Cause Of Diarrhea Research Articles

The Rationality of Antibiotics Use on Acute Diarrhea to Pediatric Inpatients in the Fatmawati Hospital for 2018-2019 Period

Background: Diarrhea is characterized by an increase in the frequency of bowel movements more than three times a day. This disease has a fairly high incidence rate in Indonesia, especially in children. One of the causes of diarrhea is a bacterial infection, therefore it needs to be treated with antibiotics. Several studies show that there are still many antibiotics that are used irrationally. It is necessary to analyze the rationality of the use of antibiotics in pediatric patients with diarrhea using the Gyssens method Objectives: This study is to ascertain the profile of acute diarrhea pediatric patients characteristic and evaluate antibiotics rationality with Gyssens method. Moreover, the purpose of this study is to analyze the factors that influence the rationality of the use of antibiotics in the inpatient pediatric acute diarrhea installation of Fatmawati Hospital 2018-2019 period. Material and Methods: This study is descriptive observational research. The study design was cross-sectional with retrospective data collection which was analysed then qualitatively with the Gyssens flow method Results: The result showed 54,29% antibiotics usde appropriately and rational. The irrational use of antibiotics was 45.7%. The results of statistical analysis with chi-square show a significant relationship between the rationality of antibiotics and the type of antibiotic (ρ = 0.000 < 0.05) and multiple logistic regression analysis showed that the route of drug administration (ρ = 0.000 < 0.05) affected the rationality of antibiotics use. Conclusions: Less than 50% of the patients received irrational treatment according to the Gyssen flow chart and according to the results of statistical analysis, the type of antibiotic and the route of drug administration affected the rationality of antibiotics.

Whole Genome Sequence Analysis of a Prototype Strain of the Novel Putative Rotavirus Species L.

Rotaviruses infect humans and animals and are a main cause of diarrhea. They are non-enveloped viruses with a genome of 11 double-stranded RNA segments. Based on genome analysis and amino acid sequence identities of the capsid protein VP6, the rotavirus species A to J (RVA-RVJ) have been defined so far. In addition, rotaviruses putatively assigned to the novel rotavirus species K (RVK) and L (RVL) have been recently identified in common shrews (Sorex araneus), based on partial genome sequences. Here, the complete genome sequence of strain KS14/0241, a prototype strain of RVL, is presented. The deduced amino acid sequence for VP6 of this strain shows only up to 47% identity to that of RVA to RVJ reference strains. Phylogenetic analyses indicate a clustering separated from the established rotavirus species for all 11 genome segments of RVL, with the closest relationship to RVH and RVJ within the phylogenetic RVB-like clade. The non-coding genome segment termini of RVL showed conserved sequences at the 5′-end (positive-sense RNA strand), which are common to all rotaviruses, and those conserved among the RVB-like clade at the 3′-end. The results are consistent with a classification of the virus into a novel rotavirus species L.

Characterization of Bacterial Microbiota Composition in Healthy and Diarrheal Early-Weaned Tibetan Piglets

The occurrence of diarrhea in Tibetan piglets is highly notable, but the microorganisms responsible are yet unclear. Its high incidence results in serious economic losses for the Tibetan pig industry. Moreover, the dynamic balance of intestinal microflora plays a crucial role in maintaining host health, as it is a prime cause of diarrhea. Therefore, the present study was performed to analyze the characteristics of bacterial microbiota structure in healthy, diarrheal and treated weaned piglets in Tibet autonomous region for providing a theoretical basis to prevent and control diarrhea. The study was based on the V3–V4 region of the 16S rRNA gene and gut microbiota functions following the metagenome analysis of fresh fecal samples (n = 5) from different groups. The Shannon and Simpson indices differed substantially between diarrheal and treated groups (p < 0.05). According to our findings, the beta diversities, especially between healthy and diarrheal groups, were found different. Firmicutes, Bacteroidetes and Proteobacteria were the dominant phyla in three groups. Furthermore, the abundance of Fusobacteria in the diarrheal group was higher than the other groups. The dominant genera in the diarrheal group were Fusobacterium, Butyricimonas, Sutterella, Peptostreptococcus, and Pasteurella. Moreover, Lactobacillus, Megasphaera and Clavibacter were distinctly less abundant in this group. It is noteworthy that the specific decrease in the abundance of pathogenic bacteria after antibiotic treatment in piglets was noticed, while the level of Lactobacillus was evidently increased. In conclusion, fecal microbial composition and structure variations were discovered across the three groups. Also, the ecological balance of the intestinal microflora was disrupted in diarrheal piglets. It might be caused by a reduction in the relative number of beneficial bacteria and an increase in the abundance of pathogenic bacteria. In the context of advocating for non-resistant feeding, we suspect that the addition of probiotics to feed may prevent early-weaning diarrhea in piglets. Moreover, our findings might help for preventing diarrhea in weaned Tibetan piglets with a better understanding of microbial population dynamics.

