Diarrheal Morbidity During Hematopoietic Cell Transplantation: The Diagnostic Yield of Stool Cultures

Tamar Berger, Odil Giladi, Dafna Yahav, Haim Ben-Zvi, Oren Pasvolsky, Liat Shargian-Alon, Ofir Wolach, Uri Rozovski, Pia Raanani, Moshe Yeshurun

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Introduction: Diarrhea affects a significant proportion of patients undergoing hematopoietic cell transplantation (HCT). We explored the diagnostic yield of stool cultures for enteric pathogens among patients undergoing HCT. Methods: This is a single-center, retrospective study. Between 5/2007 and 4/2020, consecutive patients who underwent HCT were included if inpatient bacterial stool cultures were collected. Patient characteristics, results, and timing of stool cultures obtained during hospitalization were collected. Results: A total of 1072 individuals underwent autologous (n = 603) and allogeneic (n = 469) HCT. Overall, 947 stool culture samples were obtained from 561 (52%) patients with diarrheal illness during hospitalization for HCT. Most (99%) samples were obtained beyond 3 days of admission, mainly (77%) during neutropenia. Overall, only four (0.42%) (autologous, n = 3; allogeneic, n = 1) patients had a positive stool culture and in all cases Campylobacter spp. were the pathogens identified. The number of stool cultures needed-to-test to diagnose one case of bacterial infection was 237. The cost of diagnosing one case of bacterial diarrhea was US $8770. Patients with a positive stool culture did not have discerning characteristics. Conclusions: In our experience, the yield of stool cultures for enteropathogens in patients undergoing HCT is extremely low and thus should be avoided in most cases.

Original languageEnglish
Pages (from-to)1023-1032
Number of pages10
JournalInfectious Diseases and Therapy
Volume10
Issue number2
DOIs
StatePublished - Jun 2021
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2021, The Author(s).

Keywords

  • Diarrheal morbidity
  • Hematopoietic cell transplantation (HCT)
  • Stool cultures

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