Cause Of Acute Diarrhea Research Articles

Detection of Rotavirus, Norovirus, and Astrovirus Causing Acute Diarrhoea in Children by Multiplex PCR in a Tertiary Care Hospital.

To evaluate the use of a multiplex real-time polymerase chain reaction (RT-PCR) test in detecting three viruses namely Rotavirus, Norovirus (genotypes 1 and 2), and Astrovirus that cause gastroenteritis in children under the age of five years. A cross-sectional study. Place and Duration of the Study: Department of Virology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, Pakistan, from January to July 2023. A total of 87 children having acute diarrhoea and less than 5 years of age were included in this study from the outpatient clinic. Multiplex PCR was performed for the detection of three viruses: Rotavirus, Norovirus, and Astrovirus in stool samples of patients using a commercially available PCR kit. The data were analysed using Statistical Package for Social Sciences (SPSS) version 27:00. Out of total 87 children, aged 2.5 ± 1.5 years, 56 (64.3%) were positive for multiplex RT-PCR and 31 (35.6%) were negative. Rotavirus was identified in 24 (27.5%) children as the most common cause of acute diarrhoea, followed by Norovirus in 20 (22.9%), and Astrovirus in 7 (8%) patients, while co-infection with multiple viruses occurred in 5 (5.7%) of the cases. This study revealed viral aetiology as a significant cause of acute diarrhoea in children. Multiplex PCR in the healthcare system can make it easier to identify, treat, and control the upsurge of diarrhoea. Prompt diagnosis of viral causes can lead to the prevention of unnecessary use of antibiotics. Multiplex polymerase chain reaction, Rotavirus, Norovirus, Astroviridae, Diarrhoea.

Cross-sectional study exploring the prevalence and clinical manifestations of acute diarrhea among under-5 children in primary care hospital in Democratic Republic of the Congo.

Acute diarrhea (AD), which is defined as frequent passing of liquid stools compared to normal, is a serious and worrying problem and remains a concern for healthcare systems because of its high mortality cause in children under 5 years old. The authors' study aimed to present the prevalence and to describe the clinical manifestation of AD among under-5 children. From June 2022 to May 2023, the authors conducted a retrospective, descriptive and cross-sectional study including all patients aged 0-5 years hospitalized for AD. Out of 512 patients, only 197 (38.5%) children with AD were selected for our study. The average age is 25.5 months, and the sex ratio is 1.11. Some families (75.1%) have clean latrines, and 21.8% use water from the river. Inaccessibility to clean water and intolerance or food poisoning were the causes of acute diarrhea in children. Major signs and symptoms are fever, dehydration and vomiting. Weight loss and malnutrition are the major complications of AD in children. The treatment of AD is provided by oral rehydration solutions and antibiotics. The study highlights the significant prevalence of acute diarrhea among under-5 children underscores the importance of preventive measures and government intervention, such as the introduction of rotavirus vaccination. However, conclusions regarding prevalence rates should be interpreted with caution due to the lack of detailed population data.

Azithromycin Resistance Patterns in Escherichia coli and Shigella before and after COVID-19, Kenya.

Escherichia coli and Shigella spp. are leading bacterial causes of acute diarrhea in sub-Saharan Africa and pose risks to global communities, travelers, and the US military. Increasing antimicrobial resistance (AMR) in those and other enteric pathogens creates treatment challenges for clinicians. Inappropriate use of antimicrobial drugs, such as azithromycin for viral respiratory infections, increased during the COVID-19 pandemic. We evaluated AMR trends of 116 E. coli and 109 Shigella spp. isolates obtained from 1,672 pre-COVID-19 (2017-2019) and 1,118 post-COVID-19 (2022-2023) human fecal samples from Kenya. Azithromycin resistance increased significantly from before to after COVID-19, from 6.3% to 40.4% (p = 0.001). Phenotypic AMR profiles from a subset of isolates were compared with genotypic AMR information derived from whole genome sequencing. The most common AMR gene detected was the macrolide mph(A) gene. This study highlights the need for continued AMR surveillance.