Management of severe diarrhea in an AIDS patient with inflammatory bowel disease with Short Bowel Syndrome

Introduction: The human immunodeficiency virus (HIV) can lead to a loss of lymphoid tissue through the intestinal mucosa, making the intestine susceptible to infections and inflammation. As a result, the patient may present with Crohn's Disease (CD), a chronic inflammatory bowel disease (IBD). Short Bowel Syndrome (SBS) results from loss of bowel absorption capacity after extensive bowel resection and is associated with several complications. Objective: To report the case of a patient presenting with acute chronic diarrhea, of probable multifactorial etiology, secondary to HIV, CD, and SBS. Methods: The information contained in this report was obtained through a review of the medical record and a review of the literature. Case Report: This is the report of E. F. C, male, 49 years old, who was admitted to the ICU of Hospital Ernesto Dornelles, in Porto Alegre, from 12/04/2020 to 01/07/2021, with HIV, CD, and SBS. The patient was admitted complaining of diarrhea that had started 15 days ago, which had worsened in the last 7 days, with loss of appetite, vomiting episodes, and mental confusion. Using empirical Lamivudine, Zidovudine, Tenofovir, Ciprofloxacin and Metronidazole, Methotrexate and Prednisone. On physical examination, he was sleepy, afebrile, with a normotensive abdomen, severe dehydration, and edema 3+/4+. From anthropometry, the measured weight of 50 kg, reported height of 1.70 m, and BMI of 17 kg/m2. On laboratory tests, he had severe pancytopenia and electrolyte disturbances. Although the cause of diarrhea was not clarified, bowel rest and the use of glutamine and enteral symbiotic were chosen, while treating HIV and CD, to improve enterocyte nutrition and reduce bacterial translocation capable of causing septic conditions. Despite this, diarrhea was untreatable, mean greater than 1,000 ml/day, with indication, but without the possibility of total parenteral nutrition, due to thrombocytopenia. On 12/06, E. F. C was in poor general condition, anasarca, tachycardic, hypotensive, treating septicemia caused by Candida tropicalis. On 12/07, he presented no spontaneous breathing, absence of central pulses and pupillary reflexes, opted not to institute invasive measures, and died. Final Considerations: The report highlights the need to cover IBD and opportunistic infections in the differential diagnosis of diarrhea in AIDS patients with CD and SBS. It also demonstrates the challenge of nurturing the patient who does not have conditions for enteral and/or parenteral nutrition, with a high risk of malnutrition due to the catabolism of such pathologies.

