[Viral gastroenteritis. Application of a protocol for astrovirus detection in childhood gastroenteritis]. / Gastroenteritis de etiología vírica. Aplicación de un protocolo para el diagnóstico de astrovirus en casos de gastroenteritis infantil.

BACKGROUND AND OBJECTIVE: Diagnosis of viral gastroenteritis is an important subject in clinical virology which is mainly determined by the availability of reagents in laboratories, such as in the case of astrovirus. The aim of this study was to estimate the increase in the diagnostic performance achieved after the incorporation of astrovirus search in the diagnosis protocol of acute viral gastroenteritis. We also analyzed the trend of infections in other more commonly searched virus, such as rotavirus and enteric adenovirus. MATERIAL AND METHODS: Retrospective study during 20 years that included 12,980 stool samples processed for gastroenteritis virus diagnosis. Since 1997 an enzyme immunoassay for astrovirus has been applied to those samples that are negative for rotavirus and adenovirus. The study was divided in two periods (1986-1996 and 1997-2005, without and with astrovirus diagnosis) and the percentage of patients diagnosed in each period was compared. The trend of positive results as well as the percentage of positive results over all patients studied was modelled using the least squares method. RESULTS: The percentages of positive patients for rotavirus, adenovirus and astrovirus were 10.3%, 2.3% and 6.0% respectively, and there were uncommon co-infections by rotavirus and adenovirus (0.2%). The protocol applied to the astrovirus diagnosis increased the diagnosis rate up to 16.8% of the studied cases. Significant statistical differences were observed between the 2 study periods. A quadratic growth was observed in the results of positive diagnosis of viral gastroenteritis during the study period. CONCLUSIONS: The search of astrovirus in gastroenteritis cases by a selective protocol increased the diagnostic performance of gastrointestinal virus by 6%. In view of these results, it would be useful to implement astrovirus diagnosis in faeces with liquid or semi-liquid consistency when rotavirus and adenovirus detection is negative.

Gastroenteritis de etiología vírica. Aplicación de un protocolo para el diagnóstico de astrovirus en casos de gastroenteritis infantil / Viral gastroenteritis. Application of a protocol for astrovirus detection in childhood gastroenteritis

Fundamento y objetivo: El diagnóstico de gastroenteritis víricas es un importante capítulo en la virología clínica que está fundamentalmente condicionado por la disponibilidad de reactivos en los laboratorios, como en el caso del astrovirus. El objetivo de este estudio es estimar el incremento del rendimiento diagnóstico alcanzado tras la incorporación de la búsqueda de astrovirus en el protocolo de gastroenteritis víricas agudas y analizar la tendencia de la infección por otros virus de búsqueda más general, como son rotavirus y adenovirus entéricos. Material y método: Se trata de un estudio retrospectivo de 20 años en el que se procesaron 12.980 muestras de heces para diagnóstico de virus de gastroenteritis. Desde 1997 se ha aplicado a las muestras negativas para rotavirus y adenovirus un enzimoinmunoanálisis para astrovirus. Se ha dividido el tiempo de estudio en 2 períodos (1986-1996 y 1997-2005, sin y con diagnóstico de astrovirus, respectivamente) y se ha comparado el porcentaje de pacientes en los que se obtiene un diagnóstico etiológico de virus de gastroenteritis. Se han modelizado el componente de tendencia de la serie de resultados positivos y el porcentaje que suponen del total de pacientes estudiados mediante mínimos cuadrados. Resultados: El porcentaje de pacientes positivos para rotavirus, adenovirus y astrovirus fue del 10,3, el 2,3 y el 6,0%, respectivamente, y fue infrecuente la aparición de coinfecciones entre rotavirus y adenovirus (0,2%). El protocolo aplicado para el diagnóstico de astrovirus permite aumentar el rendimiento diagnóstico hasta un 16,8% de los casos estudiados, existiendo diferencias estadísticamente significativas entre los 2 períodos. Se ha observado un crecimiento cuadrático en el diagnóstico de gastroenteritis víricas durante el período de estudio. Conclusiones: La búsqueda de astrovirus en casos de gastroenteritis mediante un protocolo selectivo ha demostrado aumentar la rentabilidad diagnóstica de los virus enteropatógenos en un 6%. A la vista de los resultados, sería de utilidad ampliar la búsqueda de astrovirus en pacientes con heces de consistencia líquida o semilíquida cuando la detección de rotavirus y adenovirus sea negativa

Background and objective: Diagnosis of viral gastroenteritis is an important subject in clinical virology which is mainly determined by the availability of reagents in laboratories, such as in the case of astrovirus. The aim of this study was to estimate the increase in the diagnostic performance achieved after the incorporation of astrovirus search in the diagnosis protocol of acute viral gastroenteritis. We also analyzed the trend of infections in other more commonly searched virus, such as rotavirus and enteric adenovirus. Material and methods: Retrospective study during 20 years that included 12,980 stool samples processed for gastroenteritis virus diagnosis. Since 1997 an enzyme immunoassay for astrovirus has been applied to those samples that are negative for rotavirus and adenovirus. The study was divided in two periods (1986-1996 and 1997-2005, without and with astrovirus diagnosis) and the percentage of patients diagnosed in each period was compared. The trend of positive results as well as the percentage of positive results over all patients studied was modelled using the least squares method. Restults: The percentages of positive patients for rotavirus, adenovirus and astrovirus were 10.3%, 2.3% and 6.0% respectively, and there were uncommon co-infections by rotavirus and adenovirus (0.2%). The protocol applied to the astrovirus diagnosis increased the diagnosis rate up to 16.8% of the studied cases. Significant statistical differences were observed between the 2 study periods. A quadratic growth was observed in the results of positive diagnosis of viral gastroenteritis during the study period. Conclusions: The search of astrovirus in gastroenteritis cases by a selective protocol increased the diagnostic performance of gastrointestinal virus by 6%. In view of these results, it would be useful to implement astrovirus diagnosis in faeces with liquid or semi-liquid consistency when rotavirus and adenovirus detection is negative

Comments on food science and technology from a university department of microbiology

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