title: The importance of microbiological investigations, medications and artificial feeding in diarrhoea evaluation.
abstract: BACKGROUND
  Diarrhoea in hospitalised patients is usually attributed to medications especially antibiotics, enteral tube feeding or enteropathogenic bacteria particularly Clostridium difficile.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the investigations performed on patients who developed diarrhoea during their stay in an acute general hospital.
  
  
  METHODS
  Over 18 working days, an unselected group of adult inpatients who developed diarrhoea following their admission to hospital were reviewed. Symptoms, medications, nutritional support and any investigations performed were assessed.
  
  
  RESULTS
  Eighty-one patients developed diarrhoea. Forty-nine (60%) were receiving antibiotics prior to the development of symptoms, 30 (37%) were being enterally tube fed, 14 (17%) had positive stool for Clostridium difficile A and B toxin and 3 (4%) had salmonella species positive stool.
  
  
  CONCLUSIONS
  The majority of cases of diarrhoea were related to medications and enteral tube feeding. A small but significant number did develop bacterial infections. In contrast to some suggested guidelines, when investigating hospital acquired diarrhoea, it is considered worthwhile to perform microbiological stool examinations.
authors.affiliation: Department of Clinical Pharmacology/Gastroenterology, Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin 9, Ireland. aoifemcerlean@eircom.net
authors.forename: A
authors.initials: A
authors.lastname: McErlean
authors.forename: O
authors.initials: O
authors.lastname: Kelly
authors.forename: S
authors.initials: S
authors.lastname: Bergin
authors.forename: S E
authors.initials: SE
authors.lastname: Patchett
authors.forename: F E
authors.initials: FE
authors.lastname: Murray
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000175:diagnosis / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D064420:Drug-Related Side Effects and Adverse Reactions; D004750:Enteral Nutrition / Q000009:adverse effects*; D005260:Female; D006769:Hospitals, General; D006784:Hospitals, Teaching; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012475:Salmonella / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents