Factores de riesgo de los casos esporádicos de diarrea por Campylobacter, Salmonella y rotavirus en niños preescolares / Risk factors for the occurrence of sporadic Campylobacter, Salmonella and rotavirus diarrhea in preschool children

RESUMEN

Antecedentes: Los casos esporádicos de diarrea en niños pequeños son muy frecuentes, sobre todo por rotavirus, Campylobacter y Salmonella. Se pretende identificar los factores asociados con estos procesos. Material y métodos: Estudio de casos y controles. Casos de diarrea hospitalizados menores de 3 años. Entrevista realizada inmediatamente al ingreso, antes de conocer el resultado del coprocultivo. Se investigaron factores de susceptibilidad, de alimentación y ambientales. Se ha distinguido en niños mayores y menores de 1 año. Resultados: Un total de 117 pacientes (rotavirus, 31; Campylobacter, 28; Salmonella, 21; negativos, 37) y 84 controles. Se identificaron varios factores protectores como lactancia materna y toma previa de antibiótico. Factores de riesgo relacionados como la exposición a productos cárnicos (por ingesta o ambiental en la cocina), a algunos animales domésticos o asistencia a guarderías. Hubo diferencias por tipo de germen y por grupo de edad. En el grupo de pacientes con el coprocultivo negativo no se identificaron factores de riesgo. Conclusión: Se discuten las dificultades que plantea el estudio epidemiológico de este tipo de casos. Se interpretan los hallazgos por grupos de microorganismos, por grupo de edad, y se plantea su aplicación en el control y prevención de estos procesos

ABSTRACT

Background: Sporadic cases of diarrhea in preschool children are highly frequent, especially those caused by rotavirus, Campylobacter and Salmonella. The aim of this study was to identify some of the factors associated with these processes. Material and methods: A case-control study of hospitalized incident cases aged less than 3 years old was performed. Questionnaires were administered at admission, before the results of stool tests were known. Susceptibility, food exposure, and environmental factors were investigated. Infants aged less than 1 year were analyzed separately. Results: A total of 117 patients (rotavirus in 31, Campylobacter in 228 and Salmonella in 21, negative results in 37) and 84 controls were studied. Several protective factors, such as breast feeding and prior antibiotic use, were identified. Risk factors for diarrhea were exposure to meat products (eating or environmental exposure in the kitchen), some kinds of pets, and attendance at day care. Differences were found by etiology and age. In the culture-negative group, no risk factors were identified. Conclusion: The problems posed by epidemiological study of this issue are discussed. The main findings in each group of cases are interpreted and proposals are made for their application in the control and prevention of these diseases