The Current Epidemiology of Rotavirus Infection in Children Less than 5 Years of Age after Introduction of RV Vaccine in India

Rotavirus is a major cause of severe acute gastroenteritis in infants and young children worldwide. It is responsible for 40% of childhood hospitalization. It has been estimated that about 23% of diarrhoeal death occurs due to the rotavirus infection in India. To study the epidemiology of rotavirus infection in children less than 5 years of age at a tertiary care teaching hospital. A total of 240 stool samples were collected from children &lt;5 years of age suffering from acute diarrhea at a tertiary health care referral hospital in Western Uttar Pradesh, India. Rotavirus antigen was detected in stool by Enzyme immunoassay (EIA) which utilizes monoclonal antibodies directed against VP6 antigen. Molecular genotyping was done by nested multiplex PCR. The rotavirus antigen positivity rate was found to be 14.58% in this study. There was male preponderance and the male: female ratio was 1.5:1. Rotavirus diarrhoea was reported predominantly (42.85 %) in the age group of 13 to 24 months. The most common circulating G/P genotype strain was G9P[4] accounting for 36% of cases. Rotavirus remains a major cause of diarrhoea in children &lt;5 years of age in Uttar Pradesh. However, the positivity rate has decreased after introduction of rotavirus vaccine into the Universal immunization program (UIP) in UP.

A189 INFLAMMATORY BOWEL DISEASE IN PEDIATRIC PATIENTS POST RENAL TRANSPLANT:A CASE SERIES

BackgroundDiarrhea in renal transplant recipients may be due to infection, medication induced colitis and post-transplant lymphoproliferative disease. Uncommonly a subset of these children develop denovo inflammatory bowel disease (IBD), despite being already immunosuppressed. Paucity of literature in the pediatric population has been noted.AimsTo describe the clinical presentation, investigations and response to treatment in a cohort of children diagnosed with IBD post renal transplantMethodsPatients diagnosed with IBD post renal transplant between January 1 - October 1, 2021 at BC Children’s Hospital were identified. Medical history, symptoms at presentation, histological characteristics, results of investigations and response to treatment were reviewedResultsData of 3 children were collected. Ages of the children were 11, 16 and 17 years (2 female). All patients had bloody diarrhea, abdominal pain and weight loss for 1 to 2 months. IBD diagnosis was made 8, 7 and 4 years respectively post renal transplant. All children were on maintenance immunosuppression with prednisone, MMF and tacrolimus. Bacterial, viral and parasitic causes were ruled out by relevant studies. All patients had negative anti-tissue transglutaminase.Patient 1 (transplanted for renal dysplasia) was diagnosed with Crohn disease involving the antrum, ileum, and colon with rectal sparing. Fecal calprotectin (FC) was 1742 ug/g, CRP elevated at 56mg/L. Histology showed focally active chronic gastritis and changes in ileum with cryptitis and crypt dropout. The colon had features of moderate chronic active colitis with focal severe ulceration in the rectum. The patient achieved clinical remission on treatment with methylprednisolone, then started on vedolizumab in context of rising BK virus titre.Patient 2 (transplanted for focal segmental glomerulosclerosis) was diagnosed with indeterminate colitis involving the IC valve and scattered colonic ulcers. FC was 674 ug/g and CRP and ESR were normal. Histology showed normal ileum, moderate active chronic changes in colon and rectal sparing. Clinical remission was achieved with oral mesalamine.Patient 3 (transplanted for Bardet-Biedl syndrome) was diagnosed with indeterminate colitis with a colonoscopy that showed patchy colonic erythema and normal ileum. FC was 966 ug/g, and CRP and ESR were normal. Histology showed patchy chronic active colitis and mild active ileitis. Clinical remission was achieved with oral and rectal mesalamine.ConclusionsDenovo IBD occurs in children post renal transplant and must be considered in the differential for ongoing diarrhea in these patients. It can be a challenge to distinguish between IBD and other causes of diarrhea. The patients in this series entered clinical remission in a short period of time. Further exploration of the pathogenesis of IBD in these immunosuppressed patients would be valuableFunding AgenciesNone

Genomic diversity and intragenic recombination of species C rotaviruses.

