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Diagnostic yield of stool culture and predictive factors for positive culture in patients with diarrheal illness

We aimed to investigate the diagnostic yield of stool cultures and identify predictive factors for positive cultures in patients with diarrheal illness. A total of 13,327 patients who underwent stool cultures due to diarrheal illness were reviewed. Stool cultures were performed for enteric pathogens...

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Autores principales: Lee, Jae Young, Cho, Sun Young, Hwang, Hannah Sun Hae, Ryu, Ja Young, Lee, Jongjin, Song, In Do, Kim, Beom Jin, Kim, Jeong Wook, Chang, Sae Kyung, Choi, Chang Hwan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5627853/
https://www.ncbi.nlm.nih.gov/pubmed/28746227
http://dx.doi.org/10.1097/MD.0000000000007641
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author Lee, Jae Young
Cho, Sun Young
Hwang, Hannah Sun Hae
Ryu, Ja Young
Lee, Jongjin
Song, In Do
Kim, Beom Jin
Kim, Jeong Wook
Chang, Sae Kyung
Choi, Chang Hwan
author_facet Lee, Jae Young
Cho, Sun Young
Hwang, Hannah Sun Hae
Ryu, Ja Young
Lee, Jongjin
Song, In Do
Kim, Beom Jin
Kim, Jeong Wook
Chang, Sae Kyung
Choi, Chang Hwan
author_sort Lee, Jae Young
collection PubMed
description We aimed to investigate the diagnostic yield of stool cultures and identify predictive factors for positive cultures in patients with diarrheal illness. A total of 13,327 patients who underwent stool cultures due to diarrheal illness were reviewed. Stool cultures were performed for enteric pathogens, including Salmonella, Shigella, Vibrio, Klebsiella oxytoca, and Yersinia. The culture-positive group was compared with the culture-negative group who were randomly selected from culture negative patients. A total of 196 patients (1.47%) were diagnosed with positive stool culture. In 196 culture positive patients, Salmonella spp. (75.0%) was detected most commonly, followed by Vibrio (19.4%). Univariate analyses showed fever (>37.8°C), vomiting, duration and frequency of diarrhea, and high C-reactive protein (CRP) were significantly associated with positive stool culture. Multivariate analysis showed fever (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.25–4.35; P = .008), ≥5/day of diarrhea (OR, 3.52; 95% CI, 1.93–6.44; P < .001) and >50 mg/L of CRP (OR, 2.27; 95% CI, 1.18–4.36; P = .014) were independent predictors for positive stool culture. OR in patients with all 3 factors was 6.55 (95% CI, 2.56–16.75; P < .001). Vomiting (OR, 0.32; 95% CI, 0.17–0.57; P < .001) was a negative predictive factor. Diagnostic yield of stool culture in patients with diarrheal illness is very low. Fever, frequency of diarrhea, and high CRP are predictors for positive stool cultures. These findings may lead to more discerning and cost-effective utilization of stool culture by clinicians.
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spelling pubmed-56278532017-10-12 Diagnostic yield of stool culture and predictive factors for positive culture in patients with diarrheal illness Lee, Jae Young Cho, Sun Young Hwang, Hannah Sun Hae Ryu, Ja Young Lee, Jongjin Song, In Do Kim, Beom Jin Kim, Jeong Wook Chang, Sae Kyung Choi, Chang Hwan Medicine (Baltimore) 4500 We aimed to investigate the diagnostic yield of stool cultures and identify predictive factors for positive cultures in patients with diarrheal illness. A total of 13,327 patients who underwent stool cultures due to diarrheal illness were reviewed. Stool cultures were performed for enteric pathogens, including Salmonella, Shigella, Vibrio, Klebsiella oxytoca, and Yersinia. The culture-positive group was compared with the culture-negative group who were randomly selected from culture negative patients. A total of 196 patients (1.47%) were diagnosed with positive stool culture. In 196 culture positive patients, Salmonella spp. (75.0%) was detected most commonly, followed by Vibrio (19.4%). Univariate analyses showed fever (>37.8°C), vomiting, duration and frequency of diarrhea, and high C-reactive protein (CRP) were significantly associated with positive stool culture. Multivariate analysis showed fever (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.25–4.35; P = .008), ≥5/day of diarrhea (OR, 3.52; 95% CI, 1.93–6.44; P < .001) and >50 mg/L of CRP (OR, 2.27; 95% CI, 1.18–4.36; P = .014) were independent predictors for positive stool culture. OR in patients with all 3 factors was 6.55 (95% CI, 2.56–16.75; P < .001). Vomiting (OR, 0.32; 95% CI, 0.17–0.57; P < .001) was a negative predictive factor. Diagnostic yield of stool culture in patients with diarrheal illness is very low. Fever, frequency of diarrhea, and high CRP are predictors for positive stool cultures. These findings may lead to more discerning and cost-effective utilization of stool culture by clinicians. Wolters Kluwer Health 2017-07-28 /pmc/articles/PMC5627853/ /pubmed/28746227 http://dx.doi.org/10.1097/MD.0000000000007641 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle 4500
Lee, Jae Young
Cho, Sun Young
Hwang, Hannah Sun Hae
Ryu, Ja Young
Lee, Jongjin
Song, In Do
Kim, Beom Jin
Kim, Jeong Wook
Chang, Sae Kyung
Choi, Chang Hwan
Diagnostic yield of stool culture and predictive factors for positive culture in patients with diarrheal illness
title Diagnostic yield of stool culture and predictive factors for positive culture in patients with diarrheal illness
title_full Diagnostic yield of stool culture and predictive factors for positive culture in patients with diarrheal illness
title_fullStr Diagnostic yield of stool culture and predictive factors for positive culture in patients with diarrheal illness
title_full_unstemmed Diagnostic yield of stool culture and predictive factors for positive culture in patients with diarrheal illness
title_short Diagnostic yield of stool culture and predictive factors for positive culture in patients with diarrheal illness
title_sort diagnostic yield of stool culture and predictive factors for positive culture in patients with diarrheal illness
topic 4500
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5627853/
https://www.ncbi.nlm.nih.gov/pubmed/28746227
http://dx.doi.org/10.1097/MD.0000000000007641
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