Viral, bacterial and parasitic pathogens associated with severe diarrhoea in the city of São Paulo, Brazil.

Viral, bacterial and parasitic pathogens associated with diarrhoea were studied in infants and young children admitted to the paediatric clinic of the University Hospital of São Paulo during the period of 13 months. A recognised pathogenic organism was detected in 78% of the diarrhoeic patients, 6% of whom had a mixed infection with two agents. Enteropathogenic E. coli (EPEC) was the most common enteropathogen detected (22%), followed by rotavirus (19%) and adenovirus (10%). Altogether 6% had diarrhoea associated with Salmonella or Shigella and 3% showed diarrhoeal illness associated with astrovirus. Infants less than 6 months of age were most commonly infected with enterobacteria (35%), mainly enteropathogenic E. coli (30%), whereas children 6 months to 2 years presented more often with viruses (38%), mainly rotaviruses (25%). Enteropathogens were found during all seasons of the year and rotaviruses showed a seasonal variation.