Skip to main content

Advertisement

SpringerLink
Log in

Etiology of Acute Gastroenteritis in Three Sentinel General Practices, Austria 2007

  • Clinical and Epidemiological Study
  • Published:
Infection Aims and scope Submit manuscript

Abstract

Background:

We studied the etiology of acute gastroenteritis in a village with a total population of approximately 6,000. This is the first study in Austria that has investigated a broad range of pathogens recovered from an unselected population of patients who had consulted general practitioners because of gastroenteritis.

Materials and Methods:

In 2007, all patients who visited one of three local general practitioners for acute gastroenteritis were invited to provide stool specimens to be tested for Salmonella, Shigella, Campylobacter, enterohemorrhagic Escherichia coli (EHEC) (mTSB enrichment [R-Biopharm] followed by toxin ELISA plus culture), enteropathogenic E. coli (EPEC), Yersinia, Vibrio cholerae, Clostridium difficile (toxin plus culture), rotavirus plus adenovirus (RIDA® Quick Rotavirus/Adenovirus Combi test), Giardia duodenalis plus Cryptosporidium parvum (RIDA® Quick Cryptosporidium/Giardia Combi test), astrovirus (ELISA), and norovirus (reverse-transcriptase PCR).

Results:

Stool specimens were provided by 306 patients (161 female) with acute diarrhea. The ages of the patients ranged from 1 to 89 years (mean 37, median 36). Pathogens were detected in 71 (23.2%) patients, with incidence peaks in February and June. Norovirus accounted for 36.0% of positive results, C. difficile for 18.7%, rotavirus for 17.3%, Campylobacter for 9.3%, Salmonella for 6.6%, adenovirus for 5.4%, G. duodenalis and C. parvum for 2.7% each, and Yersinia enterocolitica for 1.3%. No cases of shigellosis or infection with EHEC, EPEC, or astrovirus were diagnosed. Viruses accounted for 58.7% of the 75 positive results, bacteria for 36.0%, and parasites for 5.3%.

Conclusion:

Our study underlines a dominant role of norovirus and toxigenic C. difficile as etiologic agents of acute gastroenteritis among the patients of general practitioners.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Van Lier E, Havelaar A, Nanda A: The burden of infectious diseases in Europe: a pilot study. Euro Surveill 2007; 12: E3–4.

    PubMed  Google Scholar 

  2. Caspary WF, Lüpke NP, Oldiges FJ, Wahle K: Diarrhoe in der ärztlichen Praxis. Eine Bestandsaufnahme. Münch Med Wochenschr 1995; 137: 411–415.

    Google Scholar 

  3. Schlundt J, Toyofuku H, Jansen J, Herbst SA: Emerging food-borne zoonoses. Rev sci tech Off int Epiz 2004; 23: 513–533.

    CAS  Google Scholar 

  4. de Wit MA, Koopmans MP, Kortbeek LM, van Leeuwen NJ, Bartelds AI, van Duynhoven YT: Gastroenteritis in sentinel general practices, The Netherlands. Emerg Infect Dis 2001; 7: 82–91.

    PubMed  Google Scholar 

  5. Anonymous: Standardisierung und Qualitätssicherung in mikrobiologischer Labordiagnostik. Richtlinien. In: Liebeswar G (ed): Bundesministerium für soziale Sicherheit und Generationen, Innsbruck 2001. ISBN 3-85123-126-0.

    Google Scholar 

  6. Ando T, Monroe SS, Gentsch JR, Jin Q, Lewis DC, Glass RI: Detection and differentiation of antigenically distinct small round-structured viruses (Norwalk-like viruses) by reverse transcription-PCR and southern hybridization. J Clin Microbiol 1995; 33: 64–71.

    PubMed  CAS  Google Scholar 

  7. Green J, Gallimore CI, Norcott JP, Lewis D, Brown DW: Broadly reactive reverse transcriptase polymerase chain reaction for the diagnosis of SRSV-associated gastroenteritis. J Med Virol 1995; 47: 392–398.

    Article  PubMed  CAS  Google Scholar 

  8. Miller I, Gunson R, Carman WF: Norwalk-like virus by light cycler PCR. J Clin Virol 2002; 25: 231–232.

    Article  PubMed  CAS  Google Scholar 

  9. Denny J, Boelaert F, Borck B, Heuer OE, Ammon A, Makela P: Zoonotic infections in Europe: trends and figures — a summary of the EFSA-ECDC annual report 2007. Euro Surveill 12:E071220.6.

  10. CDC Preliminary FoodNet Data on the incidence of infection with pathogens transmitted commonly through food — 10 States, 2006. MMWR 2007; 56: 336–339.

    Google Scholar 

  11. Barbut F, Leluan P, Antoniotti G, Collignon A, Sedallian A, Petit JC: Value of routine stool cultures in hospitalized patients with diarrhea. Eur J Clin Microbiol Infect Dis 1995; 14: 346–349.

