Aetiology of Acute Gastroenteritis in Hospitalized Children from Lisbon Area

Abstract

Gastroenteritis is a major cause of morbidity and mortality worlwide. Aim: Determine the etiology of gastroenteritis in a cohort of children hospitalized Methods: From May 2011 to January 2012, stool samples were collected from children (4.2 ± 4.8 years). Viral agents (enteric and enterovirus) were detected by RT-PCR. Stool specimens were also tested for bacteria and parasites, by conventional methods. Results: From the 82 stool samples, 42(51.2%) were positive for virus, 22 (26.8%) for bacteria and 35.6% (26/73) for parasites. An association between viral infection and age<3 years (OR=4.92, p<0.01) was observed. Distribution of viral agents was NorovirusII (33.3%), Enterovirus (31%), Rotavirus (23.8%), Adenovirus (9.5%), NorovirusI (2.4%). Simultaneous detection of two viral agents was observed in seven cases (16.7%) - NorovirusII and Enterovirus was the most frequent (57.1%); association with another agent was detected in 33.3% samples. Eight of 22 samples (36.4%) were positive for Campylobacter jejuni, 5 (22.7%) for Salmonella spp, 7 (31.8%) for E. coli, although always in co-infection with another agent, and 1 (4.5%) for Shigella spp. 38.5% of the samples were positive for Cryptosporidium spp., 23.1% for Giardia sp. and 3.8% for Entamoeba histolytica. 69.2% of the parasites were co-detected with other agents. Conclusion: Results suggest that viral agents are the most common among children with acute gastroenteritis, although co-infections with bacteria and parasites are frequent. The most common viral agent associated with acute diarrhea was NorovirusII. An important percentage of cases with no infectious aetiology identified, suggesting that other emergent agents are probably implicated.