Exploring the impact of digestive physicochemical parameters of adults and infants on the pathophysiology of Cryptosporidium parvum using the dynamic TIM-1 gastrointestinal model

BackgroundHuman cryptosporidiosis is distributed worldwide, and it is recognised as a leading cause of acute diarrhoea and death in infants in low- and middle-income countries. Besides immune status, the higher incidence and severity of this gastrointestinal disease in young children could also be attributed to the digestive environment. For instance, human gastrointestinal physiology undergoes significant changes with age, however the role this variability plays in Cryptosporidium parvum pathogenesis is not known. In this study, we analysed for the first time the impact of digestive physicochemical parameters on C. parvum infection in a human and age-dependent context using a dynamic in vitro gastrointestinal model.ResultsOur results showed that the parasite excystation, releasing sporozoites from oocysts, occurs in the duodenum compartment after one hour of digestion in both child (from 6 months to 2 years) and adult experimental conditions. In the child small intestine, slightly less sporozoites were released from excystation compared to adult, however they exhibited a higher luciferase activity, suggesting a better physiological state. Sporozoites collected from the child jejunum compartment also showed a higher ability to invade human intestinal epithelial cells compared to the adult condition. Global analysis of the parasite transcriptome through RNA-sequencing demonstrated a more pronounced modulation in ileal effluents compared to gastric ones, albeit showing less susceptibility to age-related digestive condition. Further analysis of gene expression and enriched pathways showed that oocysts are highly active in protein synthesis in the stomach compartment, whereas sporozoites released in the ileum showed downregulation of glycolysis as well as strong modulation of genes potentially related to gliding motility and secreted effectors.ConclusionsDigestion in a sophisticated in vitro gastrointestinal model revealed that invasive sporozoite stages are released in the small intestine, and are highly abundant and active in the ileum compartment, supporting reported C. parvum tissue tropism. Our comparative analysis suggests that physicochemical parameters encountered in the child digestive environment can influence the amount, physiological state and possibly invasiveness of sporozoites released in the small intestine, thus potentially contributing to the higher susceptibility of young individuals to cryptosporidiosis.

Bifidobacterium longum and Chlorella sorokiniana Combination Modulates IFN-γ, IL-10, and SOCS3 in Rotavirus-Infected Cells.

Rotavirus is the main cause of acute diarrhea in children up to five years of age. In this regard, probiotics are commonly used to treat or prevent gastroenteritis including viral infections. The anti-rotavirus effect of Bifidobacterium longum and Chlorella sorokiniana, by reducing viral infectivity and improving IFN-type I response, has been previously reported. The present study aimed to study the effect of B. longum and/or C. sorokiniana on modulating the antiviral cellular immune response mediated by IFN-γ, IL-10, SOCS3, STAT1, and STAT2 genes in rotavirus-infected cells. To determine the mRNA relative expression of these genes, HT-29 cells were treated with B. longum and C. sorokiniana alone or in combination, followed by rotavirus infection. In addition, infected cells were treated with B. longum and/or C. sorokiniana. Cellular RNA was purified, used for cDNA synthesis, and amplified by qPCR. Our results demonstrated that the combination of B. longum and C. sorokiniana stimulates the antiviral cellular immune response by upregulating IFN-γ and may block pro-inflammatory cytokines by upregulating IL-10 and SOCS3. The results of our study indicated that B. longum, C. sorokiniana, or their combination improve antiviral cellular immune response and might modulate pro-inflammatory responses.

A Cross-sectional Study on the Role of Rotavirus and Microbial Co-infection in Children with Acute Diarrhea in Vietnam

