Abstract
Establishing the etiology of acute diarrhea is complex because of the many variables influencing its cause and/or detection, including age, geographic location, season, and availability of laboratory procedures necessary to fully identify the various agents. Regardless of the part of the world in which it occurs, acute infectious diarrhea cannot be attributed to any one enteropathogen. The presence of rotavirus (RV) in stool specimens of a substantial proportion of children with diarrhea is evidence of the importance of this agent in endemic illness. A correlation exists between identification of RV in stool specimens and serologic response to infection. Enterotoxigenic E. coli. (ETEC) is an important cause of diarrhea in persons from industrialized countries during travel to developing regions, but it does not account for a large number of endemic cases of diarrhea in children in the United States. Serotype-determined enteropathogenic E. coli (EPEC) is an important cause of infantile diarrhea, yet the relative frequency of occurrence and mechanisms of pathogenesis are unknown. Intestinal infections due to Shigella and Salmonella generally occur in the summer months in children over 3 months of age and in adults. G. lamblia is a cause of acute, chronic, and recurrent diarrhea in all age groups. Other agents which require specialized laboratory techniques for identification have been shown to cause diarrhea on occasion.
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References
Gurwith, M. J., Williams, T. W. Gastroenteritis in children: A two-year review in Manitobia: I. Etiology. J. Infect. Dis. 136: 239–247, 1977.
Pickering, L. K., Evans, D. J., Jr., MiInoz, O., et al. Prospective study of enteropathogens in children with diarrhea in Houston and Mexico. J. Pediatr. 93: 383–388, 1978.
Greenberg, H. B., Wyatt, R. G., Valdesuso, J., et al.Solid-phase microtiter radioimmunoassay for detection of the Norwalk strain of acute nonbacterial, epidemic gastroenteritis virus and its antibody. J. Med. Virol. 2: 97–108, 1978.
Gorbach, S. L., Khurana, C. M. Toxigenic Escherichia coli: A cause of infantile diarrhea in Chicago. N. Engl. J. Med. 287: 791–795, 1972.
Rudoy, R. C., Nelson, J. D. Enteroinvasive and enterotoxigenic Escherichia coli: Occurrence in acute diarrhea of infants and children. Am. J. Dis. Child. 129: 668–672, 1975.
Sack, R. B., Hirschhorn, N., Brownlee, I., et al.Enterotoxigenic Escherichia coli-associated diarrheal disease in Apache children. N. Engl. J. Med. 292: 1041–1045, 1975.
Kapikian, A. Z., Kim, H. W., Wyatt, R. G., et al.Human reovirus-like agent as the major pathogen associated with “winter” gastroenteritis in hospitalized infants and young children. N. Engl. J. Med. 294: 965–972, 1976.
Echeverria, P., Ho, M. T., Blacklow, N. R., et al. Relative importance of viruses and bacteria in the etiology of pediatric diarrhea in Taiwan. J. Infect. Dis. 136: 383–390, 1977.
Echeverria, P., Blacklow, N. R., Smith, D. H., Role of heat-labile toxigenic Escherichia coliand reovirus-like agent in diarrhoea in Boston children. Lancet 2: 1113–1116, 1975.
Dean, A. G., Ching, Y. C., Williams, R. G., et al.Test for Escherichia colienterotoxin using infant mice: Application in a study of diarrhea in children in Honolulu. J. Infect. Dis. 125: 407–411, 1972.
Evans, D. G., Olarte, J., DuPont, H. L., et al.Enteropathogens associated with pediatric diarrhea in Mexico City. J. Pediatr. 91: 65–68, 1977.
Donta, S. T., Wallace, R. B., Whipp, S. C., et al.Enterotoxigenic Escherichia coli and diarrheal disease in Mexican children. J. Infect. Dis. 135: 482–485, 1977.
Ruiz-Palacios, G., Evans, D. G., Evans, D. J., Jr., et al. Age-related acquisition of IgG and IgM antibodies to heat-labile enterotoxin of Escherichia coli (abstract). In Abstracts of the Annual Meeting of the American Society for Microbiology, Las Vegas, Nev., May 17, 1978.
Gurwith, M. J., Wiseman, D. A., Chow, P. Clinical and laboratory assessment of the pathogenicity of serotyped enteropathogenic Escherichia coli. J. Infect. Dis. 135: 735–743, 1977.
