Survey of physician diagnostic practices for patients with acute diarrhea: Clinical and public health implications

被引:60
作者
Hennessy, TW
Marcus, R
Deneen, V
Reddy, S
Vugia, D
Townes, J
Bardsley, M
Swerdlow, D
Angulo, FJ
机构
[1] Ctr Dis Control & Prevent, Foodborne & Diarrheal Dis Branch, Div Bacterial & Mycot Dis, Natl Ctr Infect Dis, Atlanta, GA USA
[2] Georgia Dept Human Resources, Div Publ Hlth, Atlanta, GA USA
[3] Connecticut Emerging Infect Program, New Haven, CT USA
[4] Minnesota Dept Hlth, Minneapolis, MN USA
[5] Calif Dept Hlth Serv, Berkeley, CA 94704 USA
[6] Oregon Dept Human Resources, Oregon Hlth Div, Portland, OR USA
关键词
D O I
10.1086/381588
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
To understand physician practices regarding the diagnosis of acute diarrheal diseases, we conducted a survey, in 1996, of 2839 physicians in Connecticut, Georgia, Minnesota, Oregon, and California. Bacterial stool culture was requested for samples from the last patient seen for acute diarrhea by 784 (44%; 95% confidence interval, 42%-46%) of 1783 physicians. Physicians were more likely to request a culture for persons with acquired immune deficiency syndrome, bloody stools, travel to a developing country, diarrhea for 13 days, intravenous rehydration, or fever. Substantial geographic and specialty differences in culture-request practices were observed. Twenty-eight percent of physicians did not know whether stool culture included testing for Escherichia coli O157: H7; 40% did not know whether Yersinia or Vibrio species were included. These variabilities suggest a need for clinical diagnostic guidelines for diarrhea. Many physicians could benefit from education to improve their knowledge about tests included in routine stool examinations.
引用
收藏
页码:S203 / S211
页数:9
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