Gastroenteritis Patients Research Articles

Surveillance of Noroviruses GII.4 variants, GII.3 and GII.17 in acute gastroenteritis patients in Shenzhen, China from 2012 to 2015

Surveillance of Noroviruses GII.4 variants, GII.3 and GII.17 in acute gastroenteritis patients in Shenzhen, China from 2012 to 2015

Seropositivity and epidemiology of human parechovirus types 1, 3, and 6 in Japan.

Human parechoviruses (HPeVs) mainly infect young children, causing mild gastrointestinal and respiratory diseases; however, HPeV type 3 (HPeV3) causes severe systemic diseases in young infants. To clarify the characteristics of HPeV infections from the aspects of seropositivity and epidemiology, we measured neutralizing antibody titres against HPeVs in individuals of in different age groups and isolated HPeVs from various clinical specimens in Niigata, Japan. The seropositivity to HPeV1, 3, and 6 was higher in older age group. HPeV1 and HPeV6 seropositivities were maintained in adults, whereas HPeV3 seropositivity was significantly lower in subjects aged >40 years (P < 0·001, P = 0·003). This result suggests that adults have increased susceptibility to HPeV3 as they lack neutralizing antibodies against HPeV3. Of the HPeV isolates, HPeV1 and HPeV6 frequently caused gastrointestinal symptoms. Moreover, gastroenteritis patients with HPeV1 and HPeV6 were mainly aged 6 months-1 year and ⩾2 years, respectively. In contrast, only HPeV3 was isolated from neonates and young infants with sepsis or sepsis-like syndrome, often with respiratory symptoms. These results suggest that clinical symptoms are clinically related to HPeV genotype and patients' age.

Rotavirus vaccine effectiveness in Hong Kong children

BackgroundRotavirus is a common infectious cause of childhood hospitalisation in Hong Kong. Rotavirus vaccines have been used in the private sector since licensure in 2006 but have not been incorporated in the government’s universal Childhood Immunisation Programme. This study aimed to evaluate rotavirus vaccine effectiveness against hospitalisation. MethodsThis case-control study was conducted in the 2014/2015 rotavirus season in six public hospitals. Hospitalised acute gastroenteritis patients meeting inclusion criteria were recruited and copies of their immunisation records were collected. Case-patients were defined as enrolled subjects with stool specimens obtained in the first 48h of hospitalisation that tested positive for rotavirus, whereas control-patients were those with stool specimens obtained in the first 48h of hospitalisation testing negative for rotavirus. Vaccine effectiveness for administration of at least one dose of either Rotarix® (GlaxoSmithKline Biologicals) or RotaTeq® (Merck Research Laboratories) was calculated as 1 minus the odds ratio for rotavirus vaccination history for case-patients versus control-patients. ResultsAmong the 525 eligible subjects recruited, immunisation records were seen in 404 (77%) subjects. 31% (162/525 and 126/404) tested positive for rotavirus. In the 404 subjects assessed for vaccine effectiveness, 2.4% and 24% received at least 1 dose of either rotavirus vaccine in case- and control-patients respectively. The unmatched vaccine effectiveness against hospitalisation for administration of at least one dose of either rotavirus vaccines was 92% (95% confidence interval [CI]: 75%, 98%). The matched analyses by age only and both age and admission date showed 96% (95% CI: 72%, 100%) and 89% (95% CI: 51%, 97%) protection against rotavirus hospitalisation respectively. ConclusionsRotavirus vaccine is highly effective in preventing hospitalisation from rotavirus disease in young Hong Kong children.

