Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
권호 표지
DOI QR코드

DOI QR Code

Prevalence, Laboratory Findings and Clinical Characteristics of Campylobacteriosis Agents among Hospitalized Children with Acute Gastroenteritis in Lebanon

  • Ghssein, Ghassan (Rammal Hassan Rammal Research Laboratory, PhyToxE Research Group, Faculty of Sciences, Lebanese University) ;
  • Awada, Rana (Rammal Hassan Rammal Research Laboratory, PhyToxE Research Group, Faculty of Sciences, Lebanese University) ;
  • Salami, Ali (Department of Mathematics, Faculty of Sciences, Lebanese University) ;
  • Bahmad, Hisham F. (Arkadi M. Rywlin M.D. Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center) ;
  • Awad, Ali (Department of Biology, Faculty of Sciences, Lebanese University) ;
  • Joumaa, Wissam H. (Rammal Hassan Rammal Research Laboratory, PhyToxE Research Group, Faculty of Sciences, Lebanese University) ;
  • Roz, Ali El (Rammal Hassan Rammal Research Laboratory, PhyToxE Research Group, Faculty of Sciences, Lebanese University)
  • Received : 2020.10.15
  • Accepted : 2021.03.06
  • Published : 2021.07.15
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: Campylobacter species are currently the most common cause of bacterial gastroenteritis. In Lebanon, Campylobacter infection occurrence is underdiagnosed owing to the lack of specific culture and rapid test kits, particularly among children. This study aimed to evaluate the prevalence, laboratory findings, and clinical characteristics of Campylobacter infection in hospitalized children with acute gastroenteritis in South Lebanon. Methods: We conducted a 6-month retrospective cohort study between January and June 2018, including 291 children aged between 1 month and 12 years, who were admitted to a tertiary healthcare center in South Lebanon. The medical files of the patients were reviewed to retrieve the required clinical information, including clinical and laboratory data. Results: The prevalence of campylobacteriosis agents in pediatric patients with acute gastroenteritis is 12.02%. Patients infected with Campylobacter had more severe acute gastroenteritis than Campylobacter-negative patients and often presented with high-grade fever, diarrhea episodes more than six times per day, diarrhea lasting for more than five days, and dehydration. Indeed, children with high-grade fever (≥38.5℃) were five times more likely to test positive for Campylobacter than those with low-grade fever. In addition, the results showed a higher Vesikari score for the majority of Campylobacter-positive patients with severe acute gastroenteritis compared to a moderate profile for Campylobacter-negative patients. Conclusion: The present study findings highlight that Campylobacter infection is frequent among children with acute gastroenteritis. Therefore, the detection of Campylobacter should be carried out for the diagnosis of human gastroenteritis in Lebanon, along with the detection of routine enteropathogens.

Keywords

Acknowledgement

We would like to thank all the parents of the children enrolled in this study who accepted to give us the requested information. Second, we would like to express our gratitude to the healthcare center and Lebanese University for their support in conducting this study.

