Korean J Parasitol.  2017 Oct;55(5):513-521. 10.3347/kjp.2017.55.5.513.

High Frequency of Enteric Protozoan, Viral, and Bacterial Potential Pathogens in Community-Acquired Acute Diarrheal Episodes: Evidence Based on Results of Luminex Gastrointestinal Pathogen Panel Assay

• Hawash YA
• Ismail KA
• Almehmadi

• KMID: 2395755
• DOI: http://doi.org/10.3347/kjp.2017.55.5.513

Abstract

Infectious diarrhea is endemic in most developing countries. We aimed to investigate the protozoan, viral, and bacterial causes of acute diarrhea in Taif, Saudi Arabia. A cross-sectional prospective 1-year study was conducted on 163 diarrheal patients of various ages. Stool samples were collected, 1 per patient, and tested for 3 protozoa, 3 viruses, and 9 bacteria with the Luminex Gastrointestinal Pathogen Panel. Overall, 53.4% (87/163) of samples were positives (20.8% protozoa, 19.6% viruses, 2.8% bacteria, and 9.8% mixed). Rotavirus (19.6%), Giardia duodenalis (16.5%), and Cryptosporidium spp. (8.5%) were the mostly detected pathogens. Adenovirus 40/41 (4.2%), Salmonella (3%), Shiga toxin-producing Escherichia coli (3%), and Entamoeba histolytica (2.4%) were also detected. Norovirus GI/II, Vibrio cholerae, Yersinia enterocolitica, and Clostridium difficile toxin A/B were not detected in any patients. All pathogens were involved in coinfections except E. histolytica. Giardia (5.5%) and rotavirus (3%) were the most commonly detected in co-infections. Enterotoxigenic E. coli (2.4%), Campylobacter spp. (2.4%), E. coli 0157 (1.8%), and Shigella spp. (1.2%) were detected in patients only as co-infections. Infections were more in children 0-4 years, less in adults < 40 years, and least >40 years, with statistically significant differences in risk across age groups observed with rotavirus (P < 0.001), Giardia (P=0.006), and Cryptosporidium (P=0.036) infections. Lastly, infections were not significantly more in the spring. This report demonstrates the high burden of various enteropathogens in the setting. Further studies are needed to define the impact of these findings on the clinical course of the disease.

Keyword

Giardia duodenalis; Entamoeba histolytica; Cryptosporidium; diarrhea; enteropathogen; co-infection; mono-infection; xTAGâ„¢ GPP

MeSH Terms

Adenoviridae
Adult
Bacteria
Campylobacter
Child
Clostridium difficile
Coinfection
Cryptosporidium
Developing Countries
Diarrhea
Entamoeba histolytica
Enterotoxigenic Escherichia coli
Giardia
Giardia lamblia
Humans
Norovirus
Prospective Studies
Rotavirus
Salmonella
Saudi Arabia
Shiga-Toxigenic Escherichia coli
Shigella
Vibrio cholerae
Yersinia enterocolitica