Pathogens and possible opinion for antibiotic treatment in adult patients with 1-14 fecal WBC/HPF of acute non-bloody diarrhea

doi:10.5246/jcps.2015.02.014

Abstract

Abstract:

The pathogens and opinion for antibiotic treatment in adult patients with 1–14 fecal white blood cells per high power field (WBC/HPF) of acute non-bloody diarrhea remain obscure. The study attempts to clarify it. Stool specimens of adult patients with acute non-bloody diarrhea and stool examination showing 1–14 fecal WBC/HPF were collected for bacterial culture and viral detection. Patients included in this study were 196 cases with mean age of (37.9±17.4) years and 42.3% was women. The bacterial and viral detection rates were 63 (32.1%) and 21 (10.7%), respectively. Of the isolated pathogens, campylobacteria was present in 14 (22.0%) samples and was the most common bacteria and calicivirus was found in 10 (47.6%) samples and was the most common virus. Based on single pathogens, 46 cases were caused by invasive pathogens, 26 cases were caused by non-invasive pathogens. The body temperature was significantly higher in feverish patients caused by invasive pathogens than those caused by non-invasive pathogens ((38.4±0.7) ºC vs (37.7±0.4) ºC, P = 0.002). The probability of diarrhea caused by invasive pathogens was higher in patients with T>38.4 ºC than those with T≤38.4 ºC (RR = 1.5). When T>38.4 ºC is used as the threshold for antibiotic treatment, the misuse rate of antibiotics would decrease from 26.9% to 3.8% (P = 0.021). So T>38.4 ºC may be used as a possible reference value for antibiotic treatment in adult patients with 1–14 fecal WBC/HPF of acute non-bloody diarrhea.

Key words: Acute infectious diarrhea, Fecal white blood cells, Pathogens, Antibiotics

CLC Number:

R915

Supporting:

Fengqin Hou, Xinting Sun, Guiqiang Wang. Pathogens and possible opinion for antibiotic treatment in adult patients with 1-14 fecal WBC/HPF of acute non-bloody diarrhea[J]. Journal of Chinese Pharmaceutical Sciences, 2015, 24(2): 121-127.

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