Rotavirus C (RVC) is a major cause of diarrhoea in swine, cattle, and humans worldwide. RVC exhibits sequence diversity in all 11 genes, especially in VP4 and VP7, and all segment-based genotyping has been performed similar to rotavirus A. To date, recombination events have been reported in rotavirus A and B. However, there are no reports describing gene recombination of RVC, except for recombination in NSP3 between RVC and rotavirus H. In this study, nine porcine RVC strains identified in Japanese pigs were completely sequenced and analysed together with RVC sequences from the GenBank database. The analyses showed that sequences of the VP4, VP2, and NSP1 of several porcine RVC strains did not branch with any of those of the RVC strains in the GenBank database, suggesting new genotypes. Several homologous recombination events, between or within genotypes, were identified in the VP4, VP7, VP2, NSP1, and NSP3 genes. Of these, nine, one, and one intergenotypic recombination events in the VP4, VP2, and NSP3 genes, respectively, were supported with sufficient statistical values. Although these findings suggest occurrences of the intragenic recombination events in the RVC genome, potential sequence errors and poor sequence assemblies in the databases should be watched with care. The results in this study present data about the important recombination events of the RVCs, which influence evolution of the virus by aiding them to gain genetic diversity and plasticity, although further sequence data will be necessary to obtain more comprehensive understanding of such mechanisms.

THE LEVEL OF MOTHER’S KNOWLEDGE ON THE USE OF ZINC IN TODDLERS WITH DIARRHEA IN KARANG PRING HAMLET, RW 01, SUMBER JERUK VILLAGE

Diarrhea is influenced by several factors, including environmental conditions, community behavior, community services, nutrition, population, education which includes knowledge, and socio-economic conditions. Diarrhea is defecation in the form of liquid more than three times in one day and lasts for two or more days. The cause of diarrhea is mostly due to infection.Prevention of diarrhea that can be done is to continue breastfeeding, formula milk, and solid baby food, give ORS or sugar-salt solution to replace lost fluids, give foods that contain fiber, and give zinc for 10 consecutive days.The purpose of this study was to determine the level of mother's knowledge of the use of zinc in toddlers with diarrhea in Karang Pring RW 01, Sumber Jeruk village in the realm of knowing, understanding, and application. The method used is descriptive method with cross sectional analysis research design. In this study, the researcher used a validated questionnaire instrument. The sampling technique used total sampling and obtained 44 samples.Based on the results of data analysis, it was obtained that the percentage level of mother's knowledge on the use of zinc in toddlers with diarrhea in Karang Pring RW 01, Sumber Jeruk village for the July 2021 period in the tofu domain was 64.6%, the understanding domain was 74.2%, and in the application domain 72.7 %. The conclusion in this study is that the realm of knowing is categorized as sufficient, the realm of understanding is categorized as sufficient and in the realm of application it is categorized as sufficient. Keywords: Knowledge level, Diarrhea, zinc

THE LEVEL OF MOTHER’S KNOWLEDGE ON THE USE OF ZINC IN TODDLERS WITH DIARRHEA IN KARANG PRING HAMLET, RW 01, SUMBER JERUK VILLAGE

Diarrhea is influenced by several factors, including environmental conditions, community behavior, community services, nutrition, population, education which includes knowledge, and socio-economic conditions. Diarrhea is defecation in the form of liquid more than three times in one day and lasts for two or more days. The cause of diarrhea is mostly due to infection.Prevention of diarrhea that can be done is to continue breastfeeding, formula milk, and solid baby food, give ORS or sugar-salt solution to replace lost fluids, give foods that contain fiber, and give zinc for 10 consecutive days.The purpose of this study was to determine the level of mother's knowledge of the use of zinc in toddlers with diarrhea in Karang Pring RW 01, Sumber Jeruk village in the realm of knowing, understanding, and application. The method used is descriptive method with cross sectional analysis research design. In this study, the researcher used a validated questionnaire instrument. The sampling technique used total sampling and obtained 44 samples.Based on the results of data analysis, it was obtained that the percentage level of mother's knowledge on the use of zinc in toddlers with diarrhea in Karang Pring RW 01, Sumber Jeruk village for the July 2021 period in the tofu domain was 64.6%, the understanding domain was 74.2%, and in the application domain 72.7 %. The conclusion in this study is that the realm of knowing is categorized as sufficient, the realm of understanding is categorized as sufficient and in the realm of application it is categorized as sufficient.Keywords: Knowledge level, Diarrhea, zinc

