Korean J Pediatr Infect Dis.  2006 Nov;13(2):147-154. 10.14776/kjpid.2006.13.2.147.

Etiology and Clinical Manifestation of Acute Gastroenteritis in Children

• IM IJ
• Lee MJ
• Chung EH
• Yu J
• Chang YP
• Park WS
• Park K
• Song NS
• Baek KA
• Cha YT

• KMID: 2439982
• DOI: http://doi.org/10.14776/kjpid.2006.13.2.147

Abstract

PURPOSE
The purpose of this study is to evaluate epidemiological data of pathogens obtained from stool exams and compare them with the clinical course in pediatric patients with symptoms of acute gastroenteritis.
METHODS
Subjects were selected from patients presenting with symptoms of acute gastroenteritis who visited the outpatient clinic or who were admitted to the Dankook University Hospital from December of 2004 to December of 2005. Stool exams for 17 pathogens was performed. RT-PCR was used to detect norovirus and enzyme-linked immunoabsorbant assay (ELISA) was used to detect rotavirus, adenovirus and astrovirus in the subjects stool samples. Ten different species of bacteria(Salmonella spp., Shigella spp., Clostridium perfrigens, Campylobacter spp., Escherichia coli, Vibrio spp., Staphylococcus aureus, Bacillus cereus, Yersinia spp., and L. monocytogenes) were each selectively cultivated and enzyme immunoassays(EIA) was used to test for antigens for C. parvum, E. histolytica and G. lamblia. Retrospective chart review was performed for comparisons of clinical manifestations.
RESULTS
A total of 215 subjects was selected and of these 89 cases(41.4%) showed positive results for at least one pathogen. Male to female ratio was 1.3:1. Age distribution showed 4 cases less than one month(4.5%), 4 cases from 1~2 months(4.5%), 24 cases from 3~12 months(26.7%), 47 cases form 13~48 months(52.8%), 10 cases greater than 48 months (21.2%). Viruses showed the greatest proportion of cases with 68 subjects(77.5%), of these rotavirus being the most commonly reported in 50 cases. Bacteria was identified in 26 cases (29.2%), of these nontyphoidal salmonella was noted in 10 cases. Protozoa followed with 21 cases(23.6%), of these C. parvum was noted in 11 cases and G. lamblia was noted in 10 cases. Mixed infections with more than two pathogens were seen in 22 cases(24.7%), of these viral infection with accompanying parasitic infection was seen in 12(54.5%) cases.
CONCLUSION
In this study we examined various pathogens known to cause acute gastroenteritis in children. Further studies for various pathogens can provide useful information for management of the acute gastroenteritis.

Keyword

Etiology; Gastroenteritis; Diarrhea; Children

MeSH Terms

Adenoviridae
Age Distribution
Ambulatory Care Facilities
Bacillus cereus
Bacteria
Campylobacter
Child*
Clostridium
Coinfection
Diarrhea
Escherichia coli
Female
Gastroenteritis*
Giardia
Humans
Male
Norovirus
Retrospective Studies
Rotavirus
Salmonella
Shigella
Staphylococcus aureus
Vibrio
Yersinia