Pattern of Enteropathogens during Diarrhoeal Episode in Children with Haematological Malignancy

Abstract

Background: Haematological malignancies comprise 82% of all malignancies in children at the department of Paediatric Haematology and Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh; Gastro-intestinal infections were the leading causes of infection in paediatric oncology patients. Objectives: This study was conducted to see the type of enteropathogens in stool samples during diarrhoeal episode in children with haematological malignancy. Methods: This observational study was conducted from April 2012 through March 2013 at BSMMU, Bangladesh. A total of 58 diarrhoeal   episodes experienced by 51 children   of various types of haematological malignancies were included in the study. Faecal samples from   studied children   were sent   to Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B), laboratory to do aerobic culture for common bacteria; Enzyme Immunoassay (EIA) for Clostridium difficile and multiplex real-time polymerase chain reaction (PCR) for parasitic infection. Results: Among the total 58 diarrhoeal episodes, potential pathogenic bacteria were isolated from only 5.17% sample. Faecal samples from 22.41% episodes were found positive for GDH antigen for Clostridium difficile; none of the focal samples   were positive for toxin A and/ or B.  Several different parasites were identified from 70.37%   samples and most frequently identified protozoa was Giardia lamblia in 68.52%. Conclusion: The study found 22.41% colonization rate with Clostridium difficile but none was toxigenic. Parasitic infections were seen more frequently in children with haematological malignancy. The study also found significant association of severe neutropenia with GDH positive diarrhoeal episodes.