Probiotics and antisecretory agents though costly are effective alone in mild to moderate non bacterial acute gastroenteritis

Objectives: To evaluate the utilization of Probiotics and Racecadotril for the patients of acute gastroenteritis (AGE) and subsequently their health outcome at an Infectious Disease Hospital and to observe the relationship among demographic profile of the patients as well as antisecretory consumed exerting impact on AGE . Materials and Methods: A retrospective study was undertaken collecting total 459 patient’s data from patient admission ticket of an infectious disease hospital. Mainly drugs used and outcome of the patients were recorded. Of all patients 190 were found to be treated with fluid and probiotics, 150 with fluid plus probiotics plus ofloxacin and ornidazole, 49 with fluid plus racecadotril, 40 with fluid plus racecadotril plus oflxacin and ornidazole and only 30 patients got fluid plus ofloxacin and ornidazole. Data were statistically analyzed in respect of demographic profile, drugs used and clinical features of the patients. Results: Best outcome was observed in patients treated with fluid and probiotcs where 189 patients were cured. 146 out of 150 patients got cured with ofloxacin and ornidazole in addition. All 49 patients having racecadotril and fluid recovered. Fluid plus racecadotril plus ofloxacin and ornidazole cured 38 of 40 patients. 27 of 30 patients were cured with fluid plus ofloxacin and ornidazole. Conclusion: Probiotics and antisecretory agents like Racecadotril are costly but are very effective along with fluid and electrolyte to prevent AGE.

Clinico-epidemiology and genetic diversity of Salivirus in acute gastroenteritis cases from Pune, Western India: 2007–2011

Acute gastroenteritis is a leading cause of mortality in children from developing countries. Recently, Salivirus has been frequently detected in acute gastroenteritis patients, suggesting its possible aetiological role. Conflicting reports available on disease association of Salivirus have made it difficult to ascertain their causative role. The overall epidemiology and clinical features of Salivirus infections are poorly understood. The present five year study was undertaken to investigate the presence and genetic diversity of Salivirus in acute gastroenteritis cases from Pune, Western India and to determine the clinico-epidemiological features of Salivirus infections. A total of 985 faecal samples (778 acute gastroenteritis and 207 asymptomatic controls), collected from three local hospitals (Jan2007–Dec2011) were examined for the presence of Salivirus by RT-PCR. Molecular characterization was performed by PCR amplification of the 3D and VP regions. Frequency of Salivirus detection in cases (2.6%) and controls (1.93%) was not significantly different (p = 0.57). Co-infection with other enteric viruses was seen in 50% of the cases. Comparison of clinical features between Salivirus mono and mixed infections revealed that Salivirus alone did not exacerbate gastroenteritis. The frequency of diarrhoea and overall clinical severity of mixed infections was significantly greater than mono infections (p = 0.02). Based on clinical findings, our study suggests that Salivirus does not cause severe gastroenteritis. Phylogenetic analysis indicated that study strains belonged to Salivirus A1 and formed 2 distinct clusters which shared nucleotide identities of 94.1–96.2% and 88.9–93.8% between themselves in 3D and VP regions, respectively. Interestingly, the more divergent Cluster2 strains shared a low nucleotide identity with the closest reference strain in both regions (~95% in 3D and ~92% in VP) suggesting that they could represent a variant type of Salivirus A1. The genetic diversity in strains detected from study region, emphasizes the need for Salivirus surveillance from other regions of India.

Hyperuricemia in acute gastroenteritis is caused by decreased urate excretion via ABCG2.

To clarify the physiological and pathophysiological roles of intestinal urate excretion via ABCG2 in humans, we genotyped ABCG2 dysfunctional common variants, Q126X (rs72552713) and Q141K (rs2231142), in end-stage renal disease (hemodialysis) and acute gastroenteritis patients, respectively. ABCG2 dysfunction markedly increased serum uric acid (SUA) levels in 106 hemodialysis patients (P = 1.1 × 10−4), which demonstrated the physiological role of ABCG2 for intestinal urate excretion because their urate excretion almost depends on intestinal excretion via ABCG2. Also, ABCG2 dysfunction significantly elevated SUA in 67 acute gastroenteritis patients (P = 6.3 × 10−3) regardless of the degree of dehydration, which demonstrated the pathophysiological role of ABCG2 in acute gastroenteritis. These findings for the first time show ABCG2-mediated intestinal urate excretion in humans, and indicates the physiological and pathophysiological importance of intestinal epithelium as an excretion pathway besides an absorption pathway. Furthermore, increased SUA could be a useful marker not only for dehydration but also epithelial impairment of intestine.

Multi drug resistance and Extended Spectrum Beta Lactamases in clinical isolates of Shigella: A study from New Delhi, India.

Shigella is an important cause of gastroenteritis in local Indian population, as well as of traveler's diarrhea in the international visitors to India. These patients often require appropriate antimicrobial therapy; however, rapid development of antimicrobial resistance poses a major hurdle in achieving this goal. A prospective study was conducted during 2009-12 in New Delhi, India, including 6339 stool samples from gastroenteritis patients. 121 Shigella strains were identified on the basis of colony morphology, biochemical reactions, serotyping and ipaH gene based PCR. Antimicrobial susceptibility testing by disc diffusion, MIC determination by Vitek(®) 2 and phenotypic tests for ESBL/AmpC production were done. Nineteen percent strains (23/121) were found to be resistant to third generation cephalosporins and all were phenotypically confirmed to be ESBL producers; one strain was positive for AmpC. ESBL producing strains were also found to be significantly more resistant (p<0.05) to several other antimicrobials agents in comparison to ESBL non-producers, [ampicillin (100% vs. 62.2%), ampicillin/sulbactam (100% vs. 30.6%), cotrimoxazole (100% vs. 77.6%), ciprofloxacin (87.0% vs. 49.0%), ofloxacin (87.0% vs. 52.0%) and gentamicin (30.4% vs. 7.1%)]. Multidrug resistance was seen in 76% strains. Inappropriate use of antimicrobial agents puts high selection pressure on the higher-end antibiotics. Multi-drug resistance and high rates of ESBL production by Shigella is a matter of concern for the local population as well as international travelers. Therefore, better national level antimicrobial management programs are the priority needs.

Prevalence and molecular characterization of human noroviruses and sapoviruses in Ethiopia.

Viral gastroenteritis is a major public health problem worldwide. In Ethiopia, very limited studies have been done on the epidemiology of enteropathogenic viruses. The aim of this study was to detect and characterize noroviruses (NoVs) and sapoviruses (SaVs) from acute gastroenteritis patients of all ages. Fecal samples were collected from diarrheic patients (n=213) in five different health centers in Addis Ababa during June-September 2013. The samples were screened for caliciviruses by reverse transcription polymerase chain reaction (RT-PCR) using universal and genogroup-specific primer pairs. Phylogenetic analyses were conducted using the sequences of the PCR products. Of the clinical samples, 25.3% and 4.2% were positive for NoV and SaV RNA, respectively. Among the norovirus positives, 22 were sequenced further, and diverse norovirus strains were identified: GI (n=4), GII (n=17) and GIV (n=1). Most strains were GII (n=17/22: 77.2%), which were further divided into three different genotypes (GII.4, GII.12/GII.g recombinant-like and GII.17), with GII.17 being the dominant (7/17) strain detected. GI noroviruses, in particular GI.4 (n=1), GI.5 (n=2) and GI.8 (n=1), were also detected and characterized. The GIV strain detected is the first from East Africa. The sapoviruses sequenced were also the first reported from Ethiopia. Collectively, this study showed the high burden and diversity of noroviruses and circulation of sapoviruses in diarrheic patients in Ethiopia. Continued surveillance to assess their association with diarrhea is needed to define their epidemiology, disease burden, and impact on public health.

Effect of Achillea millefolium Distillate on Recovery Time in Patients with Gastroenteritis

Background Some animal studies have reported that Achillea millefolium (A. millefolium) extract can affect intestinal movements in rats. However, no study is available on the effect of A. millefolium on recovery from gastroenteritis in human subjects. Objectives This study aimed to investigate the effect of A. millefolium on recovery from gastroenteritis in patients over 12 years old. Patients and Methods A randomized controlled trial was conducted on 44 patients with gastroenteritis. The patients were randomly assigned to two groups of 22 each. The control group received the usual treatments. In addition to the usual treatments, the intervention group received 0.5 mL/kg of A. millefolium distillate every 8 hours. The duration of recovery was recorded for both groups. Descriptive statistics, Chi-square, Fisher’s exact test, and the t-test were used to compare the two groups. Results The mean duration of recovery in the group receiving A. millefolium distillate was 1.31 ± 0.71 days, while it was 1.86 ± 0.71 days in the control group (P = 0.015). Conclusions Adding A. millefolium distillate to the usual treatment for simple gastroenteritis was effective in shortening the recovery time.

