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Pseudomonas aeruginosa as a potential cause of antibiotic-associated diarrhea
1Division of Infectious Diseases, Kyungpook National University School of Medicine, Taegu, Korea.
Abstract:
Although Pseudomonas aeruginosa is not generally considered as a cause of antibiotic-associated diarrhea, several cases of diarrhea caused by P. aeruginosa have been reported. We experienced seven cases of nosocomial diarrhea presumably caused by P. aeruginosa, which was the predominant organism isolated from stool cultures. Clostridium difficile toxin was also positive in one patient. No other potential or recognized enteropathogens were identified from stools. All patients had underlying diseases and had been receiving antibiotics before the diarrheal onset. All of the seven P. aeruginosa isolates were resistant to previously given antibiotics. Diarrhea stopped three days after withdrawal of probable offending antibiotics without specific treatment in two patients. The other five patients having continuous diarrhea despite withdrawal of probable offending antibiotics, were successfully treated with antipseudomonal agents. The median duration of diarrhea after the initiation of treatment was 6.3 days. These data suggest that P. aeruginosa can be a potential cause of antibiotic-associated diarrhea. Further investigations are warranted to evaluate the possible etiologic role of P. aeruginosa in antibiotic-associated diarrhea.
Insights
Pseudomonas aeruginosa, a bacterium not typically linked to diarrhea, was identified as the main cause in seven hospital-acquired diarrhea cases. Antibiotic withdrawal or specific treatments resolved symptoms, suggesting its potential role in antibiotic-associated diarrhea.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Pseudomonas aeruginosa is rarely implicated as a cause of diarrhea.
- Antibiotic-associated diarrhea (AAD) is a significant clinical concern, often linked to dysbiosis of gut microbiota.
- Understanding emerging pathogens in AAD is crucial for effective patient management.
Purpose of the Study:
- To investigate the potential role of Pseudomonas aeruginosa in nosocomial antibiotic-associated diarrhea.
- To describe the clinical characteristics and outcomes of patients with P. aeruginosa-associated diarrhea.
Main Methods:
- Retrospective case series of seven patients with nosocomial diarrhea.
- Identification of P. aeruginosa as the predominant organism in stool cultures.
- Analysis of patient history, antibiotic exposure, and treatment outcomes.
Main Results:
- Seven cases of nosocomial diarrhea attributed to P. aeruginosa were identified.
- All patients had underlying conditions and recent antibiotic exposure.
- P. aeruginosa isolates exhibited resistance to prior antibiotics; diarrhea resolved with antibiotic withdrawal or antipseudomonal agents.
Conclusions:
- Pseudomonas aeruginosa can be a causative agent of antibiotic-associated diarrhea.
- Prompt identification and appropriate management, including targeted antibiotic therapy, are essential.
- Further research is needed to elucidate the full spectrum of P. aeruginosa's role in AAD.