Background: Rotavirus is the leading cause of acute diarrhea in children. Understanding co-infections with other bacterial or viral microorganisms alongside Rotavirus is crucial. Objectives: This study aimed to determine the frequency distribution of Rotavirus infections and related co-infections in children with acute diarrhea. Additionally, it sought to compare 2 groups: Those with Rotavirus mono-infection and those with microbial co-infections in terms of clinical and laboratory characteristics. Methods: In this cross-sectional study, we collected a total of 171 rectal swabs at Can Tho Children′s Hospital, Can Tho City, Vietnam, from November 2022 to April 2023. We used real-time polymerase chain reaction (PCR) to detect infectious agents. Patients underwent examinations and tests to assess clinical features and laboratory data. Results: Rotavirus was the most commonly detected agent (42.7%). The incidence of co-infection with other bacterial or viral microorganisms alongside Rotavirus was 45.2%. Acute diarrhea caused by Rotavirus significantly increased the percentage of children with watery stools (P = 0.004) and vomiting (P < 0.001) and led to a greater number of loose stools per day (P = 0.007) compared to cases without Rotavirus. However, there were no significant differences in clinical features or laboratory data between cases with Rotavirus mono-infection and those with co-infections involving other bacterial or viral microorganisms. Conclusions: This study sheds light on the prevalence of Rotavirus and co-infections in Vietnam. Among these findings, identifying Rotavirus in children with acute diarrhea is more critical than detecting co-infecting agents.

A-286 Performance Evaluation of Molecular Clostridium Difficile Assay using BD MaxTM System

Abstract Background Clostridium difficile (C.Diff) is a gram positive anaerobe producing Enterotoxin and Cytotoxin (toxin A and B respectively); toxin B has been reported to be essential for its virulence. It is estimated that C. Diff will cause over half a million infection yearly and one in 11 people over the age of 65 diagnosed with healthcare-associated C.Diff infection die within one month. It is the most common cause of acute diarrhea; residents in Long-Term Care Facilities (LTCF) are more prone to have C. Diff infection (CDI) because of their age, the frequent use of antibiotics, fragilities, co-morbidity, and living environment. Diagnosing CDI is based on clinical signs and symptoms as well as laboratory tests. Several tests available for diagnosing the infection which include: enzyme immunoassays, tissue culture cytotoxicity, anaerobic culture, glutamate dehydrogenase antigen and nucleic acid amplification. The BD MAX™ System is a PCR based assay that provides the sensitivity, specificity and faster turnaround. Methods The MAX™ System is an automated in vitro diagnostic test for the direct qualitative detection of the C. difficile toxin B gene (tcdB) in human liquid or soft stool specimens from patients suspected of having Clostridium difficile Infection (CDI).The test is performed directly on the specimen, utilizing real-time polymerase chain reaction (PCR) for the amplification of C. difficile toxin B gene (tcdB). The test utilizes fluorogenic sequence-specific hybridization probes for detection of the amplified DNA. The test was validated for accuracy, precision, and patient correlation to enzyme-immunoassay using Premier Toxins A & B is an enzyme immunoassay for the direct detection of Clostridium difficile toxin A and toxin B in stool samples. Statistical analyses were done using Analyse-it. Results The percentage agreement for precision, reproducibility, and accuracy were 100%. We had 100% agreement for positive patients on EIA and 85% for negative patients on EIA; however, upon investigation we found the discrepancies were due to false negative EIA results. Conclusion The BD Max gave the benefit of a fully automated with high sensitivity and specificity for the presence of toxin B producing C. Diff. The faster turnaround gives the physician the ability to diagnose CDI and prevent spreading of the disease to other patients. It is very important to remember that C.diff infection can be prevented with appropriate use of antibiotics and implementing antibiotic stewardship and infection control plan to prevent and stop spreading of the infection.

Aerotolerance and Multi-Locus Sequence Typing of Campylobacter jejuni Isolated from Commercial Broiler Processing Plants.

Campylobacter jejuni is one of the leading causes of acute diarrhea in the United States. Despite being a microaerophilic pathogen, C. jejuni continues to endure within the domain of food production, especially in poultry processing. Recent research on aerotolerance indicates that close monitoring of this pathogen is necessary. A total of 40 C. jejuni isolates previously obtained from commercial broiler processing plants were analyzed for aerotolerance and genetic diversity. In addition, the effect of aerotolerance and storage time (days) on the survival of C. jejuni on broiler drumsticks at refrigeration (4 °C) and freezing conditions (-20 °C) was also evaluated. Out of 40 isolates, 25 (62.5%) were aero-sensitive (AS), 10 (25%) were intermediately aerotolerant (IAT), and 5 (12.5%) were hyper aerotolerant (HAT). The isolates belonged to four clonal complexes (CCs) and six sequence types, with the majority of isolates assigned to the CC-353 clonal complex. C. jejuni counts were reduced by 0.40 log CFU/g after 7 days at 4 °C and by 1.50 log CFU/g after 14 days at -20 °C, respectively, irrespective of aerotolerance (p < 0.001). At both refrigeration (p < 0.013) and freezing (p < 0.001), HAT showed greater reductions as compared to AS and IAT. These findings suggest that both refrigeration and freezing reduce C. jejuni counts.

