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Bacterial Etiology of Diarrhea in Children Admitted in Hematologic Unit in a Tertiary Care Hospital

Anuradha S De, Sujata M Baveja and Farhana I Attar

Introduction: Diarrhea is a frequent complication observed in patients with hematologic cancer. The normal fecal micro flora changes in chemotherapy-induced diarrhea, which shows a higher proportion of aerobic and oxygentolerant bacteria. Hence the causative bacterial pathogens maybe different than the usual etiology.

Objectives: Therefore, the objective of the study was to find outthe etiology of diarrhea in children suffering from hematological malignancy and who are on chemotherapy.

Material and Methods: A retrospective study was carried out on patients in hematologic unit of pediatric ward over a period of one and half years at a tertiary care hospital in Mumbai. A total of 55 stool samples from patients of hematological malignancy who presented with diarrhea, were included in this study. The samples were processed as per standard techniques and the bacterial pathogens were identified by standard biochemical tests.

Results: Growth of pathogenic bacteria was seen in 15 (27.27%) stool samples, of which 13 patients had acute lymphatic leukemia(ALL) and only two patients had acute myeloid leukemia (AML). Among 15 growths, 11 grew Pseudomonas aeruginosa, two grew Morganella morganii and one each grew Aeromonas hydrophila and Klebsiella pneumoniae.

Conclusion: Organisms usually considered as non pathogenic may cause disease in immunocompromised patients. Stool specimens of all leukemic patients suffering from diarrhea and on chemotherapy, should be sent routinely for culture, so as to find out the exact cause of diarrhea.