Abstract
The study presented here aimed to elucidate the diagnostic value of bacterial stool cultures and viral antigen tests when performed based on the clinical characteristics of acute gastroenteritis in infants and young children. A total of 21 (11.2%) bacterial and 74 (39.6%) viral infections affecting 187 children under the age of 3 years was investigated. Blood (p<0.001) and mucus (p=0.014) in the stool and a C-reactive protein (CRP) level of ≥50 mg/l (p=0.006) were more significantly associated with gastroenteritis of bacterial rather than viral origin. Vomiting (p<0.001) was significantly associated with viral gastroenteritis. Among children with bloody stool, culture grew a Salmonella spp. in 35% and for vomiting children, stool antigen tests detected rotavirus in 60% of cases. In conclusion, etiologic tests to determine the cause of childhood gastroenteritis according to their characteristic clinical features or laboratory test results, or both, are of low diagnostic value.
Similar content being viewed by others
References
Kafetzis DA, Maltezou HC, Zafeiropoulou A, Attilakos A, Stavrinadis C, Foustoukou M (2001) Epidemiology, clinical course, and impact on hospitalization costs of acute diarrhea among hospitalized children in Athens, Greece. Scand J Infect Dis 33:681–685
Yang YJ, Huang MC, Wang SM, Wu JJ, Cheng CP, Liu CC (2002) Analysis of risk factors for bacteremia in children with nontyphoidal Salmonella gastroenteritis. Eur J Clin Microbiol Infect Dis 21:290–293
Yang YJ, Liu CC, Wu JJ, Wang SM, Huang AH, Cheng CP (1998) High rates of antimicrobial resistance among clinical isolates of nontyphoidal Salmonella in Taiwan. Eur J Clin Microbiol Infect Dis 17:880–883
Chao HC, Chiu CH, Kong MS, Chang LY, Huang YC, Lin TY, Lou CC (2000) Factors associated with intestinal perforation in children’s nontyphi Salmonella toxic megacolon. Pediatr Infect Dis J 19:1158–1162
Bates PR, Bailey AS, Wood DJ, Morris DJ, Couriel JM (1993) Comparative epidemiology of rotavirus, subgenus F (types 40 and 41) adenovirus, and astrovirus gastroenteritis in children. J Med Virol 39:224–228
Naficy AB, Abu-Elyazeed R, Holmes JL, Rao MR, Savarino SJ, Kim Y, Wierzba TF, Peruski L, Lee YJ, Gentsch JR, Glass RI, Clemens JD (1999) Epidemiology of rotavirus diarrhea in Egyptian children and implications for disease control. Am J Epidemiol 150:770–777
Qiao H, Nilsson M, Abreu ER, Hedlund KO, Johansen K, Zaori G, Svensson L (1999) Viral diarrhea in children in Beijing, China. J Med Virol 57:390–396
Uhnoo I, Olding-Stenkvist E, Kreuger A (1986) Clinical features of acute gastroenteritis associated with rotavirus, enteric adenoviruses, and bacteria. Arch Dis Child 61:732–738
de Wit MA, Koopmans MP, Kortbeek LM, van Leeuwen NJ, Vinje J, van Duynhoven YT (2001) Etiology of gastroenteritis in sentinel general practices in the Netherlands. Clin Infect Dis 33:280–288
Chiu TF, Lee CN, Lee PI, Kao CL, Lin HC, Lu CY, Tseng HY, Hsu HL, Lee CY, Huang LM (2000) Rotavirus gastroenteritis in children: 5-year experience in a medical center. J Microbiol Immunol Infect 33:181–186
Grimwood K, Carzino R, Barnes GL, Bishop RF (1995) Patients with enteric adenovirus gastroenteritis admitted to an Australian pediatric teaching hospital from 1981 to 1992. J Clin Microbiol 33:131–136
Lin JH (1999) Astrovirus-associated gastroenteritis among children in Taipei. Newslett Infect Dis Train Program Taiwan 4:37
Maurer AM, Sturchler D (2000) A waterborne outbreak of small round structured virus, Campylobacter and Shigella coinfections in La Neuveville, Switzerland, 1998. Epidemiol Infect 125:325–332
Borgnolo G, Barbone F, Guidobaldi G, Olivo G (1996) C-reactive protein in viral and bacterial gastroenteritis in childhood. Acta Paediatr 85:670–674
Meloni GF, Tomasi PA, Spanu P, Piga S, Porcu A (1999) C-reactive protein levels for diagnosis of Salmonella gastroenteritis. Pediatr Infect Dis J 18:471–473
Acknowledgements
This work was supported by grant NCKUH-90-062 from the National Cheng Kung University Hospital, Tainan, Taiwan
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Liu, LJ., Yang, YJ., Kuo, PH. et al. Diagnostic value of bacterial stool cultures and viral antigen tests based on clinical manifestations of acute gastroenteritis in pediatric patients. Eur J Clin Microbiol Infect Dis 24, 559–561 (2005). https://doi.org/10.1007/s10096-005-1373-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10096-005-1373-z