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Antibiotic-associated diarrhea: Candidate organisms other than Clostridium difficile

Title
Antibiotic-associated diarrhea: Candidate organisms other than Clostridium difficile
Authors
Song H.J.Shim K.-N.Jung S.-A.Choi H.J.Lee M.A.Ryu K.H.Kim S.-E.Yoo K.
Ewha Authors
이미애유권정성애최희정심기남김성은
SCOPUS Author ID
이미애scopus; 유권scopus; 정성애scopus; 최희정scopus; 심기남scopus; 김성은scopus
Issue Date
2008
Journal Title
Korean Journal of Internal Medicine
ISSN
1226-3303JCR Link
Citation
vol. 23, no. 1, pp. 9 - 15
Indexed
SCIE; SCOPUS; KCI scopus
Abstract
Background/Aims : The direct toxic effects of antibiotics on the intestine can alter digestive functions and cause pathogenic bacterial overgrowth leading to antibiotic-associated diarrhea (AAD). Clostridium difficile (C. difficile) is widely known to be responsible for 10-20% of AAD cases. However, Klebsiella oxytoca, Clostridium perfringens, Staphylococcus aureus, and Candida species might also contribute to AAD. Methods : We prospectively analyzed the organisms in stool and colon tissue cultures with a C. difficile toxin A assay in patients with AAD between May and December 2005. In addition, we performed the C. difficile toxin A assays using an enzyme-linked fluorescent assay technique. Patients were enrolled who had diarrhea with more than three stools per day for at least 2 days after the initiation of antibiotic treatment for up to 6-8 weeks after antibiotic discontinuation. Results : Among 38 patients (mean age 59±18 years, M:F=18:20), the organism isolation rates were 28.9% (11/38) for stool culture, 18.4% (7/38) for colon tissue cultures and 13.2% (5/38) for the C. difficile toxin A assay. The overall rate of identification of organisms was 50.0% (19/38). Of the five patients that had a positive result by the C. difficile toxin A assay, two had no organism isolated by the stool or colon tissue culture. The organisms isolated from the stool cultures were C. difficile (4), Klebsiella pneumoniae (K. pneumoniae) (3), Candida species (3), and Staphylococcus aureus (1). C. difficile (4) and K. pneumoniae (3) were isolated from the colon tissue culture. Conclusions : For C. difficile negative AAD patients, K. pneumoniae, Candida species, and Staphylococcus aureus were found to be potential causative organisms.
DOI
10.3904/kjim.2008.23.1.9
Appears in Collections:
의학전문대학원 > 의학과 > Journal papers
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