» Articles » PMID: 38854779

Epidemiological Study on Case Definition of Methicillin-Resistant Enteritis

Overview
Publisher Dove Medical Press
Date 2024 Jun 10
PMID 38854779
Authors
Affiliations
Soon will be listed here.
Abstract

Background: Methicillin-resistant (MRSA) enteritis is a condition in which MRSA grows abnormally in the intestine after administration of antimicrobial agents, resulting in enteritis. Patients with MRSA detected in stool culture tests are often diagnosed with MSRA enteritis. However, uncertainty remains in the diagnostic criteria; therefore, we conducted epidemiological studies to define these cases.

Patients And Methods: Patients who tested positive for MRSA by stool culture using selective media 48 h after admission to Kochi Medical School Hospital between April 1, 2012, and December 31, 2022, and did not meet the exclusion criteria were included. We defined MRSA enteritis (Group A) as cases that were responsive to treatment with vancomycin hydrochloride powder, had a Bristol Stool Scale of ≥ 5, and a stool frequency of at least three times per day; all others were MRSA carriers (Group B). Multivariate analysis was performed to risk factors associated with MRSA enteritis.

Results: Groups A and B included 18 (25.4%) and 53 (74.6%) patients, respectively. Multivariate logistic regression analysis showed that a white blood cell count of > 10000/µL (odds ratio [OR], 5.50; 95% confidence interval [CI], 1.12-26.9), MRSA count of ≥ 2+ in stool cultures (OR, 8.91; 95% CI, 1.79-44.3), and meropenem administration within 1 month of stool specimen submission (OR, 7.47; 95% CI, 1.66-33.6) were risk factors of MRSA enteritis.

Conclusion: The case definitions reviewed for MRSA enteritis may be useful as diagnostic criteria.

References
1.
Bartlett J . Clinical practice. Antibiotic-associated diarrhea. N Engl J Med. 2002; 346(5):334-9. DOI: 10.1056/NEJMcp011603. View

2.
de Groot V, Beckerman H, Lankhorst G, Bouter L . How to measure comorbidity. a critical review of available methods. J Clin Epidemiol. 2003; 56(3):221-9. DOI: 10.1016/s0895-4356(02)00585-1. View

3.
Dodemont M, Verhulst C, Nonhoff C, Nagant C, Denis O, Kluytmans J . Prospective Two-Center Comparison of Three Chromogenic Agars for Methicillin-Resistant Staphylococcus aureus Screening in Hospitalized Patients. J Clin Microbiol. 2015; 53(9):3014-6. PMC: 4540930. DOI: 10.1128/JCM.01006-15. View

4.
Iwai S, Akutsu M . [Severe infection in gastroenterological field; MRSA (methicillin resistant Staphylococcus aureus) enterocolitis]. Nihon Rinsho. 1994; 52(2):456-61. View

5.
Piao C, Karasawa T, Totsuka K, Uchiyama T, Kikuchi K . Prospective surveillance of community-onset and healthcare-associated methicillin-resistant Staphylococcus aureus isolated from a university-affiliated hospital in Japan. Microbiol Immunol. 2005; 49(11):959-70. DOI: 10.1111/j.1348-0421.2005.tb03691.x. View