Usefulness of a gastrointestinal panel in adult patients with diarrhea in a tertiary care hospital

Abstract

Introduction: acute diarrhea is one of the main causes of morbidity and mortality worldwide. Molecular tests like the gastrointestinal panel aim to identify the etiological agent more rapidly and specifically, thus favoring early treatment. However, there is little evidence in Latin American adults regarding its usefulness. Therefore, this study seeks to describe the clinical, paraclinical and treatment characteristics of adult patients with acute diarrhea who had a gastrointestinal panel.

Method: a cross-sectional study including patients over the age of 18 diagnosed with diarrhea, on whom a gastrointestinal panel was performed between November 2015 and March 2019, at a Colombian tertiary care hospital.

Results: a total of 807 patients were included, 82.6 % of whom had comorbidities, with a median of three days with acute diarrhea (IQR 1-7). Fifty-four percent of all the gastrointestinal panels had microbial isolation. The most common etiology was bacterial (49.2 %), with enteropathogenic E. coli being the main cause (18.6 %). The most commonly used empirical antibiotic was ampicillin/sulbactam (31 %). The antibiotic was changed in close to 56 % and discontinued in 18 %, mostly secondary to the gastrointestinal panel result (79.4 %).

Conclusion: bacteria were the main cause of diarrhea in the adults in this study, and the gastrointestinal panel result was relevant for changing the antibiotic treatment used; thus, it was a useful diagnostic tool for dealing with patients with diarrhea.