    Article  PubMed  CAS  Google Scholar 

  12. Bauer TM, Lalvani A, Fahrenbach J, Steffen I, Aponte JJ, Segovia R, Vila J, Philippczik G, Steinbrückner B, Frei R, Bowler I, Kist M: Derivation and validation of guidelines for stool cultures for enteropathogenic bacteria other than Clostridium difficile in hospitalized adults. JAMA 2001; 285: 313–319.

    Article  PubMed  CAS  Google Scholar 

  13. Thielman NM, Guerrant RL: Acute infectious diarrhea. N Engl J Med 2004; 350: 38–47.

    Article  PubMed  CAS  Google Scholar 

  14. Vesikari T, Karvonen A, Prymula R, Schuster V, Tejedor JC, Cohen R, Meurice F, Han HH, Damaso S, Bouckenooghe A: Efficacy of human rotavirus vaccine against rotavirus gastroenteritis during the first 2 years of life in European infants: randomised, double-blind controlled study. Lancet 2007; 370: 1739–1740.

    Article  CAS  Google Scholar 

  15. Colomba C, Saporito L, Giammanco GM, De Grazia S, Ramirez S, Arista S, Titone L: Norovirus and gastroenteritis in hospitalized children, Italy. Emerg Infect Dis 2007; 9: 1389–1391.

    Google Scholar 

  16. Guerrant RL, van Gilder T, Steiner TS, Thielman NM, Slutsker L, Tauxe RV, Hennessy T, Griffin PM, DuPont H, Sack RB, Tarr P, Neill M, Nachamkin I, Reller LB, Osterholm MT, Bennish ML, Pickering LK: Infectious Diseases Society of America Practice guidelines for the management of infectious diarrhea. Clin Infect Dis 2001; 32: 331–351.

    Article  PubMed  CAS  Google Scholar 

  17. McFarland LV, Beneda HW, Clarridge JE, Raugi GJ: Implications of the changing face of Clostridium difficile disease for health care practitioners. Am J Infect Contr 2007; 35: 237–53.

    Article  Google Scholar 

  18. Fekety R: Guidelines for the diagnosis and management of Clostridium difficile-associated diarrhea and colitis. Am J Gastroenterol 1997; 92: 739–50.

    PubMed  CAS  Google Scholar 

  19. Indra A, Schmid D, Huhulescu S, Hell M, Gattringer R, Hasenberger P, Fiedler A, Wewalka G, Allerberger F: Characterization of clinical Clostridium difficile isolates by PCR-ribotyping and detection of toxin genes-Austria, 2006/2007. J Med Microbiol 2008; 57: 702–708.

    Article  PubMed  CAS  Google Scholar 

  20. Allerberger F, Rossboth D, Dierich MP, Aleksic S, Schmidt H, Karch H: Prevalence and clinical manifestations of shiga toxinproducing Escherichia coli infections in Austrian children. Eur J Clin Microbiol Infect Dis 1996; 15: 545–550.

    Article  PubMed  CAS  Google Scholar 

  21. Heymann DL: Control of communicable diseases manual. (18th edn.). American Public Health Association, Washington D.C., 2004.

    Google Scholar 

  22. Lederer W, Allerberger F, Dierich MP: Cryptosporidia-associated gastroenteritis: epidemiologic investigation in children from Tyrol and Vorarlberg. Wien Klin Wochenschr 1996; 108: 649–653.

    PubMed  CAS  Google Scholar 

  23. Schwaiger M, Grif K, Pierard D, Karch H, Allerberger F: Shiga toxin-producing Escherichia coli are the third most frequent bacterial cause of diarrhea in Austria. Clin Microbiol Infect 1999; 5: 645–647.

    Article  PubMed  Google Scholar 

  24. Lindqvist R, Andersson Y, Lindbäck J, Wegscheider M, Eriksson Y, Tideström L, Lagerqvist-Widh A, Hedlund KO, Löfdahl S, Svensson L, Norinder A: A one-year study of foodborne illnesses in the municipality of Uppsala, Sweden. Emerg Infect Dis 2001; 7: 588–593.

    Article  PubMed  CAS  Google Scholar 

  25. Huhulescu S, Indra A, Feierl G, Stoeger A, Rupptisch W, Sarkar B, Allerberger F: Occurrence of Vibrio cholerae serogroups other than O1 and O139 in Austria. Wien Klin Wochenschr 2007; 119: 235–241.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Österreichische Agentur für Gesundheit und Ernährungssicherheit (AGES), Spargelfeldstr. 191, 1220, Vienna, Austria

    S. Huhulescu, R. Kiss, M. Brettlecker, R. J. Cerny, C. Hess, G. Wewalka & F. Allerberger

Authors
  1. S. Huhulescu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. Kiss
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Brettlecker
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. J. Cerny
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. C. Hess
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. G. Wewalka
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. F. Allerberger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to F. Allerberger.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Huhulescu, S., Kiss, R., Brettlecker, M. et al. Etiology of Acute Gastroenteritis in Three Sentinel General Practices, Austria 2007. Infection 37, 103–108 (2009). https://doi.org/10.1007/s15010-008-8106-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s15010-008-8106-z

Keywords

Search

Navigation