Microscopic Examination of Fecal Leukocytes as a Simple Method to Detecting Infective Colitis in Children
Abstract: Various pathogenic
bacteria are reported as the cause of infectious colitis in children.
Infectious colitis does not have a specific sign, therefore an accurate
examination is required. The implementation of fecal cultures accompanied with
drug resistance tests often have constraints, beside the relatively expensive
costs, longer times are needed, and not all health care facilities have
required instruments. On the other hand, this condition requires an immediate
antibiotic therapy, so that the infection should not be continued. In daily
practice, it is not uncommon to find diarrhea with the amount of fecal
leukocyte < 10/hpf with pathogenic bacteria on the examination of the fecal
culture.Cross-sectional study was conducted to observe the pattern of bacterial
distribution in children’s fecal who have acute diarrhea and the correlation between the existence of
pathogenic bacteria and the number of leukocytes in the fecal, as well as
antibiotic resistance patterns. The population of this study is children with
age of 6 months old - 18 years old who were suffering from acute diarrhea with
the amount of fecal leucocyte ≥ 5/hpf, who recruited from polyclinic or
patient admitted at Cipto Mangunkusumo Hospital and Fatmawati General Hospital, Jakarta. Based on
examinations of fecal cultures and PCR, Salmonella sp and C. dificille were
found subsequently in 2 children (33.3%), Enterophatogenic E. Coli(EPEC) and
Shigella were found subsequently in 1 child (16.7%). Based on the ROC curve, it
was found that there was no intersection of maximum and minimal leukocyte value with the midline,
whereas the best sensitivity and specificity value was found at the cut-off
point of 8.5, hence the cut-off
point of leukocytes was
determined at < 8 and > 8. The sensitivity value was 83.3% and the
specificity value was 45.1%. The antibiotic sensitivity test showed that one
child infected by EPEC was sensitive to
ciprofloxacin. Two children infected by
Salmonella, were still sensitive to chloramphenicol, cotrimoxazole, cefixime,
and ceftriaxone. Two children infected by C. Difficile were sensitive to
ceftriaxone, and 1 child infected by Shigella was sensitive to cefixime,
ceftriaxone and ciprofloksazine.
Keywords: infectious colitis;
fecal leukocytes; fecal cultures
Author: Nuraini I Susanti,
Reynaldo Reynaldo, Aria Kekalih, Anis Karuniawati, Badriul Hegar
Journal Code: jpkedokterangg170381
