Determination of Risk Factors for Infectious Diarrhea in Patients with Hematological Malignancy.

BACKGROUND: The study aimed to determine the risk factors for infectious diarrhea in patients receiving chemotherapy or hematopoietic stem cell transplantation due to hematological malignancy.

MATERIALS AND METHODS: This study was designed as a prospective observational study. Patients whose infectious agent was determined in laboratory examination were defined as having infectious diarrhea. Patients with diarrhea were categorized into infectious and unidentified, and compared regarding demographic data, treatments, risk factors, laboratory findings, and prognosis.

RESULTS: In the study, 838 patients were hospitalized, and 105 (12.5%) of those who met the definition criteria were included. The patients were divided into two groups: 67 (63.8%) unidentified and 38 (36.2%) infectious diarrhea. There were no differences between these groups in terms of age, gender, types of hematological malignancies, and the presence of comorbidities. The highest rate of isolated microorganisms was Clostridioides difficile (12.4%). The rate of corticosteroid use was higher in the group with infectious diarrhea (39.5%) than in the group with unidentified diarrhea (7.5%) ( P <0.001). The rate of granulocyte colony-stimulating factor (GCSF) use was higher in patients with unidentified diarrhea (7.5% vs. 42.1%, P = 0.022). The median duration of diarrhea was 9 (4 - 10) days in the group with infectious diarrhea, while it was 5 (3 - 8) in the group with unidentified diarrhea ( P = 0.012). According to the multivariate logistic regression model, it was determined that corticosteroid treatment increased the risk of infectious diarrhea by odds ratio [OR] = 4.75 (confidence interval [CI]: 1.32 - 17.02) times. It was concluded that the duration of diarrhea may result in a 1.15 (CI: 1.02 - 1.31) fold increase in the risk of infectious diarrhea, while GCSF treatment had an OR = 2.84 (CI: 0.12 - 0.96) fold risk-reducing effect against infectious diarrhea.

CONCLUSION: Infectious diarrhea lasts longer in patients with hematological malignancies. While corticosteroid use is a risk factor for developing infectious diarrhea, GCSF use has a protective effect.