BACKGROUND: Acute diarrhea continues to be an important cause of hospitalization in young children, and deaths still occur as a result. We reviewed a large cohort of hospitalized children affected by gastroenteritis. The hypothesis of our study was that clinical characteristics and a limited set of laboratory data can differentiate between the different causative pathogens of diarrhea. METHODS: A chart review was performed of 650 patients with pathogen-proven diarrhea treated between April 2005 and May 2008 in the children's hospital of the University of Würzburg. Clinical presentation at the time of admission and during hospital stay, laboratory findings, stool pathogen results, and epidemiological data were collected and compared. A severity score was generated. RESULTS: Rotavirus was the most common gastroenteritis pathogen identified, followed by norovirus, adenovirus and Salmonella spp. Nosocomial infections were caused most commonly by norovirus. Rotavirus was the most common agent when there was simultaneous detection of two or more viruses. Rotavirus infections were significantly more severe, with a higher frequency of diarrhea and elevated liver enzymes. Infections due to Salmonella spp showed significantly higher values for C-reactive protein, erythrocyte sedimentation rate, and body temperature. A seasonal distribution was noted, with the peak for rotaviruses/noroviruses in winter/spring, the peak for adenoviruses in November/December, and the peak for Salmonella spp in the summer months. Younger children and toddlers had significantly higher gastroenteritis and airway inflammation scores. Of note, respiratory symptoms and parameters of systemic inflammation differed between the different pathogens. CONCLUSIONS: Gastroenteritis is a common reason for hospital admission in previously healthy children during the first years of life. Rotaviruses were found to be the most common pathogens in our cohort. On the basis of clinical and laboratory parameters it appears possible to distinguish between the different causative agents. This may have implications for hospital hygiene management and for the identification of predictive markers of a severe course.
BACKGROUND: Acute diarrhea continues to be an important cause of hospitalization in young children, and deaths still occur as a result. We reviewed a large cohort of hospitalized children affected by gastroenteritis. The hypothesis of our study was that clinical characteristics and a limited set of laboratory data can differentiate between the different causative pathogens of diarrhea. METHODS: A chart review was performed of 650 patients with pathogen-proven diarrhea treated between April 2005 and May 2008 in the children's hospital of the University of Würzburg. Clinical presentation at the time of admission and during hospital stay, laboratory findings, stool pathogen results, and epidemiological data were collected and compared. A severity score was generated. RESULTS: Rotavirus was the most common gastroenteritis pathogen identified, followed by norovirus, adenovirus and Salmonella spp. Nosocomial infections were caused most commonly by norovirus. Rotavirus was the most common agent when there was simultaneous detection of two or more viruses. Rotavirus infections were significantly more severe, with a higher frequency of diarrhea and elevated liver enzymes. Infections due to Salmonella spp showed significantly higher values for C-reactive protein, erythrocyte sedimentation rate, and body temperature. A seasonal distribution was noted, with the peak for rotaviruses/noroviruses in winter/spring, the peak for adenoviruses in November/December, and the peak for Salmonella spp in the summer months. Younger children and toddlers had significantly higher gastroenteritis and airway inflammation scores. Of note, respiratory symptoms and parameters of systemic inflammation differed between the different pathogens. CONCLUSIONS:Gastroenteritis is a common reason for hospital admission in previously healthy children during the first years of life. Rotaviruses were found to be the most common pathogens in our cohort. On the basis of clinical and laboratory parameters it appears possible to distinguish between the different causative agents. This may have implications for hospital hygiene management and for the identification of predictive markers of a severe course.
Authors: Kaisa M Kemppainen; Kristian F Lynch; Edwin Liu; Maria Lönnrot; Ville Simell; Thomas Briese; Sibylle Koletzko; William Hagopian; Marian Rewers; Jin-Xiong She; Olli Simell; Jorma Toppari; Anette-G Ziegler; Beena Akolkar; Jeffrey P Krischer; Åke Lernmark; Heikki Hyöty; Eric W Triplett; Daniel Agardh Journal: Clin Gastroenterol Hepatol Date: 2016-11-10 Impact factor: 11.382
Authors: Sue E Crawford; Sasirekha Ramani; Jacqueline E Tate; Umesh D Parashar; Lennart Svensson; Marie Hagbom; Manuel A Franco; Harry B Greenberg; Miguel O'Ryan; Gagandeep Kang; Ulrich Desselberger; Mary K Estes Journal: Nat Rev Dis Primers Date: 2017-11-09 Impact factor: 52.329
Authors: Sylvia Becker-Dreps; Marlon Meléndez; Lan Liu; Luis Enrique Zambrana; Margarita Paniagua; David J Weber; Michael G Hudgens; Mercedes Cáceres; Carina Källeståll; Douglas R Morgan; Félix Espinoza; Rodolfo Peña Journal: Am J Trop Med Hyg Date: 2013-07-01 Impact factor: 2.345
Authors: Sheila J Barton; Robert Murray; Karen A Lillycrop; Hazel M Inskip; Nicholas C Harvey; Cyrus Cooper; Neerja Karnani; Irma Silva Zolezzi; Norbert Sprenger; Keith M Godfrey; Aristea Binia Journal: J Infect Dis Date: 2019-02-15 Impact factor: 5.226
Authors: Mariona Bustamante; Marie Standl; Quique Bassat; Natalia Vilor-Tejedor; Carolina Medina-Gomez; Carolina Bonilla; Tarunveer S Ahluwalia; Jonas Bacelis; Jonathan P Bradfield; Carla M T Tiesler; Fernando Rivadeneira; Susan Ring; Nadja H Vissing; Nadia R Fink; Astanand Jugessur; Frank D Mentch; Ferran Ballester; Jennifer Kriebel; Jessica C Kiefte-de Jong; Helene M Wolsk; Sabrina Llop; Elisabeth Thiering; Systke A Beth; Nicholas J Timpson; Josefine Andersen; Holger Schulz; Vincent W V Jaddoe; David M Evans; Johannes Waage; Hakon Hakonarson; Struan F A Grant; Bo Jacobsson; Klaus Bønnelykke; Hans Bisgaard; George Davey Smith; Henriette A Moll; Joachim Heinrich; Xavier Estivill; Jordi Sunyer Journal: Hum Mol Genet Date: 2016-08-23 Impact factor: 6.150