Adenovirus infection: A potential risk for developing intussusception in pediatric patients.

The pathogenesis of intussusception without obvious anatomical leading points remains unclear. The objective of this study was to determine a feasibility of association between certain gastroenteritis viruses and intussusception. This was a prospective cohort study. Forty intussusception cases and 136 acute gastroenteritis controls with comparable age and gender were separately consecutively enrolled and relevant clinical data of both groups were recorded. The clinical specimens collected from all patients were screened for adenovirus, rotavirus, norovirus, and astrovirus by PCR and RT-PCR using specific primers. The genomes of detected viruses were characterized further to identify their genotypes by nucleotide sequencing. In 40 intussusception cases, adenovirus, rotavirus, and norovirus were detected in 12 (30.0%), 2 (5.0%), and 2 (5.0%), respectively while astrovirus was undetectable. In contrast, 136 acute gastroenteritis patients, adenovirus, rotavirus, and norovirus were detected in 11 (8.1%), 24 (17.7%), and 24 (17.7%) patients, respectively and again astrovirus was undetectable. The detection of adenovirus in intussusception patients was significantly higher than those in the control group (P < 0.001) with an odd ratio of 4.87 (95%CI: 1.95, 12.16). Interestingly, molecular analysis of adenovirus genome demonstrated that all of adenovirus detected in intussusception patients belonged to adenovirus C. This could be a potential risk factor or pathogenesis for developing intussusception in the cases of those without apparent anatomical leading points. J. Med. Virol. 88:1930-1935, 2016. © 2016 Wiley Periodicals, Inc.

Prevalence of rotavirus, norovirus and enterovirus in diarrheal diseases in Himachal Pradesh, India.

Diarrheal diseases are responsible for a significant proportion of mortality and morbidity all around the globe. The contribution of viruses to gastroenteritis incidences in humans is well established. In the present study, we have studied the prevalence of rotavirus, norovirus and enterovirus in Himachal Pradesh, a north Indian state. A total of 287 (111 children and 176 adults) stool samples of gastroenteritis patients were screened for the viruses using RT-PCR method. 34.5% samples were positive for the viral pathogens of gastroenteritis. Rotavirus was the predominant virus detected in the study with 49.5 and 14.8% positivity in children and adults, respectively. Enterovirus was present in 5.6% cases whereas norovirus had least prevalence (1.4%). Co infection (rotavirus and enterovirus) was witnessed at the prevalence rate of 0.6%. Among different age groups, the prevalence of studied viruses was highest in the children belonging to the age groups of <5years. Rotavirus infections were found to be significantly associated with vomiting and trend of higher rates of fever and dehydration was seen in children along with diarrhea. Seasonal distribution shows circulation of diarrheagenic viruses throughout the year. This is the first report of prevalence of various diarrheagenic viruses circulating in this region. The outcome of the study from this cohort provides a baseline data which can be used to design the preventive strategies in the otherwise unexplored state of Himachal Pradesh.

Effect of Oral Dimenhydrinate in Children with Acute Gastroenteritis: A Clinical Trial.

One of the major causes of mortality in children is acute gastroenteritis. Vomiting is common in early stages of the disease. The aim of this study was to determine the effect of oral dimenhydrinate (DH) in the control of vomiting in cases of acute gastroenteritis in children. This double-blind, randomized, clinical trial was conducted in a university-affiliated hospital in a western province of Iran. Two hundred children aged one to 12 years old were randomly assigned to either drug or placebo groups. Children in the drug group received oral DH as four doses of 1 mg/kg every six hours (maximum 200 mg), and children in the placebo group received a placebo drug. The patients variables were compared 24 hours after receiving the first dose and at seven and 14 days after discharge. The mean number of episodes of vomiting was 4.4±2.5 in the drug group versus 4.4±2.1 in the placebo group, which was not statistically significant (p<0.050). The mean number of episodes of diarrhea was 7.4±3.2 and 10.1±2.8 in the drug and placebo groups, respectively, (p<0.050). The duration of diarrhea, side effects, need to revisit, and parent's satisfaction in both groups were also significantly different (p>0.050). Oral DH in children with acute gastroenteritis does not reduce the number and duration of vomiting. However, our results showed that consumption of DH in acute gastroenteritis patients was effective in reducing the frequency and duration of diarrhea and further investigation into this is warranted.

