Kim S W, Peck K R, Jung S I, Kim Y S, Kim S, Lee N Y, Song J H
Division of Infectious Diseases, Kyungpook National University School of Medicine, Taegu, Korea.
J Korean Med Sci. 2001 Dec;16(6):742-4. doi: 10.3346/jkms.2001.16.6.742.
Although Pseudomonas aeruginosa is not generally considered as a cause of antibiotic-associated diarrhea, several cases of diarrhea caused by P. aeruginosa have been reported. We experienced seven cases of nosocomial diarrhea presumably caused by P. aeruginosa, which was the predominant organism isolated from stool cultures. Clostridium difficile toxin was also positive in one patient. No other potential or recognized enteropathogens were identified from stools. All patients had underlying diseases and had been receiving antibiotics before the diarrheal onset. All of the seven P. aeruginosa isolates were resistant to previously given antibiotics. Diarrhea stopped three days after withdrawal of probable offending antibiotics without specific treatment in two patients. The other five patients having continuous diarrhea despite withdrawal of probable offending antibiotics, were successfully treated with antipseudomonal agents. The median duration of diarrhea after the initiation of treatment was 6.3 days. These data suggest that P. aeruginosa can be a potential cause of antibiotic-associated diarrhea. Further investigations are warranted to evaluate the possible etiologic role of P. aeruginosa in antibiotic-associated diarrhea.
虽然铜绿假单胞菌通常不被认为是抗生素相关性腹泻的病因，但已有数例由铜绿假单胞菌引起腹泻的报道。我们经历了7例疑似由铜绿假单胞菌引起的医院内腹泻病例，该菌是从粪便培养物中分离出的主要病原体。1例患者的艰难梭菌毒素检测也呈阳性。粪便中未发现其他潜在或已确认的肠道病原体。所有患者均有基础疾病，且在腹泻发作前均接受过抗生素治疗。7株铜绿假单胞菌分离株均对之前使用的抗生素耐药。2例患者在停用可能引起问题的抗生素后未进行特殊治疗，腹泻在3天后停止。另外5例患者尽管停用了可能引起问题的抗生素仍持续腹泻，使用抗假单胞菌药物治疗成功。治疗开始后腹泻的中位持续时间为6.3天。这些数据表明铜绿假单胞菌可能是抗生素相关性腹泻的一个潜在病因。有必要进行进一步调查，以评估铜绿假单胞菌在抗生素相关性腹泻中可能的病因学作用。
