Non-Clostridium difficile nosocomial diarrhea in the intensive care unit

It is assumed that most cases of nosocomial diarrhea are due to Clostridium difficile because of the widespread use of broad-spectrum antibiotic agents. Enteral tube feedings are another important cause of hospital-acquired diarrhea, especially in intensive care units (ICUs). We report the results of a recent survey of patients in the ICU with nosocomial diarrhea and describe an illustrative case. We conclude on the basis of this and a previous larger study that C. difficile diarrhea is very uncommon in enterally fed patients in the ICU; nosocomial diarrhea in the ICU is most commonly caused by enteral tube feedings.