References

  1. Thompson SA, Blaser MJ. Pathogenesis of Campylobacter fetus infections. In: Nachamkin I, Blaser MJ, eds. Campylobacter. 2nd ed. Washington, DC: ASM Press, 2000:321-47.
  2. European Food Safety Authority and European Centre for Disease Prevention and Control (EFSA and ECDC). The European Union summary report on trends and sources of zoonoses, zoonotic agents and food-borne outbreaks in 2017. EFSA J 2018;16:e05500. https://doi.org/10.2903/j.efsa.2018.5500
  3. Kaakoush NO, Castano-Rodriguez N, Mitchell HM, Man SM. Global epidemiology of Campylobacter infection. Clin Microbiol Rev 2015;28:687-720. https://doi.org/10.1128/CMR.00006-15
  4. Fischer GH, Paterek E. Campylobacter. In: StatPearls. Treasure Island (FL): StatPearls Publishing, 2020.
  5. Liu F, Ma R, Wang Y, Zhang L. The clinical importance of Campylobacter concisus and other human hosted Campylobacter species. Front Cell Infect Microbiol 2018;8:243. https://doi.org/10.3389/fcimb.2018.00243
  6. Igwaran A, Okoh AI. Human campylobacteriosis: a public health concern of global importance. Heliyon 2019;5:e02814. https://doi.org/10.1016/j.heliyon.2019.e02814
  7. Hameed A. Human immunity against Campylobacter infection. Immune Netw 2019;19:e38. https://doi.org/10.4110/in.2019.19.e38
  8. Humphries RM, Linscott AJ. Practical guidance for clinical microbiology laboratories: diagnosis of bacterial gastroenteritis. Clin Microbiol Rev 2015;28:3-31. https://doi.org/10.1128/CMR.00073-14
  9. Kulkarni SP, Lever S, Logan JM, Lawson AJ, Stanley J, Shafi MS. Detection of campylobacter species: a comparison of culture and polymerase chain reaction based methods. J Clin Pathol 2002;55:749-53. https://doi.org/10.1136/jcp.55.10.749
  10. Wagenaar JA, French NP, Havelaar AH. Preventing Campylobacter at the source: why is it so difficult? Clin Infect Dis 2013;57:1600-6. https://doi.org/10.1093/cid/cit555
  11. Silva J, Leite D, Fernandes M, Mena C, Gibbs PA, Teixeira P. Campylobacter spp. as a foodborne pathogen: a review. Front Microbiol 2011;2:200. https://doi.org/10.3389/fmicb.2011.00200
  12. Same RG, Tamma PD. Campylobacter infections in children. Pediatr Rev 2018;39:533-41. https://doi.org/10.1542/pir.2017-0285
  13. Ibrahim JN, Eghnatios E, El Roz A, Fardoun T, Ghssein G. Prevalence, antimicrobial resistance and risk factors for campylobacteriosis in Lebanon. J Infect Dev Ctries 2019;13:11-20. https://doi.org/10.3855/jidc.10729
  14. Ruuska T, Vesikari T. Rotavirus disease in Finnish children: use of numerical scores for clinical severity of diarrhoeal episodes. Scand J Infect Dis 1990;22:259-67. https://doi.org/10.3109/00365549009027046
  15. Dabboussi F, Alam S, Mallat H, Hlais S, Hamze M. [Preliminary study on the prevalence of Campylobacter in childhood diarrhoea in north Lebanon]. East Mediterr Health J 2012;18:1225-8. French. https://doi.org/10.26719/2012.18.12.1225
  16. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39:175-91. https://doi.org/10.3758/BF03193146
  17. Salami A, Fakih H, Chakkour M, Salloum L, Bahmad HF, Ghssein G. Prevalence, risk factors and seasonal variations of different Enteropathogens in Lebanese hospitalized children with acute gastroenteritis. BMC Pediatr 2019;19:137. https://doi.org/10.1186/s12887-019-1513-8
  18. Talhouk RS, el-Dana RA, Araj GF, Barbour E, Hashwa F. Prevalence, antimicrobial susceptibility and molecular characterization of Campylobacter isolates recovered from humans and poultry in Lebanon. J Med Liban 1998;46:310-6.
  19. Ghssein G, Salami A, Salloum L, Chedid P, Joumaa WH, Fakih H. Surveillance study of acute gastroenteritis etiologies in hospitalized children in south Lebanon (SAGE study). Pediatr Gastroenterol Hepatol Nutr 2018;21:176-83. https://doi.org/10.5223/pghn.2018.21.3.176
  20. Zaraket R, Salami A, Bahmad M, El Roz A, Khalaf B, Ghssein G, et al. Prevalence, risk factors, and clinical characteristics of rotavirus and adenovirus among Lebanese hospitalized children with acute gastroenteritis. Heliyon 2020;6:e04248. https://doi.org/10.1016/j.heliyon.2020.e04248
  21. Howard P, Alexander ND, Atkinson A, Clegg AO, Gerega G, Javati A, et al. Bacterial, viral and parasitic aetiology of paediatric diarrhoea in the highlands of Papua New Guinea. J Trop Pediatr 2000;46:10-4. https://doi.org/10.1093/tropej/46.1.10
  22. Mukherjee P, Ramamurthy T, Bhattacharya MK, Rajendran K, Mukhopadhyay AK. Campylobacter jejuni in hospitalized patients with diarrhea, Kolkata, India. Emerg Infect Dis 2013;19:1155-6. https://doi.org/10.3201/eid1907.121278
  23. Greige S, Rivoal K, Osman M, Safadi DE, Dabboussi F, Hage RE, et al. Prevalence and genetic diversity of Campylobacter spp. in the production chain of broiler chickens in Lebanon and its association with the intestinal protozoan Blastocystis sp. Poult Sci 2019;98:5883-91. https://doi.org/10.3382/ps/pez286
  24. Rafei R, Al Kassaa I, Osman M, Dabboussi F, Hamze M. Molecular epidemiology of Campylobacter isolates from broiler slaughterhouses in Tripoli, North of Lebanon. Br Poult Sci 2019;60:675-82. https://doi.org/10.1080/00071668.2019.1645945
  25. Semaan EH, Dib H, Mrad R, Chami C, Jalkh R. Dynamic of Campylobacter species contamination along a poultry slaughtering chain. Ital J Food Saf 2014;3:2246.
  26. Sadiq A, Bokhari H, Noreen Z, Asghar RM, Bostan N. Magnitude of Rotavirus A and Campylobacter jejuni infections in children with diarrhea in Twin cities of Rawalpindi and Islamabad, Pakistan. BMC Infect Dis 2019;19:978. https://doi.org/10.1186/s12879-019-4575-1
  27. Shim DH, Kim DY, Cho KY. Diagnostic value of the Vesikari Scoring System for predicting the viral or bacterial pathogens in pediatric gastroenteritis. Korean J Pediatr 2016;59:126-31. https://doi.org/10.3345/kjp.2016.59.3.126
  28. Janssen R, Krogfelt KA, Cawthraw SA, van Pelt W, Wagenaar JA, Owen RJ. Host-pathogen interactions in Campylobacter infections: the host perspective. Clin Microbiol Rev 2008;21:505-18. https://doi.org/10.1128/CMR.00055-07