Abstract
Background
Information on the epidemiology and susceptibility patterns of main pathogens causing
severe acute diarrhea may help to reduce inappropriate antimicrobial use in emergency
departments.
Objectives
We sought to investigate the micro-organisms causing severe acute diarrhea in patients
requiring hospital admission by means of a commercial multiple polymerase chain reaction
system.
Methods
Between November 2016 and October 2018 we studied 132 patients with acute diarrhea
who required hospital admission at a 250-bed hospital in Spain. Demographic, clinical,
analytical, and microbiological data were collected from the medical records. Stool
samples were processed using a rapid commercial multiple polymerase chain reaction
system (FilmArray Gastrointestinal Panel), stool culture, and standard microbiological
procedures.
Results
The median age (range) of patients was 45.5 (0.1–92) years, and 50% were male; 46.2%
presented with fever, 62.8% presented with vomiting, and 12.9% presented with rectal
bleeding. At least 1 enteric pathogen was identified in 93 (70.4%) patients; 28 (21.2%)
patients had >1 micro-organism. FilmArray Gastrointestinal Panel results were available
in a median (range) of 1 (0–3) days. The micro-organisms most frequently identified
were 24 cases of Campylobacter species, 20 cases of Clostridioides difficile producing toxin A or toxin B, 20 cases of Salmonella species, 12 cases of rotavirus, and 30 cases of different types of pathogenic Escherichia coli. Among the cases of C. difficile, 12 (60%) were community-acquired and 8 (40%) had an undetermined origin.
Conclusion
The FilmArray Gastrointestinal Panel system provides fast and reliable results and
could be useful to select the most appropriate antimicrobial based on local susceptibilities
until the results of the cultures are available.
Keywords
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Article info
Publication history
Published online: August 09, 2019
Accepted:
June 8,
2019
Received in revised form:
May 6,
2019
Received:
February 18,
2019
Footnotes
Reprints are not available from the authors.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
