Infection status of hospitalized diarrheal patients with gastrointestinal protozoa, bacteria, and viruses in the Republic of Korea.

To understand protozoan, viral, and bacterial infections in diarrheal patients, we analyzed positivity and mixed-infection status with 3 protozoans, 4 viruses, and 10 bacteria in hospitalized diarrheal patients during 2004-2006 in the Republic of Korea. A total of 76,652 stool samples were collected from 96 hospitals across the nation. The positivity for protozoa, viruses, and bacteria was 129, 1,759, and 1,797 per 10,000 persons, respectively. Especially, Cryptosporidium parvum was highly mixed-infected with rotavirus among pediatric diarrheal patients (29.5 per 100 C. parvum positive cases), and Entamoeba histolytica was mixed-infected with Clostridium perfringens (10.3 per 100 E. histolytica positive cases) in protozoan-diarrheal patients. Those infected with rotavirus and C. perfringens constituted relatively high proportions among mixed infection cases from January to April. The positivity for rotavirus among viral infection for those aged < or = 5 years was significantly higher, while C. perfringens among bacterial infection was higher for > or = 50 years. The information for association of viral and bacterial infections with enteropathogenic protozoa in diarrheal patients may contribute to improvement of care for diarrhea as well as development of control strategies for diarrheal diseases in Korea.

Cryptosporidium parvum in Korea: prevalence in individuals residing in three major river valleys and genetic characteristics of the isolates.

Cryptosporidiosis is a diarrheal illness caused by apicomplexa parasite Cryptosporidium spp. In this study, to examine the overall infection status of Cryptosporidium spp. in individuals residing in southern parts of Korea, eight counties around Yeongsan, Seomjin and Nakdong River valleys was surveyed. The investigation was carried out from April to October 2005. A total of 9,498 stool samples were collected from individuals. Stool samples were analyzed for modified acid-fast stains, and DNA fragment extracted from positive samples was identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) for 18S rRNA polymorphic region. Oocysts of Cryptosporidium spp. were detected in 239 specimens (2.5%) by a modified acid-fast stain. Infection rate was not significantly different between male (2.2%) and female (2.8%) individuals examined (P>0.05). In the infection rate by age, totally 1-9 (4.8%) and 80< (3.7%) age group were shown to the highest, and there was shown to significant differences (P<0.05). Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis of 18S rRNA gene from 51 isolates showed that all the isolates were identified as C. parvum. Our data collectively suggested that C. parvum infection is prevalent in the studied areas of Korea and more comprehensive nation-wide epidemiological studies are needed to elucidate the infection status of Cryptosporidium infection in Korea.