Identifying Etiologic Agents in Acute Diarrhea in Children. Therapy with Antibiotics or Probiotics?

Abstract

In infants and toddlers, acute diarrhea is the most common gastrointestinal disorder. Recent literature has shown that viruses are the most common cause and of these, Rotavirus is a major causative agent of diarrhea in children under five years old, representing a major cause of mortality in this age. Since there is no etiologic treatment for viral diseases, hydro-electrolytic rebalancing is the standard therapy and vaccination is the most effective way to prevent these diseases. The study is a retrospective one and aims at establishing the etiology and correlation with origin environment (urban or rural) of children with acute diarrhea in Sibiu area. The study included 3135 children aged 1 month - 18 years old, admitted to the Pediatric Clinic, Sibiu, between January 1, 2014 - December 31, 2016. Laboratory tests were used to determine viral and /or bacterial etiology of acute diarrhea. Viral etiology was the most common, being confirmed in 34.1% of cases, and the bacterial one was confirmed in 10.8% of cases, of which the most frequent etiological agent involved was Campylobacter jejuni (40.0%). The most frequent aetiology of acute diarrhea in children in the Sibiu area are the viral infections, Rotavirus being the first, and of bacterial aetiology, rare in frequency, Campylobacter jejuni is the leader followed by Salmonella spp., and Shigella spp. Children in urban areas were more frequently affected by acute diarrhea than those in rural areas, unlike data from the literature.