Background: Clostridium difficile is a significant cause of nosocomial diarrhea. We sought to determine the role of bacterial pathogens in patients with infectious colitis in our community.
Methods: We reviewed the records of patients who were tested positive for C. difficile toxin A or B by enzyme-linked immunosorbent assay, or had a positive stool culture for a bacterial pathogens.
Results: A total of 1374 patients had positive C. difficile toxin assays; 67 had positive cultures for other bacterial pathogens. Of the patients with C. difficile, 568 were outpatients, whereas 804 were inpatients. Four hundred eighty-eight (83%) of outpatients were extended-care facility residents. Detection of C. difficile toxin was preceded within 2 months by a urine culture in 32.6% of the outpatients; half of these had a positive urine culture.
Conclusions: C. difficile is the most common identifiable bacterial pathogen among patients with infectious colitis in our community. Patients with C. difficile toxin detection were likely to have a suspected urinary tract infection. We speculate that empiric antibiotics for urinary tract infections may contribute to the higher C. difficile toxin detection in these patients.
*Internal Medicine, William Beaumont Hospital, Royal Oak, MI; †Infectious Diseases, Henry Ford Health System, Detroit, MI; ‡Clinical Pathology, William Beaumont Hospital, Royal Oak, MI and §Gastroenterology Division, Henry Ford Health System, Detroit, MI.
This article was presented in poster form at the American College of Gastroenterology annual meeting in Honolulu on October 2005.
Address correspondence and reprint requests to Ann Lynne Silverman, MD, FACG, Gastroenterology Division, Henry Ford Hospital, 6777 W. Maple Rd, W. Bloomfield, MI 48322. E-mail: firstname.lastname@example.org.