Enteropathogens in acute diarrhea: a general practice-based study in a Nordic country

Abstract

The epidemiology of infectious diarrhea influences the microbiological investigation of the disease, and is best elucidated through prospective studies. We undertook such a study in a Nordic country. Patients of all age groups who had acute diarrhea were recruited prospectively from general practice clinics in Iceland. They completed a questionnaire and provided stool samples for the detection of pathogenic viruses, bacteria, and parasites. Of the 464 recruited patients, 211 (45%) had 224 infections. The most common pathogens were calici- and rotaviruses (23% and 18% of 224 infections, respectively), Campylobacter jejuni (17%), Cryptosporidium species (12%), and Salmonella serotypes (10%). Other agents found were Giardia lamblia, astro- and adenoviruses, and Yersinia enterocolitica. Viral pathogens were associated with vomiting, illness for ≤7 days, and younger age groups, while bacterial pathogens were associated with fever, rectal pain, and local or foreign travel, and parasitic pathogens with illness for >7 days. Detection rates for viral infections in the elderly and for Cryptosporidium species were higher than expected. Our study indicates the existence of regional differences in pathogen prevalence that should be taken into account when implementing guidelines for stool testing in patients with acute diarrheal disease.

Etiology of acute diarrhea due to enteropathogenic bacteria in Beijing, China

“…11,12 The stool of different trait was also respective of specific bacteria, such as watery stool frequently observed in Salmonella infection and bloody stool in Shigella infection, in agreement with other reports. 17,37 Our analysis reveals that although there are differences between clinical symptoms, there are also many overlaps.…”

Analysis of Bacterial Pathogens Causing Acute Diarrhea on the Basis of Sentinel Surveillance in Shanghai, China, 2006–2011

“…Enteric bacterial pathogens were isolated using traditional diagnostic techniques from 10z of patients with acute diarrhea, which falls within the previously reported range of 4.8z to 55.1z (6,(8)(9)(10). It should be noted that variations pertaining to geographical area, the types of enteric pathogens, and diagnostic methods were observed in these studies.…”

Prevalence and factors associated with different pathogens of acute diarrhea in adults in Beijing, China

“…Our analysis of the association between patientrelated factors and different pathogen groups (viral, bacterial, or mixed infections) confirms some of the findings of Dutch and Nordic studies [22,23]. Nausea, living in a suburb, and autumn or winter infection correlated positively with viral pathogens, whereas abdominal pain was negatively associated with viral pathogens.…”

“…Nausea, place of residence, leukocytosis, and abdominal pain correlated differently with viral and bacterial infections. Many studies have reported that viral pathogens are more likely to be transmitted by person-to-person contact [22][23][24]. Although very few cases were reported to be transmitted by other patients in this study, we found that living in a suburb of Beijing was associated with viral infection.…”