Non-Clostridium difficile nosocomial diarrhea in the intensive care unit

It is assumed that most cases of nosocomial diarrhea are due to Clostridium difficile because of the wide spread use of broad-spectrum antibiotic agents. Enteral tube feedings are another important cause of hospital-acquired diarrhea, especially in intensive care units (ICUs). We report the results of a recent survey of patients in the ICU with nosocomial diarrhea and describe an illustrative case. We conclude on the basis of this and a previous larger study that C. difficile diarrhea is very uncommon in enterally fed patients in the ICU; nosocomial diarrhea in the ICU is most commonly caused by enteral tube feedings.