Viral Gastroenteritis among Children under 5 Years in Dutsinma Local Government Area, Katsina State, North-West Nigeria, West Africa

Rotaviruses and adenoviruses conjointly form the leading cause of epidemic gastroenteritis in developed and developing countries. The prevalence of this array of human viral pathogens in under five years children of Dustin-ma Local Government Area of Katsina State, North-west Nigeria was investigated on diarrheal stool samples of 152 patients of acute viral gastroenteritis by Reverse Transcription Polymerase Chain Reaction (RT-PCR) as approved by the state committee on ethics after parental agreement. Analyses revealed prevalence of 54% (35/65) and 46% (30/65) for rotaviruses and adenoviruses respectively in 2013 and then 62.2% (51/82) for rotaviruses followed by 37.8% (31/82) for adenoviruses in 2014 with a total of 87 rotavirus positive samples (57.24%) while 61 samples (40.13%) were adenovirus positive. Only 4 samples (3%) were infected by other diarrheal viral pathogens.

ERIC-PCR Genotyping of Some Campylobacter jejuni Isolates of Chicken and Human Origin in Egypt.

The public health importance of the genus Campylobacter is attributed to several species causing diarrhea in consumers. Poultry and their meat are considered the most important sources of human campylobacteriosis. In this study, 287 samples from chicken (131 cloacal swabs, 39 chicken skin, 78 chicken meat, and 39 cecal parts) obtained from retail outlets as well as 246 stool swabs from gastroenteritis patients were examined. A representative number of the biochemically identified Campylobacter jejuni isolates were identified by real-time PCR, confirming the identification of the isolates as C. jejuni. Genotyping of the examined isolates (n = 31) by enterobacterial repetitive intergenic consensus PCR (ERIC-PCR) revealed a high discriminatory index of ERIC-PCR (D = 0.948), dividing C. jejuni isolates of chicken and human origins into 18 profiles and four clusters. The 18 profiles obtained indicated the heterogeneity of C. jejuni. Dendrogram analysis showed that four clusters were generated; all human isolates fell into clusters I and III. These observations further support the existence of a genetic relationship between human and poultry isolates examined in the present study. In conclusion, the results obtained support the speculation that poultry and poultry meat have an important role as sources of infection in the acquisition of Campylobacter infection in humans.

The Most Common Microbial Causes of Gastroenteritis in Patients With Clinical Manifestations

Background: Gastroenteritis is a remarkable hygiene problem worldwide. Bacteria and parasites can cause gastroenteritis-associated disorders. Objectives: The aims of study were to survey the most common cause of gastroenteritis in patients referred to Imam Khomeini Hospital of Ilam, Iran. Patients and Methods: This descriptive-analytical study was performed during 2012 to 2013. After collecting 2376 stool samples, standard biochemical and microbiological tests were performed. Susceptibility was tested by disc diffusion method agreeing with clinical and laboratory standards institute (CLSI) guidelines. The protozoa were detected by sediment wet-mount method. Results: Of 2376 patients, 466 (19.6%) were contaminated with pathogenic bacteria or protozoa. The frequency of microorganisms isolated from the patients were 10.3%, 2.5%, 2.5%, 2.1%, 46.4%, 30.9%, 2.5% and 2.5% for enteropathogenic Escherichia coli (EPEC), Shigella dysenteriae, Klebsiella pneumonia, Yersinia enterocolitica, Entamoeba histolytica, Giardia lamblia, E. coli and Candida spp., respectively. Sensitivities to ciprofloxacin in E. coli and S. dysenteriae strains were 100% and 91.66%, respectively. Conclusions: The results showed that some patients were probably contaminated with nonbacterial and nonparasitic agents. All the parasitic isolates were resistant to most antibiotics. Therefore determination of microbial isolates and antibiotic susceptibility is necessary before treatment procedures.