Knowledge, Attitudes and Practices of Mothers with Children Under Five Years towards Diarrheal Diseases in Displaced People Camp

A cross sectional-community based study was conducted in Al-Salaam displaced people Camp to assess knowledge, attitudes and practices of mothers with under five years children towards diarrheal diseases, the study aimed to study knowledge, attitudes and practices of mothers with under five years children towards diarrheal diseases. 380 mothers with fewer than five children were selected using a systematic random sampling technique. The data collected through structured questionnaire designed to cover all research objectives and observations. The statistical Package for Social Science (SPSS) was used to analyze the data; the results were presented in figures. The study clarified that mothers have low knowledge regarding the possible causes of diarrheal diseasess. Large number of mothers (70.5%) believe that tooth loss is a major cause of diarrhea in children under five years old, regarding practices during diarrheal infections, 50.8% of mothers increased numbers of meals to their children. Very small numbers of mothers (28.2%) prepared oral rehydration salts solution correctly, most mothers believe in seeking health services when home management was failed, sanitation was very weak, the majority (78%) of residences were using shared toilets. The study recommended that the local health authorities should increase knowledge of mothers about diarrheal diseases and its management through health education sessions, provision of clean water and sanitation services.

Intraepithelial and Lamina Propria Lymphocytes Do Not Correlate With Symptoms or Exposures in Microscopic Colitis.

INTRODUCTION:Microscopic colitis, a common cause of diarrhea, is characterized by a largely normal appearance of the mucosa but increased numbers of lymphocytes in the epithelium and lamina propria on microscopy. We sought to determine whether T-cell percentage was associated with exposures or symptoms.METHODS:We conducted a case-control study that enrolled patients referred for colonoscopy for diarrhea. Patients were classified as microscopic colitis cases or controls by an experienced pathologist. Participants provided information on symptoms and exposures during a telephone or internet survey. Research biopsies from the ascending colon and descending colon were examined using immunofluorescence stains for CD3, CD8, and FOXP3 to determine percent T cells per total epithelial or lamina propria cells. Digital images were analyzed by regions of interest using Tissue Studio.RESULTS:There were 97 microscopic colitis cases and 165 diarrhea controls. There was no association between demographic factors and percentage of intraepithelial or lamina propria T cells. In cases, the mean percent T cells were similar in the right colon and left colon. There was no association between mean percent T cells and stool frequency or consistency. There was no association with irritable bowel syndrome, abdominal pain, or medications purported to cause microscopic colitis.DISCUSSION:The lack of association between the density of T cells and medications raises further doubts about their role in disease etiology. Loose and frequent stools in patients with microscopic colitis are not correlated with T-cell density.

Seroprevalence of Rotavirus among Selected Group of Sudanese Children

Rota virus is the second causes of diarrhea among childrenIn Sudan [2]. The current study was conduct to detect rotavirus gastroenteritis among vaccinated children Methodolgy: A total of59 diarrheal samples was collected from children with acute diarrhea admittedto Mohammed AL Amin Hamid paediatric Hospital throw period from October to November 2019, ELISA was dine to detect Rota virus antigen. Result: Out of 59 samples 84.7% was vaccinated were 15.3% was unvaccinated.in total of 50 vaccinated children 30% is re-infected with rota virus with acute to chronic illness and show positive antigen with ELISA. Conclusions: vaccinated children is infected with rota virus and symptoms is occurs samples for virus antigen was record positive result in ELISA this may related to other genotype or serotype or mutation.

