with diarrhea in rehabilitation settings.
- Diagnostic evaluation should include C. difficile toxin assay, with prompt initiation of appropriate therapy if positive.