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Narrowing of the Diagnostic Gap of Acute Gastroenteritis in Children 0-6 Years of Age Using a Combination of Classical and Molecular Techniques, Delivers Challenges in Syndromic Approach Diagnostics.
Steyer, Andrej; Jevsnik, Monika; Petrovec, Miroslav; Pokorn, Marko; Grosek, Stefan; Fratnik Steyer, Adela; Soba, Barbara; Ursic, Tina; Cerar Kisek, Tjasa; Kolenc, Marko; Trkov, Marija; Sparl, Petra; Duraisamy, Raja; Lipkin, W Ian; Terzic, Sara; Kolnik, Mojca; Mrvic, Tatjana; Kapoor, Amit; Strle, Franc.
Afiliação
  • Steyer A; *Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; †Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia; ‡Department of Pediatric Surgery and Intensive Care, University Medical Centre Ljubljana, Ljubljana, Slovenia; §Department for Public Health Microbiology, Centre for Medical Microbiology, National Laboratory of Health, Environment and Food, Ljubljana, Slovenia; ¶Faculty of Organizational Science
Pediatr Infect Dis J ; 35(9): e262-70, 2016 09.
Article em En | MEDLINE | ID: mdl-27276177
BACKGROUND: Twenty-five percent to 50% of acute gastroenteritis (AGE) cases remain etiologically undiagnosed. Our main aim was to determine the most appropriate list of enteric pathogens to be included in the daily diagnostics scheme of AGE, ensuring the lowest possible diagnostic gap. METHODS: Two hundred ninety seven children ≤6 years of age, admitted to hospital in Slovenia, October 2011 to October 2012, with AGE, and 88 ≤6 years old healthy children were included in the study. A broad spectrum of enteric pathogens was targeted with molecular methods, including 8 viruses, 6 bacteria and 2 parasites. RESULTS: At least one enteric pathogen was detected in 91.2% of cases with AGE and 27.3% of controls. Viruses were the most prevalent (82.5% and 15.9%), followed by bacteria (27.3% and 10.2%) and parasites (3.0% and 1.1%) in cases and controls, respectively. A high proportion (41.8%) of mixed infections was observed in the cases. For cases with undetermined etiology (8.8%), stool samples were analyzed with next generation sequencing, and a potential viral pathogen was detected in 17 additional samples (5.8%). CONCLUSIONS: Our study suggests that tests for rotaviruses, noroviruses genogroup II, adenoviruses 40/41, astroviruses, Campylobacter spp. and Salmonella sp. should be included in the initial diagnostic algorithm, which revealed the etiology in 83.5% of children tested. The use of molecular methods in diagnostics of gastroenteritis is preferable because of their high sensitivity, specificity, fast performance and the possibility of establishing the concentration of the target. The latter may be valuable for assessing the clinical significance of the detected enteric, particularly viral pathogens.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Técnicas de Diagnóstico Molecular / Tipagem Molecular / Gastroenterite Tipo de estudo: Diagnostic_studies / Observational_studies Limite: Animals / Child / Child, preschool / Humans / Infant / Newborn Idioma: En Ano de publicação: 2016 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Técnicas de Diagnóstico Molecular / Tipagem Molecular / Gastroenterite Tipo de estudo: Diagnostic_studies / Observational_studies Limite: Animals / Child / Child, preschool / Humans / Infant / Newborn Idioma: En Ano de publicação: 2016 Tipo de documento: Article