TY - JOUR
T1 - Diarrheal Morbidity During Hematopoietic Cell Transplantation
T2 - The Diagnostic Yield of Stool Cultures
AU - Berger, Tamar
AU - Giladi, Odil
AU - Yahav, Dafna
AU - Ben-Zvi, Haim
AU - Pasvolsky, Oren
AU - Shargian-Alon, Liat
AU - Wolach, Ofir
AU - Rozovski, Uri
AU - Raanani, Pia
AU - Yeshurun, Moshe
N1 - Publisher Copyright:
© 2021, The Author(s).
PY - 2021/6
Y1 - 2021/6
N2 - Introduction: Diarrhea affects a significant proportion of patients undergoing hematopoietic cell transplantation (HCT). We explored the diagnostic yield of stool cultures for enteric pathogens among patients undergoing HCT. Methods: This is a single-center, retrospective study. Between 5/2007 and 4/2020, consecutive patients who underwent HCT were included if inpatient bacterial stool cultures were collected. Patient characteristics, results, and timing of stool cultures obtained during hospitalization were collected. Results: A total of 1072 individuals underwent autologous (n = 603) and allogeneic (n = 469) HCT. Overall, 947 stool culture samples were obtained from 561 (52%) patients with diarrheal illness during hospitalization for HCT. Most (99%) samples were obtained beyond 3 days of admission, mainly (77%) during neutropenia. Overall, only four (0.42%) (autologous, n = 3; allogeneic, n = 1) patients had a positive stool culture and in all cases Campylobacter spp. were the pathogens identified. The number of stool cultures needed-to-test to diagnose one case of bacterial infection was 237. The cost of diagnosing one case of bacterial diarrhea was US $8770. Patients with a positive stool culture did not have discerning characteristics. Conclusions: In our experience, the yield of stool cultures for enteropathogens in patients undergoing HCT is extremely low and thus should be avoided in most cases.
AB - Introduction: Diarrhea affects a significant proportion of patients undergoing hematopoietic cell transplantation (HCT). We explored the diagnostic yield of stool cultures for enteric pathogens among patients undergoing HCT. Methods: This is a single-center, retrospective study. Between 5/2007 and 4/2020, consecutive patients who underwent HCT were included if inpatient bacterial stool cultures were collected. Patient characteristics, results, and timing of stool cultures obtained during hospitalization were collected. Results: A total of 1072 individuals underwent autologous (n = 603) and allogeneic (n = 469) HCT. Overall, 947 stool culture samples were obtained from 561 (52%) patients with diarrheal illness during hospitalization for HCT. Most (99%) samples were obtained beyond 3 days of admission, mainly (77%) during neutropenia. Overall, only four (0.42%) (autologous, n = 3; allogeneic, n = 1) patients had a positive stool culture and in all cases Campylobacter spp. were the pathogens identified. The number of stool cultures needed-to-test to diagnose one case of bacterial infection was 237. The cost of diagnosing one case of bacterial diarrhea was US $8770. Patients with a positive stool culture did not have discerning characteristics. Conclusions: In our experience, the yield of stool cultures for enteropathogens in patients undergoing HCT is extremely low and thus should be avoided in most cases.
KW - Diarrheal morbidity
KW - Hematopoietic cell transplantation (HCT)
KW - Stool cultures
UR - http://www.scopus.com/inward/record.url?scp=85102207070&partnerID=8YFLogxK
U2 - 10.1007/s40121-021-00415-9
DO - 10.1007/s40121-021-00415-9
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C2 - 33661515
AN - SCOPUS:85102207070
SN - 2193-8229
VL - 10
SP - 1023
EP - 1032
JO - Infectious Diseases and Therapy
JF - Infectious Diseases and Therapy
IS - 2
ER -