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Etiology of diarrhea in young children in Denmark : a case-control study

Olesen, Bente ; Neimann, Jacob ; Böttiger, Blenda LU ; Ethelberg, Steen ; Schiellerup, Peter ; Jensen, Charlotte ; Helms, Morten ; Scheutz, Flemming ; Olsen, Katharina E P and Krogfelt, Karen , et al. (2005) In Journal of Clinical Microbiology 43(8). p.3636-3641
Abstract

Infectious gastroenteritis is one of the most common diseases in young children. To clarify the infectious etiology of diarrhea in Danish children less than 5 years of age, we conducted a 2-year prospective case-control study. Stools from 424 children with diarrhea and 870 asymptomatic age-matched controls were examined, and their parents were interviewed concerning symptoms. Rotavirus, adenovirus, and astrovirus were detected by enzyme-linked immunosorbent assay, and norovirus and sapovirus were detected by PCR. Salmonella, thermotolerant Campylobacter, Yersinia, Shigella, and Vibrio spp. were detected by standard methods. Shiga toxin-producing (STEC), attaching-and-effacing (A/EEC), enteropathogenic (EPEC), enterotoxigenic,... (More)

Infectious gastroenteritis is one of the most common diseases in young children. To clarify the infectious etiology of diarrhea in Danish children less than 5 years of age, we conducted a 2-year prospective case-control study. Stools from 424 children with diarrhea and 870 asymptomatic age-matched controls were examined, and their parents were interviewed concerning symptoms. Rotavirus, adenovirus, and astrovirus were detected by enzyme-linked immunosorbent assay, and norovirus and sapovirus were detected by PCR. Salmonella, thermotolerant Campylobacter, Yersinia, Shigella, and Vibrio spp. were detected by standard methods. Shiga toxin-producing (STEC), attaching-and-effacing (A/EEC), enteropathogenic (EPEC), enterotoxigenic, enteroinvasive, and enteroaggregative Escherichia coli were detected by using colony hybridization with virulence gene probes and serotyping. Parasites were detected by microscopy. Overall, a potential pathogen was found in 54% of cases. More cases than controls were infected with rotavirus, Salmonella, norovirus, adenovirus, Campylobacter, sapovirus, STEC, classical EPEC, Yersinia, and Cryptosporidium strains, whereas A/EEC, although common, was not associated with illness. The single most important cause of diarrhea was rotavirus, which points toward the need for a childhood vaccine for this pathogen, but norovirus, adenovirus, and sapovirus were also major etiologies. Salmonella sp. was the most common bacterial pathogen, followed by Campylobacter, STEC, Yersinia, and classical EPEC strains. A/EEC not belonging to the classical EPEC serotypes was not associated with diarrhea, underscoring the importance of serotyping for the definition of EPEC.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Case-Control Studies, Child, Preschool, Diarrhea/etiology, Escherichia coli/isolation & purification, Humans, Infant, Infant, Newborn, Prospective Studies, Rotavirus/isolation & purification
in
Journal of Clinical Microbiology
volume
43
issue
8
pages
6 pages
publisher
American Society for Microbiology
external identifiers
  • scopus:23744464928
  • pmid:16081890
ISSN
0095-1137
DOI
10.1128/JCM.43.8.3636-3641.2005
language
English
LU publication?
no
id
b8ec4648-a011-46b8-9c9f-81d6e2d1a033
date added to LUP
2019-05-02 14:26:17
date last changed
2024-03-19 05:53:17
@article{b8ec4648-a011-46b8-9c9f-81d6e2d1a033,
  abstract     = {{<p>Infectious gastroenteritis is one of the most common diseases in young children. To clarify the infectious etiology of diarrhea in Danish children less than 5 years of age, we conducted a 2-year prospective case-control study. Stools from 424 children with diarrhea and 870 asymptomatic age-matched controls were examined, and their parents were interviewed concerning symptoms. Rotavirus, adenovirus, and astrovirus were detected by enzyme-linked immunosorbent assay, and norovirus and sapovirus were detected by PCR. Salmonella, thermotolerant Campylobacter, Yersinia, Shigella, and Vibrio spp. were detected by standard methods. Shiga toxin-producing (STEC), attaching-and-effacing (A/EEC), enteropathogenic (EPEC), enterotoxigenic, enteroinvasive, and enteroaggregative Escherichia coli were detected by using colony hybridization with virulence gene probes and serotyping. Parasites were detected by microscopy. Overall, a potential pathogen was found in 54% of cases. More cases than controls were infected with rotavirus, Salmonella, norovirus, adenovirus, Campylobacter, sapovirus, STEC, classical EPEC, Yersinia, and Cryptosporidium strains, whereas A/EEC, although common, was not associated with illness. The single most important cause of diarrhea was rotavirus, which points toward the need for a childhood vaccine for this pathogen, but norovirus, adenovirus, and sapovirus were also major etiologies. Salmonella sp. was the most common bacterial pathogen, followed by Campylobacter, STEC, Yersinia, and classical EPEC strains. A/EEC not belonging to the classical EPEC serotypes was not associated with diarrhea, underscoring the importance of serotyping for the definition of EPEC.</p>}},
  author       = {{Olesen, Bente and Neimann, Jacob and Böttiger, Blenda and Ethelberg, Steen and Schiellerup, Peter and Jensen, Charlotte and Helms, Morten and Scheutz, Flemming and Olsen, Katharina E P and Krogfelt, Karen and Petersen, Eskild and Mølbak, Kåre and Gerner-Smidt, Peter}},
  issn         = {{0095-1137}},
  keywords     = {{Case-Control Studies; Child, Preschool; Diarrhea/etiology; Escherichia coli/isolation & purification; Humans; Infant; Infant, Newborn; Prospective Studies; Rotavirus/isolation & purification}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{3636--3641}},
  publisher    = {{American Society for Microbiology}},
  series       = {{Journal of Clinical Microbiology}},
  title        = {{Etiology of diarrhea in young children in Denmark : a case-control study}},
  url          = {{http://dx.doi.org/10.1128/JCM.43.8.3636-3641.2005}},
  doi          = {{10.1128/JCM.43.8.3636-3641.2005}},
  volume       = {{43}},
  year         = {{2005}},
}