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KMID : 1141320170320020191
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Kosin Medical Journal
2017 Volume.32 No. 2 p.191 ~ p.203
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The clinical features and infectious etiologies of acute diarrhea in immunocompromised hosts
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Lee Jin-Young
Kim Ye-Na
Kim Nam-Ho
Cho Kyoung-Soon
Park Ji-Young
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Abstract
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Objectives: The acute diarrhea is a common complaint among immunocompromised hosts, and may cause life threatening event. The infectious etiologies vary depending on virus, bacteria, and parasites. The most common etiology of acute gastroenteritis is known as enteric virus in Korea.1 But there are few studies about the infectious etiology of acute gastroenteritis in immunocompromised hosts.2,3 The aim of this study was to investigate the infectious etiologies of acute diarrhea in immunocompromised hosts.
Methods: Seventy three patients were enrolled prospectively in a university hospital from January 2013 to July 2014. Immunocompromised hosts included above 65-year-old people, patients with chronic diseases, solid organ or stem cell transplants, solid organ malignancies, hematologic malignancies, immunosuppressive or steroid taking patients. The clinical data were collected and stool samples collected during diarrhea were undergone laboratory analysis for enteric viruses and bacterial enteropathogens including Salmonella spp., Shigella spp., and Clostridium difficile.
Results: Fifty five patients were analyzed as follows : above 65 year-old people were 36 cases (66%), previous antibiotic usage was 22 cases (41.5%). 44 cases (81.1%) were admitted to general ward whereas 9 cases to ICU (17%). 41 cases (73.6%) were treated with antibiotics. Positive C. difficile toxin assays were 6 cases (11.9%). Other infectious etiologies were not found.
Conclusions: C. difficile infection was more common infectious etiology while enteric viruses and other bacteria are not associated with acute diarrhea among immunocompromised hosts in this study. So C. difficile infection must be considered preferentially in immunocompromised hosts with acute diarrhea.
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KEYWORD
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Clostridium difficile, Diarrhea, Gastroenteritis, Immunocompromised host
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