Background Acute gastroenteritis (AGE) is diagnosed with a presentation of > 1 episode of vomiting and > 3 episodes of diarrhea in a 24-h period. Treatment is supportive, however, in severe cases antibacterial treatment may be indicated. Stool cultures can detect the responsible pathogenic bacteria and can guide antibiotic treatment, however, the indication for and efficacy of stool cultures is debatable. This study aimed to address the clinical utility of stool cultures in patients diagnosed with AGE. Methods A retrospective, multicenter study was performed in patients admitted for AGE from 2012 to 2014. Patient charts were obtained through hospital software using ICD-9 codes for AGE. Inclusion criteria was a documented diagnosis of AGE, age of 18 years or older, symptoms of both upper GI symptoms of abdominal pain and/or nausea and lower GI symptoms of diarrhea. Patients were classified into two main groups, those in whom (1) stool culture was obtained and (2) those in whom stool culture was not performed. Clinical features and outcomes were compared between groups. The diagnostic yield of stool cultures was assessed. All analysis were conducted using the Statistical Package for Social Science (SPSS). Results Of 2479 patient charts reviewed, 342 met the above criteria for AGE. 119 patients (34.8%) had stool cultures collected and 223 (65.2%) did not. Demographics, clinical features and serologic lab values are shown in Table 1. Of the 119 stool cultures performed, only 4% (n = 5) yielded growth of pathogenic bacteria (2 Pseudomonas spp, 2 Campylobacter spp, 1 Salmonella spp). The group who underwent stool culture had a higher percentage of patients with fevers (26% vs 13%,p < 0.003) and longer hospital length of stay (3.15 vs 2.28 days, p < 0.001) compared to the group that did not undergo stool cultures. Conclusion Stool cultures are commonly ordered when AGE is suspected. In our cohort, stool culture had a very low yield of detecting an underlying pathogen. Although patients who had stool cultures obtained were more likely to be febrile and to have a longer length of hospital stay than were those who did not have stool cultures, for the vast majority of patients, stool culture played little to no role in patient management. Further studies are needed to which patients benefit most from undergoing stool culture.

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Background: Human immunode ciency virus (HIV) infection and antiretroviral therapy have been associated with non-alcoholic fatty liver disease (NAFLD), but few studies have evaluated whether HIV infection is an independent risk factor for the development of hepatic steatosis and advanced liver brosis.Objectives: To study the prevalence and severity of hepatic steatosis and advanced brosis in people living with HIV and control outpatients.Methods: We conducted a cross-sectional analysis of relevant data from 875 pairs of individuals belonging to an HIV-dedicated outpatient clinic and an adult primary care clinic of an inner-city hospital.Hepatic Steatosis Index (HSI) and FIB-4 index were calculated as non-invasive measures of steatosis and brosis, respectively. A multivariate logistic regression analysis was performed to assess predictors of steatosis and advanced brosis.Results: The prevalence of hepatic steatosis, determined by HSI ≥36, was higher in HIV-negative subjects (71.5% vs. 65.4%, p=0.006). The prevalence of advanced brosis, determined by FIB-4 index ≥3.25, was higher in the HIV-positive group (7% vs. 1.7%, p <0.001). Multivariable analysis did not identify HIV infection to be an independent risk factor for hepatic steatosis (p=0.068) and advanced brosis.Conclusions: In this cohort, hepatic steatosis was more prevalent in non-HIV infected patients, while advanced brosis had a higher prevalence in people living with HIV. HIV infection was not found to be an independent risk factor for either hepatic steatosis or brosis.

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