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Clinical Significance of Fecal Lactoferrin and Multiplex Polymerase Chain Reaction in Patients with Acute Diarrhea.

Lee HM, Lee S, Lee BI, Jekarl DW, Song JY, Choi HJ, Kang BK, Im EJ, Kim JS, Kim JI, Kim BW, Choi H - Gut Liver (2015)

Bottom Line: A total of 54 patients were included (male, 23; median age, 42.5 years).Among the 31 patients who were available for fecal pathogen evaluation, fecal multiplex PCR detected bacterial pathogens in 21 patients, whereas conventional stool cultures were positive in only one patient (67.7% vs 3.2%, p=0.000).Fecal multiplex PCR can detect more causative organisms than conventional stool cultures in patients with acute diarrhea.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.

ABSTRACT

Background/aims: The diagnostic yield of fecal leukocyte and stool cultures is unsatisfactory in patients with acute diarrhea. This study was performed to evaluate the clinical significance of the fecal lactoferrin test and fecal multiplex polymerase chain reaction (PCR) in patients with acute diarrhea.

Methods: Clinical parameters and laboratory findings, including fecal leukocytes, fecal lactoferrin, stool cultures and stool multiplex PCR for bacteria and viruses, were evaluated prospectively for patients who were hospitalized due to acute diarrhea.

Results: A total of 54 patients were included (male, 23; median age, 42.5 years). Fecal leukocytes and fecal lactoferrin were positive in 33 (61.1%) and 14 (25.4%) patients, respectively. Among the 31 patients who were available for fecal pathogen evaluation, fecal multiplex PCR detected bacterial pathogens in 21 patients, whereas conventional stool cultures were positive in only one patient (67.7% vs 3.2%, p=0.000). Positive fecal lactoferrin was associated with presence of moderate to severe dehydration and detection of bacterial pathogens by multiplex PCR (21.4% vs 2.5%, p=0.049; 100% vs 56.5%, p=0.032, respectively).

Conclusions: Fecal lactoferrin is a useful marker for more severe dehydration and bacterial etiology in patients with acute diarrhea. Fecal multiplex PCR can detect more causative organisms than conventional stool cultures in patients with acute diarrhea.

No MeSH data available.


Related in: MedlinePlus

Pathogens detected by multiplex polymerase chain reaction (n=31). Values are presented as percentages.VTEC, verocytotoxin-producing Escherichia coli.
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f1-gnl-09-636: Pathogens detected by multiplex polymerase chain reaction (n=31). Values are presented as percentages.VTEC, verocytotoxin-producing Escherichia coli.

Mentions: Causative pathogens were detected in only one patient (Salmonella spp. Group C) by conventional cultures (1/54, 1.9%). However, various pathogens were detected in 24 out of 31 patients (77.4%) who were available for multiplex PCR assays as follows: 28 bacteria for 21 patients, five viruses for four patients, one coinfection of a bacterium and a virus for a patient. Campylobacter spp. (25.8%) were most prevalent, followed by C. perfringens (22.6%), Aeromonas spp. (16.1%), Salmonella spp. (12.9%), Group A rotavirus (9.7%), C. difficile toxin B (6.5%), norovirus GII (3.2%), Vibrio spp. (3.2%), and VTEC (3.2%) (Fig. 1).


Clinical Significance of Fecal Lactoferrin and Multiplex Polymerase Chain Reaction in Patients with Acute Diarrhea.

Lee HM, Lee S, Lee BI, Jekarl DW, Song JY, Choi HJ, Kang BK, Im EJ, Kim JS, Kim JI, Kim BW, Choi H - Gut Liver (2015)

Pathogens detected by multiplex polymerase chain reaction (n=31). Values are presented as percentages.VTEC, verocytotoxin-producing Escherichia coli.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4562781&req=5

f1-gnl-09-636: Pathogens detected by multiplex polymerase chain reaction (n=31). Values are presented as percentages.VTEC, verocytotoxin-producing Escherichia coli.
Mentions: Causative pathogens were detected in only one patient (Salmonella spp. Group C) by conventional cultures (1/54, 1.9%). However, various pathogens were detected in 24 out of 31 patients (77.4%) who were available for multiplex PCR assays as follows: 28 bacteria for 21 patients, five viruses for four patients, one coinfection of a bacterium and a virus for a patient. Campylobacter spp. (25.8%) were most prevalent, followed by C. perfringens (22.6%), Aeromonas spp. (16.1%), Salmonella spp. (12.9%), Group A rotavirus (9.7%), C. difficile toxin B (6.5%), norovirus GII (3.2%), Vibrio spp. (3.2%), and VTEC (3.2%) (Fig. 1).

Bottom Line: A total of 54 patients were included (male, 23; median age, 42.5 years).Among the 31 patients who were available for fecal pathogen evaluation, fecal multiplex PCR detected bacterial pathogens in 21 patients, whereas conventional stool cultures were positive in only one patient (67.7% vs 3.2%, p=0.000).Fecal multiplex PCR can detect more causative organisms than conventional stool cultures in patients with acute diarrhea.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.

ABSTRACT

Background/aims: The diagnostic yield of fecal leukocyte and stool cultures is unsatisfactory in patients with acute diarrhea. This study was performed to evaluate the clinical significance of the fecal lactoferrin test and fecal multiplex polymerase chain reaction (PCR) in patients with acute diarrhea.

Methods: Clinical parameters and laboratory findings, including fecal leukocytes, fecal lactoferrin, stool cultures and stool multiplex PCR for bacteria and viruses, were evaluated prospectively for patients who were hospitalized due to acute diarrhea.

Results: A total of 54 patients were included (male, 23; median age, 42.5 years). Fecal leukocytes and fecal lactoferrin were positive in 33 (61.1%) and 14 (25.4%) patients, respectively. Among the 31 patients who were available for fecal pathogen evaluation, fecal multiplex PCR detected bacterial pathogens in 21 patients, whereas conventional stool cultures were positive in only one patient (67.7% vs 3.2%, p=0.000). Positive fecal lactoferrin was associated with presence of moderate to severe dehydration and detection of bacterial pathogens by multiplex PCR (21.4% vs 2.5%, p=0.049; 100% vs 56.5%, p=0.032, respectively).

Conclusions: Fecal lactoferrin is a useful marker for more severe dehydration and bacterial etiology in patients with acute diarrhea. Fecal multiplex PCR can detect more causative organisms than conventional stool cultures in patients with acute diarrhea.

No MeSH data available.


Related in: MedlinePlus