24 Yield of Stool Cultures and Latex Agglutination for Rotavirus in Children with Acute Diarrhea in a Developing Country

Abstract

Objective: To assess the performance of stool culture and a rotavirus diagnostic test in children with acute diarrhea attending an emergency hospital in a developing country. Methods: Stool microbiologic results were reviewed for fecal simples of children from 0 through 18 years old attending the Hospital de Emergencias Pediátricas, Lima, Peru, from January through September 2002. Results: Overall, 522 underwent stool cultures. Positive cultures were obtained in 223 samples (43%) and 299 were negative. A latex agglutination test for rotavirus was performed in 225 samples, and 87 were positive (38.6%). The most frequently isolated enteropathogens included Shigella flexneri (32.3%), Shigella sonnei (19.7%), Campylobacter sp (16.6%), enteropathogenic E. Coli (7.3%), enteroinvasive E. coli (3.1%), Salmonella enteritidis (3.1%), others (6.7%). Co-infection with two pathogens was obtained in 23 stool cultures (10.3%) and three pathogens were identified in 2 subjects (0.9%). Discussion and conclusions: The performance of stool culture was substantially higher than in other series from developed and developing countries. Prevalence of rotavirus was similar to other reports. The frequency of co-infection was lower than previously reported. The comparatively higher performance of stool culture may be explained by the short time between the sampling and culture of stools and by a more comprehensive diagnostic approach in the study hospital, which is relatively smaller, with more efficient processes than a large, overburdened hospital.