title: Diagnostic Yield of Routine Enteropathogenic Stool Tests in Pediatric Ulcerative Colitis.
abstract: OBJECTIVE
  It can be important to exclude infectious etiologies prior to adjusting immunosuppressive therapy in patients with ulcerative colitis (UC) exacerbation. We sought to determine the diagnostic yield of routine infectious stool studies in pediatric UC patients.
  
  
  METHODS
  We conducted a retrospective review of 152 pediatric UC patients at Texas Children's Hospital between January 2003 and December 2009. The patient records were followed through July 2014. The number and type of infectious stool studies performed and the results of those were collected.
  
  
  RESULTS
  Three hundred fifty-four diagnostic stool tests were conducted for Clostridium difficile; 13.6% were positive. Two hundred twenty stool bacterial cultures were performed, and 1.8% were positive, all growing non-typhoid Salmonella. One of 13 (7.7%) Adenovirus PCR tests was positive. Two of 152 examinations (1.3%) for Ova and Parasites were positive. No stool tests for viral culture, viral particles, Yersinia or Rotavirus were positive.
  
  
  CONCLUSIONS
  Clostridium difficile infection is common in pediatric UC, and routine screening during flares is strongly recommended. Other bacterial and parasitic infections routinely tested for are uncommon, but Salmonella may be a potentially important attribute to disease exacerbations in select patients. In patients without co-morbid conditions, the utility of performing non-specific fecal viral tests is questionable.
authors.affiliation: Section of Pediatric Gastroenterology, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Texas Children's Hospital, Houston, TX, USA faith.ihekweazu@bcm.edu.
authors.forename: Faith D
authors.initials: FD
authors.lastname: Ihekweazu
authors.affiliation: Section of Pediatric Gastroenterology, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Texas Children's Hospital, Houston, TX, USA.
authors.forename: Avanthi
authors.initials: A
authors.lastname: Ajjarapu
authors.affiliation: Section of Pediatric Gastroenterology, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Texas Children's Hospital, Houston, TX, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Kellermayer
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016360:Clostridioides difficile / Q000472:pathogenicity; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000382:microbiology*; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis / Q000382:microbiology; D005243:Feces / Q000382:microbiology*; D006801:Humans; D012189:Retrospective Studies; D012475:Salmonella / Q000472:pathogenicity; D012480:Salmonella Infections / Q000175:diagnosis / Q000382:microbiology; D013781:Texas