Klipstein F. A., Rowe, B., Engert, R. F., et al. Enterotoxigenicity of enteropathogenic serotypes of Escherichia coli isolated from infants with epidemic diarrhea. Infect. Immun. 21: 171–178, 1978.
Rodriguez, W. J-., Kim, H. W., Arrobio, J. O., et al. Clinical features of acute gastroenteritis associated with human reovirus-like agent in infants and young children. J. Pediatr. 91: 188–193, 1977.
Guerrant, R. L., Moore, R. A., Kirshenfeld, P. M., et al. Role of toxigenic and invasive bacteria in acute diarrhea of childhood. N. Engl. J. Med.293: 567–572, 1975.
Echeverria, P., Blacklow, N. R., Vollet, J. L., III, et al.Reovirus-like agent and enterotoxigenic Escherichia coli infections in pediatric diarrhea in the Philippines. J. Infect. Dis. 138: 326–332, 1978.
DuPont, H. L., Olarte, J., Evans, D. G., et al.Comparative susceptibility of Latin American and United States students to enteric pathogens. N. Engl. J. Med. 295: 1520–1521, 1976.
Wadstrom, T., Aust-Kettis, A., Habte, D., et al. Enterotoxin-producing bacteria and parasites in stools of Ethiopian children with diarrheal disease. Arch. Dis. Child. 51: 865–870, 1976.
King, E. O.: Human infections with Vibrio fetus and a closely related vibrio. J. Infect. Dis. 101: 119–128, 1957.
Véron, M., Chatelain, R.: Taxonomic study of the genus Campylobacter Sebald and Véron and designation of the neotype strain for the type species, Campylobacter fetus (Smith and Taylor) Sebald and Veron. Int. J. Syst. Bacteriol. 23: 122–134, 1973.
Smibert, R. M. In R. E. Buchanan & N.E. Gibbons (eds.), Bergey’s Manual of Determinative Bacteriology, 8th ed. Williams & Wilkins, Baltimore, 1974, pp. 207–212.
Bryner, J. H., O’Berry, P. A., Estes, P. C., et al.Studies of vibrios from gallbladder of market sheep and cattle. Am. J. Vet. Res. 33: 1439–1444, 1972.
Butzler, J. P., Dekegel, D., Hubrechts, J. M., et al. Mode of transmission of human campylobacteriosis. In W. Siegenthaler & R. Luthy (eds.), Current Chemotherapy: Proceedings of the 10th International Congress of Chemotherapy, Vol. 1. American Society for Microbiology, Washington, D. C., 1978, pp. 174–175.
United States Department of Health, Education and Welfare, Public Health Service, Center for Disease Control. Waterborne Campylobacter gastroenteritis-Vermont. Morbid. Mortal. Week. Rep. 27: 207, 1978.
Skirrow, M. B.: Campylobacter enteritis: A “new” disease. Br. Med. J. 2: 9–11, 1977.
Lindquist, B., Kjellander, J., Kosunen, T.: Campylobacter enteritis in Sweden. Br. Med. J. 1: 303, 1978.
Wheeler, W. E., Borchers, J.: Vibrionic enteritis in infants. Am. J. Dis. Child. 101: 60–66, 1961.
United States Department of Health, Education and Welfare, Public Health Service, Center for Disease Control. Campylobacterenteritis—Colorado. Morbid. Mortal. Week. Rep. 27: 226–231, 1978.
Levy, A. J.: A gastro-enteritis outbreak probably due to a bovine strain of vibrio. Yale J. Biol. Med. 18: 243–258, 1946.
Communicable Disease Surveillance Centre. Outbreaks of campylobacter infection. Commun. Dis. Rep. 78: 20, 1978.
Lauwers, S., DeBoeck, M., Butzler, J. P.: Campylobacter enteritis in Brussels. Lancet 1: 604–605, 1978.
Cadranel, S., Rodesch, P., Butzler, J. P., et al. Enteritis due to “related vibrio” in children. Am. J. Dis. Child. 126: 152 155, 1973.
Karmali, M. A., Fleming, P. C.: Campylobacter enteritis in children. J. Pediatr. 94: 527–533, 1979.
Vinzent, R., Dumas, J., Picard, N.: Septicémie grave au cours de la grossesse, due à un vibrion: Avortement consécutif. Bull. Acad. Natl. Méd. Paris 131: 90–92, 1947.
Eden, A. N.: Perinatal mortality caused by Vibrio fetus. J. Pediatr. 68: 297–304, 1966.