Genome analyses ofspecies A rotavirus isolated from various mammalian hosts inNorthern Ireland during 2013-2016.

Rotavirus group A (RVA) is the most important cause of acute diarrhoea and severe dehydration in young mammals. Infection in livestock is associated with significant mortality and economic losses and, together with wildlife reservoirs, acts as a potential source of zoonotic transmission. Therefore, molecular surveillance of circulating RVA strains in animal species is necessary to assess the risks posed to humans and their livestock. An RVA molecular epidemiological surveillance study on clinically diseased livestock species revealed high prevalence in cattle and pigs (31 per cent and 18 per cent, respectively) with significant phylogenetic diversity including a novel and divergent ovine artiodactyl DS-1-like constellation G10-P[15]-I2-R2-C2-M2-A11-N2-T6-E2-H3. An RVA gene reassortment occurred in an RVA asymptomatic pig and identified as a G5-P[13] strain, and a non-structural protein (NSP)2 gene had intergenomically reassorted with a human RVA strain (reverse zoonosis) and possessed a novel NSP4 enterotoxin E9 which may relate to the asymptomatic RVA infection. Analysis of a novel sheep G10-P[15] strain viral protein 4 gene imparts a putative homologous intergenic and interspecies recombination event, subsequently creating the new P[15] divergent lineage. While surveillance across a wider range of wildlife and exotic species identified generally negative or low prevalence, a novel RVA interspecies transmission in a non-indigenous pudu deer (zoo origin) with the constellation of G6-P[11]12-R2-C2-M2-A3-N2-T6-E2-H3 was detected at a viral load of 11.1 log10 copies/gram. The detection of novel emerging strains, interspecies reassortment, interspecies infection, and recombination of RVA circulating in animal livestock and wildlife reservoirs is of paramount importance to the RVA epidemiology and evolution for the One Health approach and post-human vaccine introduction era where highly virulent animal RVA genotypes have the potential to be zoonotically transmitted.

Usefulness of Stool Multiplex Polymerase Chain Reaction Assays in Patients with Acute Diarrhea

There is a recent increase in the use of stool multiplex PCR assay-based diagnostic tests in patients with acute diarrhea. We used multiplex PCR assays to analyze the distribution of diarrhea-causing bacteria and viruses, as well as the clinical features of patients with acute diarrhea. We retrospectively reviewed stool specimens of inpatients complaining of acute diarrhea from October 2018 to July 2020. The stool specimens had been tested for bacteria and viruses using multiplex PCR assays. A total of 414 stool specimens from 346 patients were tested, and 152 pathogens were detected in 131 stool samples (131/414, 31.6%). Co-infection was detected in 20 patients (20/346, 5.8%). The common pathogens detected as causes of acute diarrhea, including co-infection, were Clostridium perfringens (34.9%), Clostridioides difficile (19.7%), and Campylobacter spp. (18.4%). The average age of patients with multiplex PCR-positive tests was lower than those with multiplex PCR-negative tests (p=0.001). In patients with suspected C. difficile infection (CDI), the RT-PCR for toxin gene assay was performed in 370 stool samples, 35 of which were positive (9.5%). Furthermore, 16 of the 35 samples were positive on the multiplex PCR assay (45.7%). The multiplex PCR assay revealed that C. perfringens was the most common diarrhea-causing pathogen. In addition, in patients with suspected CDI, the multiplex PCR assay alone was insufficiently sensitive to detect pathogens and a conventional CDI test was additionally required.

