The 12 Gastrointestinal Pathogens Spectrum of Acute Infectious Diarrhea in a Sentinel Hospital, Shenzhen, China.

Hongwei Shen,Jinjin Zhang,Yixiang Jiang,Qinghua Hu,Yanjie Wu,Chaoman Situ,Yinghui Li,Sirou Xie,Haolian Mo,Hong Yang,Yuhui Ye

doi:10.3389/fmicb.2016.01926

Abstract

Acute infectious gastroenteritis is one of the most common diseases among all ages, particularly in developing countries. The pathogen spectrum may differ among different regions and seasons. To investigate the etiology of acute diarrhea in Shenzhen, a prospective study was conducted from August 2014 to September 2015. Stools from 412 patients with diarrhea (286 of whom were adults) including the general epidemiological information of the patients were collected. The 19 pathogens were detected by conventional culture method or multiplex PCR assay, which included five viruses (rotavirus, adenovirus, sapovirus, norovirus, and astrovirus), 11 bacterial pathogens (Salmonella, Campylobacter jejuni, Shigella, Listeria monocytogenes, Vibrio parahaemolyticus, Vibrio cholera, Enterohemorrhagic (EHEC), enteropathogenic (EPEC), enteroinvasive (EIEC), enterotoxigenic (ETEC); and enteroaggregative Escherichia coli (EAEC)) and three parasites (Entamoeba histolytica, Giardia lamblia, and Cryptosporidium parvum). A potential pathogen and coinfection was found in 41.5 and 7.0% of cases, respectively. The bacterial infection was the dominant cause of diarrhea (32.3%), and the three most frequently identified organisms were Salmonella (12.1%), ETEC (8.0%), and Campylobacter jejuni (4.9%). Salmonella enteritidis was the leading serotype of Salmonella sp. Norovirus (8.3%) and sapovirus (2.2%) were the most common viral pathogens, followed by adenovirus (1.5%) and rotavirus (1.2%). No EHEC, L. monocytogenes, V. cholera, Shigella, and parasites were found. The single most important causes of diarrhea were Salmonella spp. and Campylobacter jejuni, which points toward the need for testing and surveillance for these pathogens in this region.

Highlights

Acute infectious diarrhea accounts for substantial morbidity and mortality in all regions in the world and among all ages (Fischer Walker et al, 2010), with over 2 million death occurring each year, among infants younger than 5 years (Clarke et al, 2003; Kosek et al, 2003)
Stool samples were consecutively collected by Peking University Shenzhen Hospital from patients who presented with acute diarrhea to the diarrhea outpatient clinics during the period from August 2014 through September 2015
Bacterial pathogens were confirmed as the leading cause of acute infectious diarrhea in outpatients in Shenzhen

Summary

Introduction

Acute infectious diarrhea accounts for substantial morbidity and mortality in all regions in the world and among all ages (Fischer Walker et al, 2010), with over 2 million death occurring each year, among infants younger than 5 years (Clarke et al, 2003; Kosek et al, 2003). In developing countries, such as China, the associated mortality is high because of the high incidence and poor medical condition in some regions. Some less common pathogens, such as astrovirus, and parasites may cause acute diarrhea (Olesen et al, 2005; Denno et al, 2012)

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Conclusion