Communicable Disease Surveillance Centre. Reports of campylobacter isolates in 1977. Commun. Dis. Rep. 78: 13, 1978.
Bokkenheuser, V. Vibrio fetus infection in man: I. Ten new cases and some epidemiologic observations. Am. J. Epidemiol.91: 400–409, 1970.
Wyatt, R. A., Younoszai, K., Anuras, S., et al. Campylobacter fetus septicemia and hepatitis in a child with agammaglobulinemia. J. Pediatr.91: 441–442, 1977.
Dekeyser, P., Gossuin-Detrain, M., Butzler, J. P., et al. Acute enteritis due to related vibrio: First positive stool cultures. J. Infect. Dis. 125: 390–392, 1972.
Butzler, J. P., Dekeyser, P., Detrain, M., et al. Related vibrio in stool. J. Pediatr. 82: 493–495, 1973.
Butzler, J. P.: Related vibrios in Africa. Lancet 2: 858, 1973.
DeMol, P., Bosmans, E.: Campylobacter enteritis in central Africa. Lancet 1: 604, 1978.
Laboratory Centre for Disease Control. Campylobacter enteritis—Ontario. Can. Dis. Week. Rep. 4: 57–58, 1978.
Butzler, J. P., Dereume, J. P., Barbier, P., et al.L’origine digestive des septicémies à campylobacter. Nouv. Presse. Méd. 6: 1033–1035, 1977.
United States Department of Health, Education and Welfare, Public Health Service, Center for Disease Control. Campylobacterenteritis—Iowa. Morbid. Mortal. Week. Rep. 28: 565–566, 1979.
Butzler, J. P., Dekeyser, P., Lafontaine, T.: Susceptibility of related vibrios and Vibrio fetus to twelve antibiotics. Antimicrob. Agents Chemother. 5: 86–89, 1974.
Vanhoof, R., Vanderlinden, M. P., Dierickx, R., et al.Susceptibility of Campylobacter fetussubsp. jejunito twenty-nine antimicrobial agents. Antimicrob. Agents Chemother. 14: 553–556, 1978.
Chow, A. W., Patten, V., Bednorz, D.: Susceptibility of Campylobacter fetusto twenty-two antimicrobial agents. Antimicrob. Agents Chemother. 13: 416–418, 1978.
Gardner, A. D., Venkatraman, K. V.: The antigens of the cholera group of vibrios. J. Hyg. (London) 35: 262–282, 1935.
Hsi-Chia, H., Liu, P. V.: Serological identities of proteases and alkaline phosphatases of the so-called nonagglutinable (NAG) vibrios and those of Vibrio cholerae. J. Infect. Dis. 121: 251–259, 1970.
: Zinnaka, Y., Carpenter, C. C., J., Jr.: An enterotoxin produced by noncholera vibrios. Johns Hopkins Med. J. 131: 403–411, 1972.
Ohashi, M., Shimada, T., Fukumi, H. In vitroproduction of enterotoxin and hemor- rhagic principle by Vibrio cholerae, NAG. Jpn. J. Med. Sci. Biol. 25: 179–194, 1972.
McIntyre, O. R., Feeley, J. C., Greenough, W. B., et al.Diarrhea caused by noncholera vibrios. Am. J. Trop. Med. 14: 412–418, 1965.
El-Shawi, N., Thewaini, A. J.: Nonagglutinable vibrios isolated in the 1966 epidemic of cholera in Iraq. Bull. W. H. O. 40: 163–166, 1969.
Hughes, J. M., Hollis, D. G., Gangarosa, E. J., et al.Noncholera vibrio infections in the United States. Clinical, epidemiologic and laboratory features. Ann. Intern. Med. 88: 602–606, 1978.
Back, E., Ljunggren, A., Smith, H., Jr.: Noncholera vibrios in Sweden. Lancet 1: 723–724, 1974.
Miyamoto, Y., Nakamura, K., Takizawa, K.: Seasonal distribution of Oceanomonasspp., halophilic bacteria, in the coastal sea: Its significance in epidemiology and marine industry. Jap. J. Microbiol. 6: 141–158, 1962.
Kaneko, T., Colwell, R. R.: Distribution of Vibrio parahaemolyticusand related organisms in the Atlantic Ocean off South Carolina and Georgia. Appl. Microbiol 28: 1009–1017, 1974.
