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Scientific article
Open access
English

Mapping of etiologies of computed tomography-proven acute colitis: a prospective cohort study

Published inScientific reports, vol. 12, no. 1, 9730
Publication date2022-06-13
First online date2022-06-13
Abstract

Our objective was to describe the etiologies of acute colitis and to identify patients who require diagnostic endoscopy. Patients with symptoms of gastrointestinal infection and colonic inflammation on CT were prospectively included. Those immunosuppressed, with history of colorectal cancer or inflammatory bowel disease (IBD), were excluded. Microbiological analysis of the feces was performed using PCR assays BD-Max and FilmArray (GI panel,) and fecal cultures. Fecal calprotectin was determined. Patients with negative BD-Max underwent colonoscopy. One hundred and seventy-nine patients were included. BD-Max was positive in 93 patients (52%) and FilmArray in 108 patients (60.3%). Patients with infectious colitis (n = 103, 57.5%) were positive for Campylobacter spp. (n = 57, 55.3%), Escherichia coli spp. (n = 8, 7.8%), Clostridioides difficile (n = 23, 22.3%), Salmonella spp. (n = 9, 8.7%), viruses (n = 7, 6.8%), Shigella spp. (n = 6, 5.8%), Entamoeba histolytica (n = 2, 1.9%) and others (n = 4, 3.9%). Eighty-six patients underwent colonoscopy, which was compatible with ischemic colitis in 18 patients (10.1%) and IBD in 4 patients (2.2%). Fecal calprotectin was elevated in all patients, with a mean concentration of 1922.1 ± 2895.6 μg/g, and was the highest in patients with IBD (8511 ± 9438 μg/g, p < 0.001). After exclusion of patients with infectious etiology, a fecal calprotectin > 625 μg/g allowed identifying patients with IBD with an area under ROC curve of 85.1%. To conclude, computed tomography-proven colitis was of infectious etiology in 57.5% of patients. The main pathogens identified were Campylobacter spp. (55.3%), Clostridioides difficile (22.3%) and Salmonella spp. (8.7%). Ischemic colitis (10.1%) and IBD (2.2%) were seldom represented. No colorectal cancer was found.

eng
Keywords
  • Biomarkers / analysis
  • Colitis / diagnostic imaging
  • Colitis, Ischemic
  • Colitis, Ulcerative
  • Colonoscopy
  • Feces / microbiology
  • Humans
  • Inflammatory Bowel Diseases / diagnosis
  • Leukocyte L1 Antigen Complex / analysis
  • Prospective Studies
  • Salmonella
  • Tomography
  • Tomography, X-Ray Computed
Citation (ISO format)
MEYER, Jérémy et al. Mapping of etiologies of computed tomography-proven acute colitis: a prospective cohort study. In: Scientific reports, 2022, vol. 12, n° 1, p. 9730. doi: 10.1038/s41598-022-13868-w
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Identifiers
ISSN of the journal2045-2322
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Creation06/16/2022 7:26:00 AM
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