Surveillance of enteric pathogens in outpatient children with acute diarrhea

Abstract

Objective To monitor the clinical epidemiology and etiology of acute diarrhea in children in the outpatient setting in Shanghai. Methods An active surveillance study in Children's Hospital of Fudan University between August 2013 and July 2014 was conducted. Outpatient children with acute diarrhea were enrolled in this study and stool samples were collected. Pathogens including norovirus, diarrheagenic Escherichia coli (DEC), nontyphoidal Salmonella spp. (NTS), Campylobacter, Shigella, pathogenic vibrio and Yersinia enterocolitica were identified and typed. The χ2 test was used for statistical analysis. Results Of the 881 stool samples from enrolled children, the pathogens included into the target detection were identified in 246 (27.92%) cases. Norovirus, DEC, NTS, Campylobacter and Shigella were detected in 98 (11.12%) cases, 74 (8.40%) cases, 61 (6.92%) cases, 34 (3.86%) cases and 2 (0.23%) cases, respectively. Neither pathogenic vibrio nor Yersinia enterocolitica was identified. Children younger than 36 months old (3.27%, 26/794) had a lower risk (χ2=7.41, P=0.006) of Campylobacter infection compared with older children (9.20%, 8/87). Vomiting (37.76%) and watery diarrhea (21.34%) were more commonly seen in children with norovirus infection; fever and mucous stool were commonly seen in diarrheal children with NTS infection (40.98% and 21.31%, respectively) and Campylobacter infection (29.41% and 26.47%, respectively). Conclusion Enteric pathogens play a major role in childhood acute diarrhea in Shanghai. Continuous monitoring of enteric pathogens will be helpful for reasonable treatment and prevention of acute diarrhea in children. Key words: Acute diarrhea; Child; Enteric pathogens