Sakazaki, R., Iwanami, S., Fukumi, H.: Studies on the enteropathogenic, facultatively halophilic bacteria, Vibrio parahaemolyticus: I. Morphological, cultural, and biochemical properties and its taxonomical position. Jpn. J. Med. Sci. Biol. 16: 161–188, 1963.
Sakazaki, R., Tamura, K., Kato, T., et al.Studies on the enteropathogenic, facultatively halophilic bacteria, Vibrio parahaemolyticus: III. Enteropathogenicity. Jpn. J. Med. Sci. Biol. 21: 325–331, 1968.
Chun, D., Chung, J. K., Tak, R., et al.Nature of the Kanagawa phenomenon of Vibrio parahaemolyticus. Infect. Immun. 12: 81–87, 1975.
Zen-Yoji, H., Sakai, S., Terayama, T.,et al. Epidemiology, enteropathogenicity, and classification of Vibrio parahaemolyticus. J. Infect. Dis. 115: 436–444, 1965.
Johnson, D. E., Calia, F. M.,: False-positive rabbit ileal loop reactions attributed to Vibrio parahaemolyticus broth filtrates. J. Infect. Dis. 133: 436–4. 40, 1976.
Lawrence, D. N., Blake, R. A., Yashuk, J. C., et al. Vibrio parahaemolyticus gastroenteritis outbreaks aboard two cruise ships. Am. J. Epidemiol. 109: 71–80, 1979.
Gangarosa, E. J., Dewitt, W. E., Hug, I., et al.Laboratory methods in cholera: Isolation of Vibrio cholerae(El Tor and classical) on TCBS medium in minimally equipped laboratories. Trans. R. Soc. Trop. Med. Hyg. 62: 693–699, 1968.
Gilbert, R.: Interesting cases and unusual specimens. N.Y. State Dep. Health Annu. Rep. Div. Lab. Res. 1933: 57. 1971
Mollaret, H. H.: L’infection humaine à “Yersinia enterocolitica”en 1970, à la lumière de 642 cas recents: Aspects cliniques et perspectives epidemiologiques. Pathol. Biol. 19: 189–205, 1971.
Lafleur, L., Martineau, B., Chicoine, L.: Yersinia enterocolitica: Aspects biologiques, épidémiologiques et cliniques de 67 cas observés à l’Hôpital Sainte-Justine (Montreal, Canada). Union Mid. Can. 101: 2407–2413, 1972.
Bergstrand, C. G., Winblad, S.: Clinical manifestations of infection with Yersinia enterocolitica in children. Acta Paediatr. Scand. 63: 875–877, 1974.
Delorme, J., Laverdiere, M., Martineau, B., et al.Yersiniosis in children. Can. Med. Assoc. J. 110: 281–284, 1974.
Schieven, B. C., Randall, C.: Enteritis due to Yersinia enterocolitica. J. Pediatr. 84: 402–404, 1974.
Bottone, E. J.: Yersinia enterocolitica: A panoramic view of a charismatic microorganism. CRCCrit. Rev. Microbiol. 52: 211–241, 1977.
Arvastson, B., Damgaard, K., Winblad, S.: Clinical symptoms of infection with Yersinia enterocolitica. Scand. J. Infect. Dis. 3: 37–40, 1971.
Leino, R., Kalliomaki, J. L.: Yersiniosis as an internal disease. Ann. Intern. Med. 81: 458–461, 1974.
Hubbert, W. T.: Yersiniosis in mammals and birds in the United States: Case reports and review. Am. J. Trop. Med. Hyg. 21: 458–463, 1972.
Mair, N. S.: Yersiniosis in wildlife and its public health implications. J. Wild. Dis. 9: 64–71, 1973.
Toma, S.: Survey on the incidence of Yersinia enterocolitica in the province of Ontario. Can. J. Public Health 64: 477–487, 1973.
Schieman, D. A., Toma, S.: Isolation of Yersinia enterocolitica from raw milk. Appl. Environ. Microbiol. 35: 54–58, 1978.
Black, R. E., Jackson, R. J., Tsai, T., et al. Epidemic Yersinia enterocolitica infection due to contaminated chocolate milk. N. Engl. J. Med. 289: 76–79, 1978.
Highsmith, A. K., Feeley, J. C., Skaliy, P., et al. Isolation of Yersinia enterocoliticafrom well water and growth in distilled water. Appl. Environ. Microbiol. 34: 745–750, 1977.
Lassen, J.: Yersinia enterocolitica in drinking water. Scand. J. Infect. Dis. 4: 125–127, 1972.
