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[Validity of a score of clinical parameters as a screening method in acute bacterial diarrhea in childhood]
T Rodríguez Ruiz1, E Berdún, I Lostal
1Servicio de Pediatría del Hospital General San Jorge de la Seguridad Social de Huesca.
Insights
This study developed a clinical score to identify bacterial diarrhea in children. A score of 7 or higher, especially with fecal occult blood, effectively screens for bacterial infections in pediatric gastroenteritis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Microbiology
Background:
- Acute diarrhea is a common pediatric illness.
- Identifying bacterial causes is crucial for appropriate treatment.
- Current diagnostic methods can be resource-intensive.
Purpose of the Study:
- To develop and validate a clinical screening tool for bacterial diarrhea in children.
- To differentiate bacterial from non-bacterial causes of acute gastroenteritis.
- To guide the judicious use of fecal cultures.
Main Methods:
- Prospective study of 172 pediatric patients with acute diarrhea.
- Evaluation of clinical presentation parameters.
- Development of a scoring system for bacterial diarrhea risk.
Main Results:
- Bacterial pathogens identified in 31.4% of cases; Salmonella and Campylobacter were most common.
- A clinical score >= 7 demonstrated 81.5% sensitivity and 60.2% specificity for bacterial diarrhea.
- Adding fecal occult blood testing to the score increased specificity to 95%.
Conclusions:
- A clinical score can serve as a first-level screening tool for bacterial diarrhea in children.
- Combining the score with fecal occult blood testing enhances diagnostic accuracy.
- This approach can help determine the need for fecal cultures in pediatric gastroenteritis.
Abstract:
We report a prospective study of the cases of acute diarrhea admitted to our pediatric service during one year (n = 172) to elaborate a screening method to identify patients with bacterial diarrhea. A bacterial causative organism was identified in 31.4%. The most common species was Salmonella, followed by Campylobacter. We evaluated the clinical presentation parameters, looking for differences between the group were a bacterial organism was isolated and in the group where it was not. We designated a score valid as a first level screening for bacterial diarrhea. With a score greater than or equal to 7 the sensitivity was 81.5% and the specificity 60.2%. The latter increased to 95% when occult blood in feces was associated with the greater than or equal to 7 score (second screening level). We propose this clinical score as a criterion for the indication of fecal cultures in children with acute gastroenteritis.