Diarrhoeagenic microbes by real-time PCR in Rwandan children under 5 years of age with acute gastroenteritis.
Artikel i vetenskaplig tidskrift, 2014

Acute gastroenteritis is a main cause of disease and death among children in low-income countries. The causality rates and pathogenic characteristics of putative aetiological agents remain insufficiently known. We used real-time PCR targeting 16 diarrhoeagenic agents to analyse stool samples from children ≤5.0 years old with acute diarrhoea in Rwanda. Among the 880 children (median age 14.2 months; 41% female) at least one pathogen was detected in 92% and two or more agents in 63% of cases. Rotavirus was detected in 36.9%, adenovirus in 39.7%, enterotoxigenic Escherichia coli (ETEC) with genes for labile (eltB) or stable (estA) toxin in 31.3% and 19.0%, E. coli with eae or bfpA genes in 25.2% and 14.2%, Shigella in 17.5% and Cryptosporidium in 7.8%. Rotavirus and ETEC-estA were associated with more severe dehydration than diarrhoea due to other causes. Shigella was associated with bloody stools and higher CRP. Microbial loads (Ct values) of rotavirus, ETEC-estA and Shigella were associated with severity of symptoms. Rotavirus, ETEC-estA and E. coli with bfpA were associated with younger age, Shigella with older age. Antibiotic treatment was given to 42% and was associated with dehydration, fever and CRP, but not with pathogen. We conclude that rotavirus and ETEC-estA were the most important causes of diarrhoea with dehydration, that Shigella caused bloody diarrhoea but less severe dehydration, that microbial loads of rotavirus, ETEC-estA and Shigella were associated with severity of symptoms, and that antibiotic use was frequent and in poor agreement with microbiological findings.

faeces

real-time PCR

epidemiology

gastroenteritis

Diarrhoea

Författare

Jean-Claude Kabayiza

Göteborgs universitet

Maria Andersson

Göteborgs universitet

Staffan Nilsson

Göteborgs universitet

Chalmers, Matematiska vetenskaper, matematisk statistik

C Baribwira

University of Maryland School of Medicine

Gregoire Muhirwa

University of Rwanda

Tomas Bergström

Göteborgs universitet

Magnus Lindh

Göteborgs universitet

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

1469-0691 (eISSN)

Vol. 20 12 O1128-35

Ämneskategorier

Infektionsmedicin

Styrkeområden

Livsvetenskaper och teknik

DOI

10.1111/1469-0691.12698

PubMed

24890572

Mer information

Skapat

2017-10-07