Management of Food-Related Diarrhea Outbreak in the Emergency Department: Lessons Learned from the German STEC O104:H4 Epidemic

Table 1

Anamnestic, clinical, and laboratory findings in STEC-positive versus STEC-negative ED patients. STEC-negative cohort was subdivided into patients without microbiological finding of fecal pathogens and those having enteropathogens other than STEC.

	STEC-positive ()	STEC-negative
		Total ()		Without stool pathogen ()		Other stool pathogens ()
Anthropometric and anamnestic parameter
Age (years, mean ± SD)	52.4 ± 20.2	43.1 ± 19.1	<0.001	43.5 ± 19.3	0.001	41.3 ± 18.4	0.614
BMI (kg/m², mean ± SD)	25.5 ± 5.5	25.5 ± 4.5	0.976	25.0 ± 4.4	0.531	27.6 ± 4.8	0.028
Female (% of patients)	57.1	63.6	0.308	64.3	0.274	60.0	0.682
Smoker (% of patients)	23.0	32.5	0.140	33.7	0.113	27.3	0.563
Start of symptoms (% of patients)
May 2011	90.3	43.2	<0.001	41.7	<0.001	50.0	0.643
June/July 2011	9.7	55.4		56.2		50.0
Defecation rate > 10/d (% of pat.)	56.9	23.2	<0.001	17.6	<0.001	52.9	0.005
Faeces “bloody” (% of patients)	86.4	58.7	<0.001	63.2	<0.001	37.5	0.020
Nausea (% of patients)	50.0	55.0	0.451	51.4	0.839	70.8	0.085
Vomiting (% of patients)	42.2	34.6	0.232	28.6	0.037	62.5	0.002
Abdominal pain (% of patients)	92.0	83.6	0.057	80.9	0.020	95.8	0.074
Pain at lower abdomen (% of patients)	71.0	41.0	<0.001	40.1	<0.001	41.7	0.283
Fever (>38°C; % of patients)	4.0	9.4	0.113	7.0	0.347	20.8	0.035
Clinical findings
Body temperature (°C, mean ± SD)	37.1 ± 0.5	37.1 ± 0.7	0.682	37.0 ± 0.7	0.210	37.4 ± 0.7	0.012
Blood pressure (mmHg, mean ± SD)
Systolic	133 ± 20	131 ± 22	0.468	132 ± 23	0.617	129 ± 20	0.554
Diastolic	78 ± 11	76 ± 11	0.141	77 ± 12	0.318	74 ± 9	0.202
Heart rate (min^−1, mean ± SD)	80.4 ± 16.2	81.1 ± 15.8	0.758	79.9 ± 15.7	0.824	87.5 ± 15.2	0.060
Abdominal tenderness (% of patients)	65.6	40.9	<0.001	39.1	<0.001	50.0	0.342
Tenderness lower abdomen (% of patients)	56.3	26.2	<0.001	21.7	<0.001	36.4	0.651
Bowel sounds present (% of patients)	96.9	98.4	0.474	90.4	0.169	90.9	0.003
Signs of dehydration (% of patients)	31.9	18.0	0.016	12.3	0.001	45.5	<0.001
Laboratory findings
Total leukocytes (/µL, mean ± SD)	10725 ± 4286	9467 ± 3737	0.019	9230 ± 3712	0.009	10431 ± 3754	0.151
Creatinine (µmol/L, mean ± SD)	116.7 ± 150.1	71.3 ± 18.7	0.001	70.7 ± 16.5	0.002	73.8 ± 26.2	0.464
LDH (U/L, mean ± SD)	270.3 ± 334.2	172.3 ± 42.4	0.001	170.5 ± 41.7	0.003	179.5 ± 45.6	0.354
Total bilirubin (µmol/L, mean ± SD)	18.2 ± 25.7	10.4 ± 7.7	0.002	9.4 ± 5.1	0.001	14.9 ± 13.4	0.002
CRP (mg/L, mean ± SD)	25.6 ± 33.4	27.3 ± 52.7	0.775	15.4 ± 32.2	0.032	74.8 ± 84.4	<0.001
Thrombocytes (/nL, mean ± SD)	207 ± 79.0	221 ± 65.8	0.130	227 ± 53.5	0.040	197 ± 64.3	0.018
Hemoglobin (g/L, mean ± SD)	135 ± 24.9	137 ± 19.8	0.446	136 ± 19.9	0.686	141 ± 19.2	0.260
Hematocrit (/L/L, mean ± SD)	0.40 ± 0.1	0.41 ± 0.1	0.352	0.40 ± 0.0	0.567	0.42 ± 0.1	0.233