Protocolo diagnóstico diferencial de la diarrea de origen infeccioso

Infectious diarrhea is the most common cause of acute diarrhea. It encompasses two large groups: watery diarrhea, which is the most common type and is mainly caused by viruses, bacteria, and parasites with little invasive capacity, and inflammatory diarrhea, characterized by feces with blood and mucus, fever, and abdominal pain and which has longer incubation and resolution times. The majority of episodes are self-limited in a few days and do not require microbiological study. It is important to properly evaluate these patients in order to identify those that require studies in order to identify the microorganism involved and the need for targeted treatment.

Hubungan Vaksinasi Rotavirus dengan Kejadian Diare pada Anak Usia 6-24 Bulan di Kota Denpasar

Diarrhea constantly becomes an issue of health because of its high mortality and morbidity. Rotavirus infection is known as the predominant cause of acute diarrhea with severe dehydration and hospitalized diarrhea among children less than five years of age. Therefore, rotavirus vaccination is supposed to provide protective effect against the diarrhea cases. The study was implemented to prove the association between rotavirus vaccination and the diarrhea cases among children 6-24 months of age in Denpasar City. The study used an observation cross-sectional analytic design located at private pediatric clinic in Denpasar City and Puskesmas III Denpasar Utara from January to June 2020. The subjects selected by consecutive sampling technique were 104 children 24-36 months of age who divided into vaccinated and unvaccinated groups. The diarrhea cases were measured retrospectively from 6-24 months of age. The study data were derived through questionnaires, processed and analyzed through chi-square and logistic regression test on SPSS. In this study, the percentage of diarrhea cases in the vaccinated group (15,4%) was smaller than the unvaccinated group (36,5%). The statistical test showed PR = 0,42, 95% CI = 0,271-0,654, and p value = 0,001 (p&lt;0,05) which means that rotavirus vaccination was significantly associated with the diarrhea cases and acts as a protective factor.&#x0D; Keywords : Children, Diarrhea, Rotavirus, Vaccination

POS-774 Role of Noro virus infection in post renal transplant persistent diarrhea

Diarrhea is common gastrointestinal problem in kidney transplant recipients. Numerous cases of post-transplant diarrhea in the past have been ascribed solely to the toxicity of immunosuppressive drugs, leading to diagnostic misconceptions. Noro Virus, one of the common cause of acute diarrhea in adult is emerging as important cause of persistent diarrhea in solid organ transplant recipients.Here, we are presenting our experience with chronic Noro virus infection in renal transplant recipients.

Immune Response after Skin Delivery of a Recombinant Heat-Labile Enterotoxin B Subunit of Enterotoxigenic Escherichia coli in Mice.

Enterotoxigenic Escherichia coli (ETEC) infections have been identified as a major cause of acute diarrhoea in children in developing countries, associated with substantial morbidity and mortality rates. Additionally, ETEC remains the most common cause of acute diarrhea of international travellers to endemic areas. The heat-labile toxin (LT) is a major virulence factor of ETEC, with a significant correlation between the presence of antibodies against LT and protection in infected patients. In the present work, we constructed a recombinant LTB unit (rLTB) and studied the capacity of this toxoid incorporated in microneedles (rLTB-MN) to induce a specific immune response in mice. MN were prepared from aqueous blends of the polymer Gantrez AN® [poly (methyl vinyl ether-co-maleic anhydride)], which is not cytotoxic and has been shown to possess immunoadjuvant properties. The mechanical and dissolution properties of rLTB-MNs were evaluated in an in vitro Parafilm M® model and in mice and pig skin ex vivo models. The needle insertion ranged between 378 µm and 504 µm in Parafilm layers, and MNs fully dissolved within 15 min of application inside porcine skin. Moreover, female and male BALB/c mice were immunized through ear skin with one single dose of 5 μg·rLTB in MNs, eliciting significant fecal anti-LT IgA antibodies, higher in female than in male mice. Moreover, we observed an enhanced production of IL-17A by spleen cells in the immunized female mice, indicating a mucosal non-inflammatory and neutralizing mediated response. Further experiments will now be required to validate the protective capacity of this new rLTB-MN formulation against this deadly non-vaccine-preventable disease.

