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

• Published in: Clinical infectious diseases Vol. 29; no. 2; pp. 356 - 360
• Main Authors: Barbut, Frédéric, Beaugerie, Laurent, Delas, Nicolas, Fossati-Marchal, Sophie, Aygalenq, Pierre, Petit, Jean-Claude
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Chicago, IL The University of Chicago Press 01-08-1999; University of Chicago Press
• Subjects: Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; Biopsies; Campylobacter; Clinical Articles; Colitis; Colonoscopy; Diarrhea; Etiology; Human bacterial diseases; Infectious diseases; Medical sciences; Pathogens; Salmonella; Shigella; Toxins; Human; Acute; Intestinal juice; Method; Infection; Biopsy; Bacteriosis; Microorganism culture; Digestive diseases; Intestinal disease; Colitis; Colon; Diagnosis; Feces; Comparative study
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/520215

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.