Bacterial and Parasitic Stool Studies Have Limited Utility in Pediatric Hematopoietic Stem Cell Transplant Patients.

IF 2.4 3区医学 Q2 HEMATOLOGY

Pediatric Blood & Cancer Pub Date : 2025-02-20 DOI:10.1002/pbc.31617

Matthew Nagy, Chiara Wychera, Jeffrey Schemm, Ryan Brewster, Christine N Duncan

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引用次数: 0

Abstract

Background: Diarrhea is a common complication among pediatric hematopoietic stem cell transplantation (HCT) recipients. Although many of the cases are secondary to graft-versus-host disease (GVHD), stool microbiological studies are often performed to evaluate an underlying infectious etiology. The aim of this study was to assess the frequency and utility of stool studies in children who have undergone HCT.

Methods: Demographics, clinical characteristics, and stool study results (viral, parasitic, and bacterial) of all patients who underwent HCT at a large, academic, freestanding children's hospital between January 2006 and December 2023 were obtained. Statistical analysis conducted included t tests, chi-square, and linear regression.

Results: Overall, 1381 HCT recipients (9.2 ± 6.6 years) were included. Altogether, 6509 stool studies were obtained among 741 (54%) patients. Salmonella, Shigella, Yersinia, Campylobacter, and Escherichia coli (SSYCE) studies were sent on 363 (26%, 2252 studies) patients with 1 (0.04%) positive result. Clostridium difficile was sent on 706 (51%, 2055 studies) patients, with 156 positive studies (7.6%). Stool ova and parasite testing was sent on 143 (10%, 242 studies) patients, with two positive results (0.8%). Viral studies were sent on 638 (46%, 1960 studies) patients, with 107 positive studies (5.5%).

Conclusions: While testing for Clostridium difficile and enteric viruses may have value in the work-up of pediatric HCT patients, SSYCE and O&P studies hold little to no value. Clinical practices surrounding routine stool microbiological studies should be reconsidered.

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背景：腹泻是小儿造血干细胞移植（HCT）受者常见的并发症。虽然许多病例继发于移植物抗宿主疾病（GVHD），但粪便微生物学检查通常是为了评估潜在的感染病因。本研究旨在评估接受 HCT 的儿童进行粪便检查的频率和效用：方法：收集了 2006 年 1 月至 2023 年 12 月间在一家大型学术性独立儿童医院接受 HCT 治疗的所有患者的人口统计学特征、临床特征和粪便检查结果（病毒、寄生虫和细菌）。统计分析包括t检验、卡方检验和线性回归：结果：共纳入 1381 名 HCT 接受者（9.2 ± 6.6 岁）。共对 741 名（54%）患者的 6509 份粪便进行了研究。对 363 例（26%，2252 例）患者进行了沙门氏菌、志贺氏菌、耶尔森氏菌、弯曲杆菌和大肠埃希氏菌（SSYCE）检测，其中 1 例（0.04%）检测结果呈阳性。对 706 名（51%，2055 例）患者进行了艰难梭菌检测，其中 156 例（7.6%）检测结果呈阳性。对 143 名患者（10%，242 项研究）进行了粪便卵子和寄生虫检测，其中 2 项检测结果呈阳性（0.8%）。对 638 例（46%，1960 例）患者进行了病毒检测，结果呈阳性的有 107 例（5.5%）：结论：艰难梭菌和肠道病毒检测可能对儿科 HCT 患者的检查有价值，但 SSYCE 和 O&P 研究几乎没有价值。围绕常规粪便微生物学研究的临床实践应重新考虑。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Blood & Cancer 医学-小儿科

CiteScore

4.90

自引率

9.40%

发文量

546

审稿时长

1.5 months

期刊介绍： Pediatric Blood & Cancer publishes the highest quality manuscripts describing basic and clinical investigations of blood disorders and malignant diseases of childhood including diagnosis, treatment, epidemiology, etiology, biology, and molecular and clinical genetics of these diseases as they affect children, adolescents, and young adults. Pediatric Blood & Cancer will also include studies on such treatment options as hematopoietic stem cell transplantation, immunology, and gene therapy.