Clinical Profile and Characterization of Rotavirus Strains in Under-Five Children with Diarrhea: A Hospital-Based Study from Eastern Odisha, India

Abstract Objective Diarrheal diseases are one of the most common causes of hospitalization in children under five. Rotavirus is the most common cause of acute diarrhea in younger children, and the prevalence decreases rapidly with increasing age. The objective of the study was to estimate the burden of rotavirus infection in acute gastroenteritis among under-five children admitted to a tertiary care hospital in eastern Odisha, for the clinical profile and identity of the prevalent strains. Methods This was a prospective observational study linked to the National Rotavirus Surveillance Network (NRSN), where 720 under-five children with diarrhea were enrolled. In total, 675 stool samples of eligible candidates were sent for rotavirus isolation, and identification of strains was done by identifying VP7 (G-type) and VP4 (P-type) genes by reverse transcription polymerase chain reaction. Results Categorical variables were presented as frequency and percentage, and continuous variables were expressed as mean ± standard deviation. Rotavirus was detected in 256 (37.92%) samples. Males outnumbered females. The most common affected age group was 7 to 12 months, followed by 13 to 18 months. G3P[8] was the most prevalent strain in this study. Conclusion Children between the age of 7 and 18 months were most vulnerable to rotavirus infection. The most prevalent strain varies from one region to another and continuous surveillance is needed.

Antibacterial Activity of Bay Leaf (Syzygium polyanthum) Ethanol Extract on Escherichia coli Growth

Acute diarrhea is liquid stool with a frequency of more than 3 times a day and lasts less than 14 days. One of the most common causes of acute diarrhea is Escherichia coli. Diarrhea caused by bacteria can be treated with the use of antibiotics, but the relatively high intensity of antibiotic use causes various health problems, especially bacterial resistance. Therefore, the search for antibacterial agents derived from natural ingredients was carried out as an alternative treatment. Bay leaf (Syzygium polyanthum) is one of the natural ingredients that has the potential as an antibacterial because it contains active compounds such as essential oils, flavonoids (quercetin), saponins, tannins, and alkaloids. This study aimed to analyze the antibacterial activity of the ethanolic extract of bay leaves on the growth of Escherichia coli. This research uses the dilution method which aims to determine the Minimum inhibitory concentration (MIC) and Minimum bactericidal concentration (MBC). The results showed that the MIC value at a concentration of 200mg/ml and the MBC value at a concentration of 500mg/ml.

Prevalence of Diarrheagenic E. Coli Among Hospitalized Children in a Clinical Centre

Abstract Introduction. Escherichia coli is a common cause of acute diarrhea mainly in young children and, less frequently, in elderly or immunosuppressed patients. Many types of E. coli are part of the normal enteric flora, but can cause urinary tract or nervous system infections. Objective. To study the prevalence of the main types and serogroups of diarrheagenic E. coli among hospitalized children with enteric infections. Material and methods. Over a period of 5 years, 1,160 hospitalized children with acute diarrhea syndrome were studied. Fecal samples underwent culturing, biochemical and phenotypic identification. Results. Among the studied patients, 112/1,160 children (9.7%) had diarrhea caused by E. coli, and only 4 of the isolates were lactose-negative. The most common was diarrhea caused by ETEC – 65/112 (58.0%), followed by EPEC – 38/112 (33.9%), and in third place – EHES 9/112 (8.0%). We did not isolate EIEC types. Depending on the group of E. coli, we observed some differences in the clinical presentation and specifics in the distribution of patients by age. Conclusion. The study shows that this causative agent is common among Bulgarian children with diarrhea. Unfortunately, in Bulgaria the microbiological network is still not able to adequately respond to the challenges of the extended serodiagnosis for detection of diarrheagenic E. coli, which is performed in Western Europe and North America.

