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Klebsiella oxytoca Linked to Antibiotic-Associated Colitis

K. oxytoca should be considered in differential diagnosis of intestinal pathogens

WEDNESDAY, Dec. 6 (HealthDay News) -- Klebsiella oxytoca may be a cause of antibiotic-associated hemorrhagic colitis, according to study findings published in the Dec. 7 issue of the New England Journal of Medicine.

Christoph Hogenauer, M.D., of the Medical University of Graz in Graz, Austria, and colleagues studied 22 patients who had suspected antibiotic-associated colitis and who were negative for Clostridium difficile. They also cultured stool samples from 385 healthy subjects for K. oxytoca.

The researchers found that six of the 22 patients showed colonoscopic evidence of antibiotic-associated hemorrhagic colitis, and that five of them had positive cultures for K. oxytoca but no other common enteric pathogens. They also found that all isolated K. oxytoca strains produced cytotoxin and identified K. oxytoca in 1.6 percent of the healthy subjects.

"Our study suggests that toxigenic K. oxytoca should be considered in the differential diagnosis of potential intestinal pathogens. When a patient with antibiotic-associated colitis is negative for C. difficile, stool samples should be cultured for K. oxytoca," the authors write. "We consider it important to draw attention to toxigenic K. oxytoca, since relatively young patients may have received a misdiagnosis of ischemic colitis with spontaneous resolution in the past, and since the diagnosis of antibiotic-associated hemorrhagic colitis has consequences for the care of such patients, who could be harmed by unnecessary treatment with drugs."

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