Pengetahuan Ibu Balita Tentang Hygiene Makanan Dan kejadian Diare Pada Balita Di Puskesmas Pekauman Banjarmasin

Diarrhea or defecation (BAB) liquid disease is one of the diseases that often attack children. One of the causes of diarrhea is disseminated through oral channels through contaminated food or water, poor hygiene and poor sanitation. Mother's behavior in maintaining cleanliness and processing food is strongly influenced by the mother's knowledge about how to process and prepare healthy and clean food. The purpose of the study to find out if there is a relationship of the level of knowledge of toddler mothers about food hygiene with the occurrence of diarrhea in toddlers in the working area of The Pekauman Health Center Banjarmasin. The method in this study used analitik correlation with the cross sectionalapproach. The number of samples of 114 respondents taken purposive sampling and data analysis using univariate, bivariate with Sperman rank test showed that the mother's knowledge about food hygiene, most of the respondents were knowledgeable enough as many as 50 people (43.9%), the incidence of diarrhea in toddlers, most of the respondents categorized diarrhea as many as 39 people (34.2%). The results of the sperman rank statistical test show p=0.000 (p&lt;0.05), with correlations coefficient = 0.731, so HI is accepted. It can be concluded that there is a relationship of the level of knowledge of toddler mothers about food hygiene with the incidence of diarrhea in toddlers aged 1-4 years in the working area of The Pekauman Health Center Banjarmasin.&#x0D; Keywords: Knowledge, Food Hygiene, Diarrhea Incidence

IDENTIFICATION OF BACTERIA CAUSING DIARRHEA IN UNDER-FIVES CHILDREN USING CULTURE METHODS IN BIMA, INDONESIA

Background: Diarrhea is still a world health issue which is one of the leading causes of morbidity and mortality, with a mortality rate of close to more than 1.30 million deaths globally in 2015. The prevalence period of diarrhea in Indonesia for under-five children in 2018 is 12.30%. The West Nusa Tenggara province is third of the ranks based on doctor’s diagnosis (13.45%) and clinical symptoms (15.12%). Purpose: This study aims to identify the bacterial infection that causes diarrhea among under-five children in Bima District, West Nusa Tenggara Province. Methods: The cross-sectional study was conducted on under-five children brought to Bolo and Wawo’s Public Health Center with diarrhea and diagnosed with acute gastroenteritis. Results: The samples involved in this study were 102 samples and the results obtained were 1 to 2 types of bacteria in 1 sample. The order of bacteria from the most is E. Coli (29.53%), Klebsiella, sp (25,50%), Shigella, sp (18,79%), Staphylococcus aureus (16,78%), Salmonella Thypii (8,73%), Proteus, sp (0,67%), male (61.76%) had more diarrhea than female (38.24%), with an age range of 1-3 years (53.92%), 0-1 years (37.26%), and 3 until &lt;5 years (8.82%). Conclusion: In this research, it was proven that E. coli bacteria are the leading cause of diarrhea in under-five children.

THE PATTERN OF COMPLEMENTARY FEEDING AFFECTS THE INCIDENCE OF DIARRHEA IN INFANTS

Background: Complementary foods for breast milk are foods or drinks that have energy and nutrients that are given to infants or children aged 6-24 months to meet nutritional needs not only from breast milk. One of the causes of diarrhea in toddlers is hygiene, including knowledge and attitudes of mothers in feeding, where babies have been fed other than breast milk before the age of 6 months. The pattern of giving complementary foods to breast milk affects the incidence of diarrhea. According to WHO, infants who receive complementary feeding before the age of six months will have a 17 times greater risk of experiencing diarrhea and 3 times more likely to develop upper respiratory tract infections (ARI) than infants who only receive exclusive breastfeeding and receive complementary feeding on time. The purpose of this study was to determine the relationship between complementary feeding and the incidence of diarrhea in infants by using a literature review study. Methods: This study uses a systematic review of articles published between 2014-2020 in the Science Direct, Scopus, Pubmed, and Google Scholar databases so that the results are 11 articles that are reviewed and meet the inclusion and exclusion criteria, included as samples for further review. Results: The factors that cause diarrhea are the child's age (6-11 months), the nutritional status of the child, exclusive breastfeeding, bottle feeding, washing hands with water, water supply, use of healthy latrines, and season. Conclusion: there is a relationship between complementary feeding and the incidence of diarrhea in infants.Keywords: Complementary Foods for Breastfeeding, Diarrhea, Infants, Literature Review

Clostridioides difficile infection and One Health: an equine perspective.