Assessment of Medication Utilization in Emergency Patients

Objectives: : To assess the utilization of medications prescribed for treating the patients suffering from commonly occurring emergency conditions. Methodology : The study protocol was approved by the hospital human ethical committee. The patients of either sex who were aged between 18 and 60 years and admitted within 72 hours of their onset of emergency conditions were enrolled prospectively as per our study criteria for six months. The patients clinical and medication data were collected from the case records. Further, the data was analyzed and compared against national essential medication list. Results and Discussion : Totally 100 emergency patients (Males 51%, Females 49%) were enrolled. Mean age of the patients was 36.3±1.1years. Of these cases, most commonly found emergencies were Fever (33%) followed by Acute Gastroenteritis (22%), and Upper respiratory tract infection (11%) among others. On average, 3.9±1.5 drugs were prescribed per patient. Anti-pyretics (80.66%), antibiotics (11.33%) and analgesics and antiinflammatory drugs (8%) were found prescribed for patients suffering from fever. Acetaminophen (81%) was prescribed to treat high fever (over 100°F), Diclofenac(75%) was found prescribed for treating patients suffering from fever with body pain and Amoxicillin(60%) was found prescribed for treating the patients suffering from fever who are susceptible for infections. The results obtained in our study was similar to the results shown by Dhamija P et al. Proton pump inhibitors (56%), Anti emetics (18.33%), Anti-diarrhoeals (7%) and Antimicrobials (%) were found prescribed for patients with Acute gastroenteritis. Pantoprazole (97.1%) was most extensively used Proton pump inhibitor. Ondansetron(71.4%) was used as Anti emetic. Loperamide (55.55%) was used for treating diarrhoea. Ofloxacin + Ornidazole infusion combination was used to treat gastroenteritis patients susceptible to infections. This study results were comparable to the study done by Pantanwala et al. All the prescribed drugs were utilized under nurse direct observation. The total number of drugs evaluated during the study was compared to the national list of essential medicines and was found to show 52.30% compliance to the NLEM 2011 which was better as shown in the study of Barot et al. Conclusion : The medications such as Acetaminophen, Diclofenac, and Amoxicillin are frequently utilized to treat emergency patients with fever while Pantoprazole, Ondansetron, Loperamide and Ofloxacin and Ornidazole combination was utilized to treat emergency patients with gastritis and these drugs were prescribed according to national essential drug list.

The Distribution of the Causative Agents of Gastroenteritis in Patients Admitted to a University Hospital: Data of Thirteen Months

The Distribution of the Causative Agents of Gastroenteritis in Patients Admitted to a University Hospital: Data of Thirteen Months

Bla CTX-M-I group extended spectrum beta lactamase-producing Salmonella typhi from hospitalized patients in Lagos, Nigeria.