Molecular and epidemiological characterization of human adenoviruses infection among children with acute diarrhea in Shandong Province, China

BackgroundHuman adenovirus (HAdV) had been recognized as one of the most common enteric viruses associated with acute diarrhea in children. The present study was carried out to demonstrate the molecular and epidemiological characterization of HAdV Infections among children in Shandong province in China between July 2017 and June 2018.MethodsFecal specimens were collected from children under 5 years old with acute diarrhea. DNA was extracted from the stool specimens and adenovirus DNA was detected by PCR amplification with specific primers. The amplification products were subjected to electrophoresis and visualized on a UV transilluminator. All positive RT-PCR amplification products were sequenced and the obtained sequences analyzed by MEGA (version 7.0). Demographic information and clinical manifestation data were also analyzed.ResultsIn total, 656 fecal specimens were collected and the overall positive rate of HAdV was 7.47%. HAdV infections were detected in all age groups, in which children aged 13–24 months presented the highest positive rate. Seasonal pattern could be observed with a peak in December, January and February. Diarrhea, vomiting, dehydration and fever were the main clinical manifestations, in which vomiting was the most common accompanied symptom. By phylogenetic analysis, four species (A, B, C, and F) were detected and seven different serotypes were identified. HAdV-41 (48.98%, 24/49) was the most common serotype followed by HAdV-3 (18.37%, 9/49), HAdV-31 (14.29%, 7/49), HAdV-7 (8.16%, 4/49), HAdV-40 (4.08%, 2/49), HAdV-1 (4.08%, 2/49) and HAdV-2 (2.04%, 1/49).ConclusionThis study indicated that HAdV infection was an important cause of acute diarrhea among children under 5 years old in Shandong province. The results will contribute to (a) increase understanding of the role of HAdV in diarrheal children and enhance identification of the predominant diarrhea pathogen for diagnosis; (b) avoid abuse of antibiotics; (c) monitor the change of prevalent HAdV serotypes and promote vaccine development and vaccination.

Evaluation of Molecular and Culture Method for Detection of Campylobacter, Salmonella, E. coli and Shigella in children infected with Diarrhea

Acute diarrhea is the second most common cause of children deaths worldwide. Bacterial pathogens havebeen confirmed as the major cause of acute diarrhea among children. In this study, 100 stool samples wereinvestigated from pediatric children with acute diarrheal illness aged from 1 month to 5 years old. Bacterialinvestigated was performed for the common enteric pathogens: Campylobacter, Salmonella, Shigella, andDiarrheagenic Escherichia coli included Microscopy, culture and confirmatory identification by biochemicalreactions included API 20E system. Finally, the real time PCR investigated for these enteric bacteria. Theoverall prevalence of the pathogens for Campylobacter, Salmonella, Shigella and Diarrheagenic E. coli were9%, 8%, 3% and 14%, respectively. The results showed significant association of the clinical symptoms withShigella and Salmonella infection. The RT-PCR markedly improves the detection rates of bacterial stoolpathogens and offers culture methods.

Antibiotic resistance pattern in Shigella species isolated from children with acute diarrhea in Tabriz city, Iran

Background and aim: Shigella is one of the leading causes of acute diarrhea in children worldwide. Antibiotic resistance in this bacterium has increased due to the indiscriminate use of common antibiotics. Therefore, the aim of this study was to investigate the prevalence and pattern of antibiotic resistance in Shigella species isolated from children with acute diarrhea in Tabriz hospitals.&#x0D; Materials and methods: In this descriptive cross-sectional study, 321 samples suspected of Shigella were collected from children's diarrhea stool samples and identified using standard microbiological and biochemical tests. Antibiotic resistance was also determined using disk diffusion by the Kirby-Bauer method.&#x0D; Results: A total of 84 samples were positive for Shigella. Among them, S. flexneri species with 83.3% had the highest frequency and S. boydii with 13.1%, S. sonnei with 2.4% and S. dysanteriae with 1.2% had the lowest frequency. The highest resistance was related to the antibiotics cotrimoxazole (92.85%), tetracycline and ampicillin (67.86%) and the lowest resistance was related to imipenem antibiotics (2.38%) and ceftizoxime (9.52%). &#x0D; Conclusion: The present study showed that Shigella flexneri is the predominant species isolated from children with Shigellosis in hospitals in Tabriz city. Our results also indicate an increase in resistance to common antibiotics. Therefore, it is recommended that antimicrobial susceptibility testing be performed in the study area prior to antibiotic administration.