title: Performance of stool cultures before and after a 3-day hospitalization: fewer cultures, better for patients and for money.
abstract: We evaluated retrospectively the yield of stool culture (SC) depending on the length of hospitalization, and we characterized the patients missed by the 3-day rejection rule. SC detects bacterial enteric pathogens (Campylobacter spp., Salmonella enterica, Yersinia spp., Shigella spp.). During this 5-year study period, 13,039 SCs were requested, and 376 were positive (2.9%). The yield of SC dropped from 11.7% before 3 days of hospitalization to 0.7% after 3 days in children and 4.3% to 0.3% in adults. Finally, only 13 clinically relevant cases (0.2% of SC prescribed after 3 days) were undiagnosed by strict application of the 3-day rule. In conclusion, rejection of SC prescribed after 3 days of hospitalization allows to reduce workload by 37.8% for children and 65.7% for adults, representing a cost of €12,500 ($16,250) per year in our hospital.
authors.affiliation: Institut de Microbiologie, CHU Lille, France.
authors.forename: Rémi
authors.initials: R
authors.lastname: Le Guern
authors.forename: Caroline
authors.initials: C
authors.lastname: Loïez
authors.forename: Bruno
authors.initials: B
authors.lastname: Grandbastien
authors.forename: René
authors.initials: R
authors.lastname: Courcol
authors.forename: Frédéric
authors.initials: F
authors.lastname: Wallet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000175:diagnosis*; D001431:Bacteriological Techniques / Q000191:economics / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D005243:Feces / Q000382:microbiology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013997:Time Factors; D055815:Young Adult
keywords: Bacterial diarrhoea; Cost savings; Length of hospitalization; Stool culture