OPEN ENDED RESULTS OF ACUTE DIARRHEA AGENT DETECTION TO VERIFY DIAGNOSIS IN ADULT CASES

Abstract

In 264 adult acute diarrhea cases with moderate course it was analyzed both symptoms and agents detected by different methods: in 91 cases (examined in the period of shigellosis high incidence level) by culture and serologic (specific antibodies detection) methods to detect Shigella spp. and Salmonella spp. plus ELISA method to detect rotavirus antigen in feces; in 173 cases (examined in the period of shigellosis low incidence level) by above mentioned methods plus PCR based method. Data obtained in the period of shigellosis high incidence level have shown that there has been no significant difference in clinical scores (including colitis frequency) between cases positive only for rotavirus antigen and those positive both for rotavirus antigen and Shigella spp. culture. That let suspect that acute diarrhea had been likely to be caused by association of rotavirus with any bacterial agent undetected by the methods used. PCR-based diagnostic method additionally used (in the period of shigellosis low incidence level) resulted in detection of Campylobacter spp. accounted for campilobacteriosis as mono infection in 20,8% cases and as mixed infection (in association with other enteropatho-gens) in 4% cases. In cases with colitis the additional usage of PCR-based diagnostic method resulted in Salmonella spp. and Campylobacter spp. detection in every third case, Shigella spp. and agent association detection in every fifth case. The target analysis of enteropathogens detected in 15 cases positive for rotavirus (examined in the period of shigellosis low incidence level) has shown that in 6 of them there has been detected association of rotavirus with other agents predominantly bacterial ones (in 5 of 6 cases). So, the PCR method might be quite useful to broaden the spectrum of detected enteropathogens in adult acute diarrhea cases especially in those with colitis syndrome available.