[Infectious acute gastroenteritis in the emergency department of an urban hospital]. / Gastroenteritis aguda infecciosa en urgencias de un hospital urbano.

OBJECTIVES: To examine the etiology, clinical, analytical and evolutionary characteristics of gastroenteritis in the pediatric population in the Emergency Department of Dr. Peset University Hospital in Health Care Area 10 in Valencia, Spain, over a 1-year period (2005). PATIENTS AND METHODS: Children < 15 years of age with acute diarrhea were prospectively enrolled in the Emergency Department. Data were collected through information sheets. Their stools were examined for diarrheagenic bacteria and viruses (rotavirus and adenovirus). RESULTS: 794 episodes of gastroenteritis were recorded. The incidence of rotavirus was 22 %, adenovirus 8 %, Campylobacter jejuni 7 % and Salmonella spp. 4 %. Socioeconomic characteristics were not helpful in differentiating disease due to specific enteropathogens. Ninety per cent cases caused by viruses only affected children under three years of age. Rotavirus gastroenteritis had a marked seasonal pattern (90 % cases in December-February). Among infants < or = 6 months of age rotavirus was less frequent as cause of diarrhea in breast-fed infants than in bottle-fed. Macroscopic blood in stools was reported almost exclusively among patients with a bacterial infection. In 96 % of all cases of diarrhea there was no dehydration, in 2 % it was mild, in 2 % moderate and none severe. Ten of the seventeen cases (59 %) of moderate dehydration were caused by rotavirus. Six percent of all children were hospitalised. CONCLUSIONS: Rotavirus was significantly more associated with the need for intravenous fluid therapy and hospitalisation than episodes negative for rotavirus. Rotavirus accounted for 3 % of hospitalisations in infants aged 1 month-2 years.

Gastroenteritis aguda infecciosa en urgencias de un hospital urbano / Infectious acute gastroenteritis in the emergency department of an urban hospital

Objetivos: Analizar la etiología, características clínicas, analíticas y evolutivas de la gastroenteritis aguda infecciosa en la unidad de urgencias del Hospital Universitario Doctor Peset, en el Departamento de Salud 10 de Valencia (España) durante el año 2005. Pacientes y métodos: Se incluyeron los niños menores de 15 años que consultaron por diarrea aguda en la unidad de urgencias. La recogida de datos se realizó mediante un cuestionario estructurado. Se remitieron muestras de heces para estudio microbiológico de bacterias y virus (rotavirus y adenovirus). Resultados: Se recogieron 794 casos. Rotavirus originó el 22 % de los casos; adenovirus, el 8 %; Campylobacter spp. el 7 %, y Salmonella spp. el 4 %. Las características socioeconómicas de los padres no se relacionaron con ningún agente causal. El 90 % de los casos producidos por virus afectaron a niños menores de 3 años. El 90 % de los casos por rotavirus se dieron en diciembre-febrero. Entre los lactantes de hasta 6 meses rotavirus fue menos frecuente en los que seguían lactancia materna frente a los alimentados con fórmula artificial. La presencia de sangre macroscópica en heces fue casi exclusiva de la infección bacteriana. En el 96 % de los casos no hubo deshidratación, en el 2 % fue leve, en el 2 % moderada y en ninguno grave. Un total de 10 de los 17 casos (59 %) con deshidratación moderada fueron causados por rotavirus. El 6 % de los niños fueron hospitalizados. Conclusiones: Rotavirus se asoció significativamente a la necesidad de fluidoterapia intravenosa e ingreso y causó el 3 % de los ingresos entre 1 mes y 2 años de edad (AU)

Objectives: To examine the etiology, clinical, analytical and evolutionary characteristics of gastroenteritis in the pediatric population in the Emergency Department of Dr. Peset University Hospital in Health Care Area 10 in Valencia, Spain, over a 1-year period (2005). Patients and methods: Children < 15 years of age with acute diarrhea were prospectively enrolled in the Emergency Department. Data were collected through information sheets. Their stools were examined for diarrheagenic bacteria and viruses (rotavirus and adenovirus). Results: 794 episodes of gastroenteritis were recorded. The incidence of rotavirus was 22 %, adenovirus 8 %, Campylobacter jejuni 7 % and Salmonella spp. 4 %. Socioeconomic characteristics were not helpful in differentiating disease due to specific enteropathogens. Ninety per cent cases caused by viruses only affected children under three years of age. Rotavirus gastroenteritis had a marked seasonal pattern (90 % cases in December-February). Among infants # 6 months of age rotavirus was less frequent as cause of diarrhea in breast-fed infants than in bottle-fed. Macroscopic blood in stools was reported almost exclusively among patients with a bacterial infection. In 96 % of all cases of diarrhea there was no dehydration, in 2 % it was mild, in 2 % moderate and none severe. Ten of the seventeen cases (59 %) of moderate dehydration were caused by rotavirus. Six percent of all children were hospitalised. Conclusions: Rotavirus was significantly more associated with the need for intravenous fluid therapy and hospitalisation than episodes negative for rotavirus. Rotavirus accounted for 3 % of hospitalisations in infants aged 1 month-2 years (AU)