[Post-antibiotic diarrheas: role of Klebsiella oxytoca].
From May 1989 to January 1991, 20 patients were investigated for antibiotic-associated acute diarrhea. Colonoscopy or rectosigmoidoscopy was performed in each patient. Cultures of colonic mucosal biopsies were carried out using conventional culture grounds (cystine-lactose-electrolyte-deficient). The aim of this study was to investigate the role of a gram negative bacillus: Klebsiella oxytoca. Among the 20 patients with antibiotic-associated acute diarrhea, 11 had bloody and mucus diarrhea and colitis ranging from a right-sided hemorrhagic to diffuse acute ulcerative or erosive colitis, 7 had a grossly normal colonic appearance, while 2 had mucus diarrhea and pseudomembranous colitis. Of colonic biopsies cultures obtained from 36 control patients, 15 had a normal colonic appearance, 15 had ulcerative or crohn's colitis, 6 had well-tolerated amoxicillin therapy. Klebsiella oxytoca was never found in the 36 control patients; Klebsiella oxytoca was noted among 8/11 patients with mucus-discharging and bloody diarrhea. These results suggest that antibiotic-associated, non pseudomembranous colitis is frequently associated with Klebsiella oxytoca infection, which may be the cause of this type of colitis.
Benoit
R
R
Service de Gastroentérologie, Hôpital Trousseau, CHU, Tours.
Dorval
D
D
Loulergue
J
J
Bacq
Y
Y
Oliver
J M
JM
Audurier
A
A
Metman
E H
EH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D003092:Colitis / Q000139:chemically induced / Q000382:microbiology / Q000473:pathology; D003967:Diarrhea / Q000139:chemically induced* / Q000382:microbiology / Q000473:pathology; D005260:Female; D006801:Humans; D007709:Klebsiella / Q000302:isolation & purification*; D007710:Klebsiella Infections / Q000382:microbiology*; D008297:Male; D008875:Middle Aged
D000900:Anti-Bacterial Agents; D000658:Amoxicillin
Diarrhée post-antibiotique: rôle de Klebsiella oxytoca.