PurposeThe global spread of blaCTX-M-I extended-spectrum beta-lactamase (ESBL)-producing Salmonella spp. remains a major threat to treatment and control. Evidence of emergence and spread of this marker are lacking in Nigeria. This study investigated blaCTX-M-I ESBL production among Salmonella isolates from hospitalized patients.MethodsPatients (158 total) made up of two groups were evaluated. Group A was composed of 135 patients with persistent pyrexia and group B was composed of 23 gastroenteritis patients and their stool samples. Samples were cultured, and isolates were identified and were subjected to antibiotic susceptibility testing by standard methods. Isolates were further screened for ESBL production, blaCTX-M-I genes and transferability by double disk synergy test, plasmid extraction, polymerase chain reaction, and conjugation experiment.ResultsThirty-five (25.9%) Salmonella isolates were identified from group A, of which 74.3% were S. typhi, 22.9% were S. paratyphi and two (5.7%) were invasive non-typhoidal S. enteritidis. Nine Plasmodium falciparum infections were recorded, four of which were identified as co-infections with typhoidal Salmonella. Only two (8.7%) S. enteritidis samples were obtained from group B (P>0.05). A total of 24 isolates were ESBL-positive, eliciting resistance to five to seven antibiotics, and were multiple-drug resistant. ESBL production due to the blaCTX-M-I gene cluster was detected in eleven (45.8%) Salmonella isolates. Nine (81.8%) of the eleven blaCTX-M-I ESBL producers were S. typhi and two (18.2%) isolates were S. enteritidis. Four of nine S. typhi blaCTX-M-I ESBL-producing strains harbored 23 kb self-transmissible plasmid that was co-transferred with cefotaxime and augmentin resistance to Escherichia coli j53-2 transconjugants.ConclusionThis study revealed the emergence of blaCTX-M-I S. typhi as an agent of persistent pyrexia with potential to spread to other Enterobacteriaceae in Lagos, Nigeria. Cautionary prescription and judicious use of third-generation cephalosporins, particularly cefotaxime, for the treatment of typhoid fever and routine screening for P. falciparum co-infection with ESBL-producing Salmonella in the laboratories during diagnosis of persistent pyrexia conditions in patients are recommended.

Differences in Clinical and Laboratory Findings between Group D and Non-Group D Non-Typhoidal Salmonella Gastroenteritis in Children.

PurposeTo investigate the differences in clinical features and laboratory findings between group D and non-group D non-typhoidal Salmonella (NTS) gastroenteritis in children.MethodsA retrospective chart review of children diagnosed with NTS confirmed by culture study was performed. The clinical features and laboratory findings of group D and non-group D NTS were compared.ResultsFrom 2003 to 2012, 75 cases were diagnosed as NTS at our center. The number of group D and non-group D patients was 45 and 30, respectively. The mean age was higher in group D than in non-group D patients (5.1 years vs. 3.4 years, p=0.038). Headaches were more frequently observed (p=0.046) and hematochezia was less frequently observed (p=0.017) in group D than in non-group D NTS gastroenteritis patients. A positive Widal test result was observed in 53.3% of group D and 6.7% of non-group D NTS cases (O-titer, p=0.030; H-titer, p=0.039). There were no differences in white blood cell counts, level of C-reactive protein and rate of antimicrobial resistance between group D and non-group D cases.ConclusionThe more severe clinical features such as headache, fever, and higher Widal titers were found to be indicative of group D NTS gastroenteritis. Additionally, group D NTS gastroenteritis was more commonly found in older patients. Therefore, old age, fever, headache, and a positive Widal test are more indicative of group D NTS than non-group D NTS gastroenteritis. Pathophysiological mechanisms may differ across serologic groups.

Human Norovirus Genogroups Detected from Acute Gastroenteritis Patients in Seoul from May 2013 to April 2015

Norovirus is an important cause of acute nonbacterial gastroenteritis in communities worldwide. It was evaluated the prevalence of norovirus infections in patients with acute gastroenteritis occurring in Seoul from May 2013 to April 2015, with regular surveillance. 7.3% (252/3,485) of the fecal specimens were determined to be positive for noroviruses by reverse transcription- polymerase chain reaction (RT-PCR). Norovirus genogroup distribution was 19.1% (48/252) genogroup GI, 71.4% (180/252) genogroup GII, and 9.5% (24/252) genogroup G1+GII respectively. It was most norovirus detection rates from November 2013 to March 2015. And it was rotavirus 0.2% (7/3,485), astrovirus 0.03% (1/3,485), sapovirus 0.03% (1/3,485) and, it was non-detective on adenovirus. Norovirus genotypes identified were nine kinds of genogroup GI (GI-1, GI-2, GI-3, GI-4, GI-6, GI-7, GI-8, GI-12, GI-14) and eight kinds of genogroup GII (GII-2, GII-3, GII-4, GII-5, GII-6, GII-7, GII-14, GII-16, GII-17). The genetic characteristics of norovirus and the epidemiological patterns of a viral pathogen from acute gastroenteritis patients may give potentially effective data for epidemiological studies in Seoul, Korea.