Detection of rotavirus and other enteropathogens in children hospitalized with acute gastroenteritis in Havana, Cuba

Abstract

The aim of the study was to diagnose infections with rotavirus and other enteric pathogens in children under five years old with acute gastroenteritis and to identify the most common epidemiological and clinical characteristics of these pathogens. The study was conducted using 110 stool samples from the same number of children under five years old who were inpatients at three paediatric hospitals in Havana, Cuba, between October and December 2011. The samples were tested for rotavirus and other enteric pathogens using traditional and molecular microbiological methods. Pathogens were detected in 85 (77.3 %) of the children. Rotavirus was the most commonly found, appearing in 54.5 % of the children, followed by bacteria (29 %) and parasites (10.9 %). Other viral pathogens detected included adenovirus (6.4 %) and astrovirus (3.6 %). In rotavirus-positives cases, at least one other pathogen was detected, usually a bacterium (26.6 %). More than three episodes of watery diarrhea in 24 hours were observed in 78.3 % of the cases. Dehydration was found in 30 (50 %) rotavirus-positive children, of whom seven (11.6 %) were transferred to an intensive care unit due to complications of metabolic acidosis. Rotavirus was most commonly observed among children under 12 months old (65 %). The highest incidence of infection occurred in children who were under the care of a relative at home (78.3 %), had not been breastfed (65 %), or had been breastfed for less than six months (28.3 %). The genotype combinations most frequently found were G9P8 (28.3 %) and G1P8 (10 %). This study demonstrates the presence of rotavirus and other enteric pathogens as causes of gastroenteritis in hospitalized infants and young children in Cuba.

Probiotic use in acute viral gastroenteritis: Is it really effective?

“…Acute gastroenteritis is an important cause of morbidity in developed countries and is the most common cause of death in developing countries after respiratory infections [2,4,5,10,18]. Acute gastroenteritis which causes the death of millions children every year, is often a viral infectious disease [1,[7][8]19]. The disease that causes severe fluid electrolyte losses due to vomiting and diarrhea lead to important rate admissions to hospital.…”

“…Regardless of the pathogen responsible for the etiology, the most important step in the treatment of acute diarrhea is to prevent fluid loss and electrolyte imbalance and to replace it if necessary. There is no ideal drug for diarrhea and treatment is usually symptomatic [4,9,[16][17][18][19]. Probiotics are defined as microbial agents that provide beneficial effects on human health when used in appropriate doses.…”

“…In recent years, an increasing number of studies have recommended prophylactic use of probiotics in the treatment of viral enteritis. It has been reported in the literature that the addition of probiotics to the management of acute gastroenteritis provides a significant improvement in disease duration and severity [3,4,10,11,[18][19][20]. Probiotics have been studied for the prevention and treatment of pediatric infectious diseases, especially upper respiratory tract infections, acute gastroenteritis, and antibiotic-associated diarrhea.…”

“…And these studies have been shown to be particularly useful in the treatment of acute viral gastroenteritis [3, 10-13, 15, 19, 21]. Although there have been many clinical studies on the probiotics in the prevention and treatment of acute diarrhea, the type, dose, and duration of the probiotics used in these studies differ [11,12,19,[20][21][22][23][24]. The efficacy of the majority of probiotics used in the prevention and treatment of childhood diarrhea varies depending on the strain and dose.…”

“…The efficacy of the majority of probiotics used in the prevention and treatment of childhood diarrhea varies depending on the strain and dose. The probiotic strains mostly used in the studies are Lactobacillus species, Bifidobacterium species and Saccharomyces boulardii [3,4,[11][12][13][14][15][18][19][20][21][22][23][24]. Especially in the treatment of diarrhea related to viral gastroenteritis, it was found that probiotics could reduce the mean duration of diarrhea until one day independently of the strain and also significantly decrease the number of watery diarrhea at first 48 hours.…”