Journal Article

Comparative Value of Colonic Biopsy and Intraluminal Fluid Culture for Diagnosis of Bacterial Acute Colitis in Immunocompetent Patients

Frédéric Barbut, Laurent Beaugerie, Nicolas Delas, Sophie Fossati-Marchal, Pierre Aygalenq and Jean-Claude Petit

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 29, issue 2, pages 356-360
Published in print July 1999 | ISSN: 1058-4838
Published online July 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/520215
Comparative Value of Colonic Biopsy and Intraluminal Fluid Culture for Diagnosis of Bacterial Acute Colitis in Immunocompetent Patients

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We compared the yield of intraluminal fluid culture to that of biopsy specimens obtained during colonoscopy for the diagnosis of bacterial colitis in 93 immunocompetent patients with a recent episode of diarrhea and macroscopic lesions of colitis. Stool culture findings were also available for 68 patients. At least one bacterial pathogen was isolated from the biopsy specimen, intraluminal fluid, or stool from 48 patients (51.6%). Salmonella species, Clostridium difficile, Klebsiella oxytoca, Shigella species, and Campylobacter species were recovered from 16 (17.2%), 15 (16.1%), 8 (8.6%), 7 (7.5%), and 4 (4.3%) of the patients, respectively. One Shigella species and one K. oxytoca strain were isolated from biopsy specimens but not from intraluminal fluid, and intraluminal fluid was the only positive specimen in 12 cases (yielding 1 Salmonella species, 2 Shigella species, 2 K. oxytoca, and 7 C. difficile isolates). In nine cases out of 10, toxin B was detected only in intraluminal fluid. A correlation of 91.2% was observed between stool and intraluminal fluid cultures for Salmonella, Shigella, and Campylobacter species isolations. Culture of biopsy specimens adds little to the diagnosis of infectious colitis, and stools and intraluminal fluids appear to have comparable value.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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