Acute gastroenteritis (AGE) is diagnosed with a presentation of > 1 episode of vomiting and > 3 episodes of diarrhea in a 24-h period. Treatment is supportive, however, in severe cases antibacterial treatment may be indicated. Stool cultures can detect the responsible pathogenic bacteria and can guide antibiotic treatment, however, the indication for and efficacy of stool cultures is debatable. This study aimed to address the clinical utility of stool cultures in patients diagnosed with AGE. A retrospective, multicenter study was performed in patients admitted for AGE from 2012 to 2014. Patient charts were obtained through hospital software using ICD-9 codes for AGE. Inclusion criteria was a documented diagnosis of AGE, age of 18 years or older, symptoms of both upper GI symptoms of abdominal pain and/or nausea and lower GI symptoms of diarrhea. Patients were classified into two main groups, those in whom (1) stool culture was obtained and (2) those in whom stool culture was not performed. Clinical features and outcomes were compared between groups. The diagnostic yield of stool cultures was assessed. All analysis were conducted using the Statistical Package for Social Science (SPSS). Of 2479 patient charts reviewed, 342 met the above criteria for AGE. 119 patients (34.8%) had stool cultures collected and 223 (65.2%) did not. Demographics, clinical features and serologic lab values are shown in Table 1. Of the 119 stool cultures performed, only 4% (n = 5) yielded growth of pathogenic bacteria (2 Pseudomonas spp, 2 Campylobacter spp, 1 Salmonella spp). The group who underwent stool culture had a higher percentage of patients with fevers (26% vs 13%,p < 0.003) and longer hospital length of stay (3.15 vs 2.28 days, p < 0.001) compared to the group that did not undergo stool cultures. Stool cultures are commonly ordered when AGE is suspected. In our cohort, stool culture had a very low yield of detecting an underlying pathogen. Although patients who had stool cultures obtained were more likely to be febrile and to have a longer length of hospital stay than were those who did not have stool cultures, for the vast majority of patients, stool culture played little to no role in patient management. Further studies are needed to which patients benefit most from undergoing stool culture.

中文翻译：

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粪便培养显示对纽约布朗克斯区住院患者的急性肠胃炎治疗缺乏影响。

急性胃肠炎 (AGE) 被诊断为在 24 小时内出现 > 1 次呕吐和 > 3 次腹泻。治疗是支持性的，但在严重的情况下可能需要抗菌治疗。粪便培养可以检测致病菌并指导抗生素治疗，然而，粪便培养的适应症和疗效尚有争议。本研究旨在探讨粪便培养在诊断为 AGE 的患者中的临床效用。对 2012 年至 2014 年因 AGE 入院的患者进行了一项回顾性、多中心研究。患者图表是通过医院软件使用 AGE 的 ICD-9 代码获得的。纳入标准是年龄在 18 岁或以上的 AGE 的记录诊断，腹痛和/或恶心的上消化道症状和腹泻的下消化道症状。患者分为两大类，（1）获得粪便培养的患者和（2）未进行粪便培养的患者。比较组间的临床特征和结果。评估粪便培养的诊断率。所有分析均使用社会科学统计软件包 (SPSS) 进行。在审查的 2479 名患者图表中，342 名符合上述 AGE 标准。119 名患者 (34.8%) 收集了粪便培养物，223 名 (65.2%) 没有。人口统计学、临床特征和血清学实验室值见表 1。在进行的 119 次粪便培养中，只有 4% (n = 5) 产生了病原菌的生长（2 种假单胞菌属、2 种弯曲杆菌属、1 种沙门氏菌属）。与未进行粪便培养的组相比，接受粪便培养的患者出现发热的比例更高（26% vs 13%，p < 0.003），住院时间更长（3.15 vs 2.28天，p < 0.001）文化。当怀疑 AGE 时，通常需要进行粪便培养。在我们的队列中，粪便培养检测潜在病原体的产量非常低。尽管进行了粪便培养的患者比没有进行粪便培养的患者更容易发热并且住院时间更长，但对于绝大多数患者而言，粪便培养在患者管理中几乎没有作用。需要进一步研究哪些患者从粪便培养中获益最多。15 天 vs 2.28 天，p < 0.001）与未进行粪便培养的组相比。当怀疑 AGE 时，通常需要进行粪便培养。在我们的队列中，粪便培养检测潜在病原体的产量非常低。尽管进行了粪便培养的患者比没有进行粪便培养的患者更容易发热并且住院时间更长，但对于绝大多数患者而言，粪便培养在患者管理中几乎没有作用。需要进一步研究哪些患者从粪便培养中获益最多。15 天 vs 2.28 天，p < 0.001）与未进行粪便培养的组相比。当怀疑 AGE 时，通常需要进行粪便培养。在我们的队列中，粪便培养检测潜在病原体的产量非常低。尽管进行了粪便培养的患者比没有进行粪便培养的患者更容易发热并且住院时间更长，但对于绝大多数患者而言，粪便培养在患者管理中几乎没有作用。需要进一步研究哪些患者从粪便培养中获益最多。尽管进行了粪便培养的患者比没有进行粪便培养的患者更容易发热并且住院时间更长，但对于绝大多数患者而言，粪便培养在患者管理中几乎没有作用。需要进一步研究哪些患者从粪便培养中获益最多。尽管进行了粪便培养的患者比没有进行粪便培养的患者更容易发热并且住院时间更长，但对于绝大多数患者而言，粪便培养在患者管理中几乎没有作用。需要进一步研究哪些患者从粪便培养中获益最多。