Summary Clostridioides (Clostridium) difficile presents a significant health risk to humans and animals. The complexity of the bacterial–host interaction affecting pathogenesis and disease development creates an ongoing challenge for epidemiological studies, control strategies and prevention planning. The recent emergence of human disease caused by strains of C. difficile found in animals adds to mounting evidence that C. difficile infection (CDI) may be a zoonosis. In equine populations, C. difficile is a known cause of diarrhoea and gastrointestinal inflammation, with considerable mortality and morbidity. This has a significant impact on both the well‐being of the animal and, in the case of performance and production animals, it may have an adverse economic impact on relevant industries. While C. difficile is regularly isolated from horses, many questions remain regarding the impact of asymptomatic carriage as well as optimization of diagnosis, testing and treatment. This review provides an overview of our understanding of equine CDI while also identifying knowledge gaps and the need for a holistic One Health approach to a complicated issue.

Genome-wide transcriptome analysis of porcine epidemic diarrhea virus virulent or avirulent strain-infected porcine small intestinal epithelial cells.

Porcine epidemic diarrhea virus (PEDV) is the main cause of diarrhea, vomiting, and mortality in pigs, which results in devastating economic loss to the pig industry around the globe. In recent years, the advent of RNA-sequencing technologies has led to delineate host responses at late stages of PEDV infection; however, the comparative analysis of host responses to early-stage infection of virulent and avirulent PEDV strains is currently unknown. Here, using the BGI DNBSEQ RNA-sequencing, we performed global gene expression profiles of pig intestinal epithelial cells infected with virulent (GDS01) or avirulent (HX) PEDV strains for 3, 6, and 12 ​h. It was observed that over half of all significantly dysregulated genes in both infection groups exhibited a down-regulated expression pattern. Functional enrichment analyses indicated that the differentially expressed genes (DEGs) in the GDS01 group were predominantly related to autophagy and apoptosis, whereas the genes showing the differential expression in the HX group were strongly enriched in immune responses/inflammation. Among the DEGs, the functional association of TLR3 and IFIT2 genes with the HX and GDS01 strains replication was experimentally validated by TLR3 inhibition and IFIT2 overexpression systems in cultured cells. TLR3 expression was found to inhibit HX strain, but not GDS01 strain, replication by enhancing the IFIT2 expression in infected cells. In conclusion, our study highlights similarities and differences in gene expression patterns and cellular processes/pathways altered at the early-stage infection of PEDV virulent and avirulent strains. These findings may provide a foundation for establishing novel therapies to control PEDV infection.

Bacteriophage EK99P-1 alleviates enterotoxigenic Escherichia coli K99-induced barrier dysfunction and inflammation

Bacteriophages, simply phages, have long been used as a potential alternative to antibiotics for livestock due to their ability to specifically kill enterotoxigenic Escherichia coli (ETEC), which is a major cause of diarrhea in piglets. However, the control of ETEC infection by phages within intestinal epithelial cells, and their relationship with host immune responses, remain poorly understood. In this study, we evaluated the effect of phage EK99P-1 against ETEC K99-infected porcine intestinal epithelial cell line (IPEC-J2). Phage EK99P-1 prevented ETEC K99-induced barrier disruption by attenuating the increased permeability mediated by the loss of tight junction proteins such as zonula occludens-1 (ZO-1), occludin, and claudin-3. ETEC K99-induced inflammatory responses, such as interleukin (IL)-8 secretion, were decreased by treatment with phage EK99P-1. We used a IPEC-J2/peripheral blood mononuclear cell (PBMC) transwell co-culture system to investigate whether the modulation of barrier disruption and chemokine secretion by phage EK99P-1 in ETEC K99-infected IPEC-J2 would influence immune cells at the site of basolateral. The results showed that phage EK99P-1 reduced the mRNA expression of ETEC K99-induced pro-inflammatory cytokines, IL-1β and IL-8, from PBMC collected on the basolateral side. Together, these results suggest that phage EK99P-1 prevented ETEC K99-induced barrier dysfunction in IPEC-J2 and alleviated inflammation caused by ETEC K99 infection. Reinforcement of the intestinal barrier, such as regulation of permeability and cytokines, by phage EK99P-1 also modulates the immune cell inflammatory response.

