VALUE OF ROUTINE STOOL CULTURES IN HOSPITALIZED-PATIENTS WITH DIARRHEA

In a prospective study conducted over a six-month period, the relative yield of 721 routine cultures of stool from adult inpatients as a fun ction of the time after hospital admission was assessed. Salmonella, C ampylobacter, Shigella or Yersinia spp. were recovered from 10.9 % (41 /377) of patients within three days of hospitalization and from only 1 .5 % (5/344) after three days. However, a review of these patients' ch arts did not suggest nosocomial transmission but rather a delay in sto ol collection or asymptomatic carriage. Clostridium difficile was isol ated with a high frequency in patients both within and after three day s of hospitalization (10.3 % and 10.2 %, respectively). Thus, stool sp ecimens from adults hospitalized for more than three days should not b e cultured except for Clostridium difficile unless there are plausible clinical or epidemiological reasons to do so.