Clinical features as predictors of positive stool culture in children with acute diarrhea
Keywords:
clinical feature, stool culture, acute diarrheaAbstract
Background: Acute diarrhea is a common problem in pediatrics. Stool culture shows low favorable rates, high cost, and time for results.
Objective: This study aimed to identify clinical features to predict positive stool culture in children with acute diarrhea at Hatyai Hospital.
Method: We conducted research with retrospective cross-sectional data collection of children with acute diarrhea at Hatyai Hospital from 1st January 2017 to 31st December 2020
Result: Of 758 children who were diagnosed with acute diarrhea, the incidence of positive stool culture in our study was 20%. In 155 culture-positive patients, Salmonella spp. (80%) was detected most common. Multivariable logistic regression demonstrated that age below 12-months (OR 3.18, 95% CI: 1.78–5.66, p-value <0.001), frequency of diarrhea > 5 times in 24 hours (OR 2.6, 95%CI: 1.93-6.44, p-value <0.001), no comorbidity (OR 2.03, 95%CI: 1.11-3.69, p-value 0.019), no moderate dehydration (OR 2.06, 95% CI: 1.14-3.73, p-value 0.015) and fecal leukocyte (OR 6, 95% CI: 3.35–10.73, p-value <0.001) were associated with positive stool culture with statistical significantly. Using these factors for scoring system to predict positive stool culture by calculating the area under the receiver operating characteristic curve and considered optimal cut-off point for assessing diagnostic accuracy test. If the score of 9 or more predicted positive stool culture. This scoring system is 59% sensitivity and 84% specificity.
Conclusion: Using this scoring system to predict positive stool culture may lead to cost-effective utilization and rationalizing antibiotics use
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แผนงานวิจัยด้านการป้องกันควบคุมโรคและภัยสุขภาพ พ.ศ.2562-2564กรมควบคุมโรคกระทรวงสาธารณสุข.
Bodhidatta L, Vithayasai N, Eimpokalarp B, et. al. Bacterial enteric pathogens in children with acute dysentery in Thailand: increasing importance of quinolone-resistant Campylobacter. Southeast Asian J Trop Med Public Health. 2002;33:752-7.
Craven D, Brick D, O Riordan MA, et al. Low yield of bacterial stool culture in children with nosocomial diarrhea. Pediatr Infect Dis J. 1998: 17(11); 1040-4.
แนวทางเวชปฏิบัติการดูแลรักษาโรคท้องร่วงเฉียบพลันในเด็ก Clinical Practice Guideline forAcute Diarrheain Children พ.ศ.2562โดยสมาคมกุมารเวชศาสตร์ทางเดินอาหารและตับ
Li R, Xiao F, Zheng X, et al. Antibiotic misuse among children with diarrhea in China: results from a national survey. PeerJ 4: e2668; DOI 10.7717/peerj.2668.
Osatakul S, Puetpaiboon A. Appropriate use of empirical antibiotics in acute diarrhoea: a cross-sectional survey in southern Thailand. Annals of Tropical Paediatrics. 2007; 27: 115–122.
Devasia RA, Varma JK, Whichard J, et al. Antimicrobial use and outcomes in patients with multidrug-resistant and pansusceptible Salmonella Newport infections, 2002-2003.Microb Drug Resist. Winter 2005. 11;4:371-7.
Cadwgan AM, Watson WA, Laing S. RB, et al. Presenting clinical features and c-reactive protein in the prediction of a positive stool Culture in Patients with Diarrhoea. Journal of Infection. 2000;41:159–161.
Lee J, Cho S, Hae Hwang H, et al. Diagnostic yield of stool culture and predictive factors for positive culture in patients with diarrheal
illness. Medicine. 2017;96:30
Fenta A, Alemu K, Angaw DA, et al. Prevalence and associated factors of acute diarrhea among under-five childrenin Kamashi district, western Ethiopia: community-based study. BMC Pediatrics. 2020; 20: 236.
E d u s a d a - C o r p u s R . C l i n i c a l a n d laboratory predictors of bacterial diarrhea in a tropical environment. Military medicine. 1991;156: 74.
Finkelstein JA, Schwartz JS, Torrey S, et al. Common clinical features as predictors of bacterial diarrhea in infants. American Journal of Emergency Medicine. 1989;7:5.
Koplan JP, Fineberg HV, Ferraro MJ, Rosenberg ML. Value of stool cultures. Lancet. 1980; 2: 413-6.
Riaz MM, Patel MJ, Khan MS, et al. Clinical characteristics and predictors of positive stool culture in adult patients with acute gastroenteritis. J Pak Med Assoc. 2012;62:1
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