A clinical study of antibiotic-associated acute hemorrhagic colitis. With special reference of clostridium difficile.

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We experienced thirty nine cases of antibiotic-associated acute hemorrhagic colitis after administration of antibiotics for past five years. The aim of this report is to evaluate in these cases from the standpoint of microbiology as well as clinical and endoscopical findings. This disease developed on several days after oral administration of synthetic penicillin with broad spectrum in most of all patients. These patients showed marked improvement on symptomatic therapy and discontinuance of antibiotics within several days.The characteristic features of endoscopic examination were redness, edema, erosion and bleeding int he deep interior colon rather than the sigmoid colon.On the microbiological examination, Klebsiella oxytoca was recovered from 31 (79.5%) of the 39 specimens. Anaerobic stool culture was performed on 27 of the 39 specimens. Clostridium difficile was recovered from 10 (37.0%) of the 27 specimens, and Clostridium sordellii was recovered from 2 (7.4%). These all clostridia were toxin-producing strains. Assay for Colstridium difficile toxin (D-1) was performed on five stools by Latex agglutination test. It was positive in 4 of the 5 specimens.These findings suggest a possivility that toxin-producing clostridia leads to a part of antibiotic-associated acute hemorrhagic colitis.