Acute kidney injury due to ammonium acid urate stones in a patient with adenovirus gastroenteritis: a case report

BackgroundAdenovirus gastroenteritis is a common cause of diarrhea and vomiting in infants, resulting in prerenal acute kidney injury (AKI). However, postrenal AKI due to urinary stones associated with adenovirus gastroenteritis is extremely rare. Here, we describe postrenal AKI due to obstructive ammonium acid urate stones associated with adenovirus gastroenteritis.Case presentationA previously healthy 6-month-old boy had an 11-day history of severe diarrhea and a 5-day history of vomiting. His stool was positive for adenovirus antigens. We initiated fluid replacement therapy. On the second hospital day, he suddenly developed anuria. Abdominal computed tomography revealed bilateral hydronephrosis, left ureteral stones, and right bladder ureteral junction stones. Laboratory data showed that the creatinine level increased to 1.00 mg/dL. We diagnosed postrenal AKI due to obstructive bilateral urinary stones. Urination with stable urine volume resumed spontaneously after hydration. A few stones were found in the urine, which consisted of ammonium acid urate (> 98%). The serum creatinine level improved to 0.25 mg/dL. He was discharged nine days after admission.ConclusionsWe suggest that adenovirus gastroenteritis be considered in pediatric patients with postrenal AKI due to urinary stones.

Obesity is associated with decreased risk of microscopic colitis in women.

BACKGROUNDMicroscopic colitis is a leading cause of diarrhea in the older adults. There is limited information about risk factors. We hypothesized that obesity would be associated with microscopic colitis.AIMTo examine the association between obesity and microscopic colitis in men and women undergoing colonoscopy.METHODSWe conducted a case-control study at the University of North Carolina Hospitals. We identified and enrolled men and women referred for elective, outpatient colonoscopy for chronic diarrhea. We excluded patients with a past diagnosis of Crohn’s disease or ulcerative colitis. A research pathologist reviewed biopsies on every patient and classified them as microscopic colitis cases or non-microscopic colitis controls. Patients provided information on body weight, height and exposure to medications via structured interviews or Internet based forms. The analysis included 110 patients with microscopic colitis (cases) and 252 non-microscopic colitis controls. Multivariable analyses were performed using logistic regression to estimate odds ratios and 95% confidence intervals.RESULTSCases were older and more likely than controls to be white race. Study subjects were well educated, but cases were better educated than controls. Cases with microscopic colitis had lower body mass index than controls and reported more weight loss after the onset of diarrhea. Compared to patients who were normal or under-weight, obese (BMI > 30 kg/m2) patients were substantially less likely to have microscopic colitis after adjusting for age and education, adjusted OR (aOR) 0.35, 95% confidence interval (CI) 0.18-0.66). When stratified by sex, the association was limited to obese women, aOR 0.21, 95%CI: 0.10-0.45. Patients with microscopic colitis were more likely to report weight loss after the onset of diarrhea. After stratifying by weight loss, there remained a strong inverse association between obesity and microscopic colitis, aOR 0.33, 95%CI: 0.10 – 1.11 among the patients who did not lose weight. Ever use of birth control pills was associated with lower risk of microscopic colitis after adjusting for age, education and BMI, aOR 0.38, 95%CI: 0.17-0.84.CONCLUSIONCompared to controls also seen for diarrhea, microscopic colitis cases were less likely to be obese. Mechanisms are unknown but could involve hormonal effects of obesity or the gut microbiome.