Spectrum of Non-Clostridium difficile Bacterial Enteric Pathogens in Hospitalized Cancer Patients with Diarrhea during 19978722;2004

JAVIER A. ADACHI, MD, KAREN J. VIGIL, MD, JEFFREY J. TARRAND, MD, KENNETH V. ROLSTON, MD, AMAR SAFDAR, MD;

Author address: 

The University of Texas-MD Anderson Cancer Center, Houston,

Abstract: 

Background: The most common cause of acute infectious diarrhea in hospitalized cancer patients is exotoxin producing Clostridium difficile. However, the clinical significance of other bacterial enteric pathogens associated with diarrhea is not certain. We sought to determine the clinical significance of non-C. difficile enteric pathogens in stool cultures at a comprehensive cancer center. Methods: Microbiology records of 5,403 stool cultures from 2,212 patients with diarrhea between November 1997, and March 2004 were reviewed retrospectively at M.D. Anderson Cancer Center. The frequency of known bacterial enteropathogens that are associated with infectious diarrhea such as Salmonella, Shigella, Vibrio, Campylobacter, Yersinia, Aeromonas, Plesiomonas and Edwarsiella spp. were further investigated. All frequencies are given in per 1000 stool samples. Results: During these 7 years, only 19 of 5,503 stool samples (4 per 1000) had a known enteropathogen isolated from 17 patients. Non-typhoidal Salmonella spp. was identified in 8 stool samples (2 per 1000) and Aeromonas spp. in 4 (1per 1000). Shigella spp. and Vibrio parahaemolyticus in 2 (0.4 per 1000), each. Campylobacter, Plesiomonas and Edwarsiella spp. in 1 (0.2 per 1000), each. One patient had two stool samples with non-typhoidal Salmonella spp. and another patient had two stool samples with V. parahaemolyticus. The non-diarrheagenic microorganisms included Pseudomonas spp. (n=204 samples; 38 per 1000), Stenotrophomonas maltophilia (n=19; 4 per 1000), Staphylococcus aureus (n=19; 4 per 1000), yeasts (n=406; 75 per 1000) and Aspergillus spp. (n=8; 2 per 1000) and probably represents lower intestinal colonizing microflora. Conclusions: In this study, the overall frequency of non-C. difficile enteropathogenic bacteria in patients with an underlying malignancy was uncommon. Stool cultures appear to mostly provide information regarding non-pathogenic, colonizing organisms
2004

abstract No: 

NULL

Full conference title: 

42nd Annual Meeting Infectious Diseases Society of America
    • Infectious Diseases Society of America 42nd