Keet, E. E.: Yersinia enterocolitica septicemia-source of infection and incubation period identified. N.Y. State J. Med. 74: 2226–2230, 1974.
Tsubokura, M., Otsuki, K., Itagaki, K.: Studies on Yersinia enterocolitica: I. Isolation of Y. enterocolitica from swine. Jpn. J. Vet. Sci. 35: 419–424, 1973.
Rabson, A. R., Koornhof, H. J., Notman, J., et al. Hepatosplenic abscesses due to Yersinia enterocolitica. Br. Med. J. 4: 341, 1972.
Ahvonen, P.: Human yersiniosis in Finland: II. Clinical features. Ann. Clin. Res. 4: 39–48, 1972.
Toivanen, P., Toivanen, A., Olkkonen, L., et al. Hospital outbreak of Yersinia enterocolitica infection. Lancet 1: 801–803, 1973.
Kohl, S., Jacobson, J. A., Nahmias, A.: Yersinia enterocolitica infections in children. J. Pediatr. 89: 77–79, 1976.
Gutman, L. T., Ottesen, E. A., Quan, T. J., et al. An inter-familial outbreak of Yersinia enterocolitica enteritis. N. Engl. J. Med. 288: 1372–1377, 1973.
Maki, M., Gronroos, P., Vesikari, T.: In vitro Invasiveness of Yersinia enterocolitica isolated from children with diarrhea. J. Infect. Dis. 138: 677–680, 1978.
Pai, C. H., Mors, V., Toma, S.: Prevalence of enterotoxigenicity in human and nonhuman isolates of Yersinia enterocolitica. Infect. Immun. 22: 334–338, 1978.
Bradford, W. D., Noce, P. S., Gutman, L. T.: Pathologic features of enteric infection with Yersinia enterocolitica. Arch. Pathol. 98: 17–22, 1974.
Vantrappen, G., Agg, H. O., Ponette, E., et al. Yersinia enteritis and enterocolitis: Gastroenterological aspects. Gastroenterology 72: 220–227, 1977.
Ahvonen, P., Rossi, T.: Familial occurrence of Yersinia enterocoliticainfection and acute arthritis. Acta Paediatr. Scand. Suppl. 206: 121–122, 1970.
Laitinen, O., Tuuhea, J., Ahvonen, P.: Polyarthritis associated with Yersinia enterocoliticainfection: Clinical features and laboratory findings in nine cases with severe joint symptoms. Ann. Rheum. Dis. 31: 34–39, 1972.
Winblad, S.: Erythema nodosum associated with infection with Yersinia enterocolitica. Scand. J. Infect. Dis. 1: 11–16, 1969.
Bissett, M. L.: Yersinia enterocolitica isolates from humans in California, 1968–1975. J. Clin. Microbiol. 4: 137–144, 1976.
Abramovitch, H., Butas, C. A.: Septicemia due to Yersinia enterocolitica. Can. Med. Assoc. J. 109: 1112–1115, 1973.
Rabson, A. R., Hallett, A. F., Koornhof, H. J.: Generalized Yersinia enterocolitica infection. J. Infect. Dis. 131: 447–451, 1975.
Spira, T. J., Kabins, S. A.: Yersinia enterocolitica septicemia with septic arthritis. Arch. Intern. Med. 136: 1305–1308, 1976.
Nilehn, B.: Studies on Yersinia enterocoliticawith special reference to bacterial diagnosis and occurrence in human enteric disease. Acta Pathol. Microbiol. Scand. Suppl. 206: 1–48, 1969.
Lee. W. H., McGrath, P. P., Carter, P. H., et al. The ability of some Yersinia enterocolitica strains to invade HeLa cells. Can. J. Microbiol. 23: 1714–1722, 1977.
Boyce, J. M., Evans, D. J., Jr., Evans, D. G., et al.Production of heat-stable, methanol-soluble enterotoxin by Yersinia enterocolitica. Infect. Immun. 25: 532–537, 1979.
Pai, C. H., Mors, V., Toma, S.: Prevalence of enterotoxigenicity in human and nonhuman isolates of Yersinia enterocolitica. Infect. Immun. 22: 234–338, 1978.
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DuPont, H.L., Pickering, L.K. (1980). Relative Importance of Enteropathogens in Acute Endemic Diarrhea and Food-Borne Diarrheal Illness. In: Infections of the Gastrointestinal Tract. Current Topics in Infectious Disease. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-3695-2_8
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