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http://dx.doi.org/10.5223/pghn.2014.17.3.140

High Incidence of Staphylococcus aureus and Norovirus Gastroenteritis in Infancy: A Single-Center, 1-Year Experience  

Sung, Kyoung (Department of Pediatrics, Pusan National University Children's Hospital)
Kim, Ji Yong (Department of Pediatrics, Pusan National University Children's Hospital)
Lee, Yeoun Joo (Department of Pediatrics, Pusan National University Children's Hospital)
Hwang, Eun Ha (Department of Pediatrics, Pusan National University Children's Hospital)
Park, Jae Hong (Department of Pediatrics, Pusan National University Children's Hospital)
Publication Information
Pediatric Gastroenterology, Hepatology & Nutrition / v.17, no.3, 2014 , pp. 140-146 More about this Journal
Abstract
Purpose: The etiology of acute gastroenteritis (AGE) has changed since the introduction of the rotavirus vaccination. The aim of this study was to clarify which common pathogens, both bacterial and viral, are currently causing AGE in infants. Methods: Infants with acute diarrhea were enrolled. We tested for 10 bacterial pathogens and five viral pathogens in stool specimens collected from infants with AGE. The clinical symptoms such as vomiting, mucoid or bloody diarrhea, dehydration, irritability, and poor oral intake were recorded, and laboratory data such as white blood cell count and C-reactive protein were collected. The clinical and laboratory data for the cases with bacterial pathogens and the cases with viral pathogens were compared. Results: Of 41 total infants, 21 (51.2%) were positive for at least one pathogen. Seventeen cases (41.5%) were positive for bacterial pathogens and seven cases (17.1%) were positive for viral pathogens. Staphylococcus aureus (13 cases, 31.7%) and Clostridium perfringens (four cases, 9.8%) were common bacterial pathogens. Norovirus (five cases, 12.2%) was the most common viral pathogen. Fever and respiratory symptoms were common in the isolated viral infection group (p=0.023 and 0.044, respectively), whereas other clinical and laboratory data were indistinguishable between the groups. Conclusion: In our study, S. aureus (41.5%) and norovirus (12.2%) were the most common bacterial and viral pathogens, respectively, among infants with AGE.
Keywords
Gastroenteritis; Infant; Korea; Staphylococcus aureus; Epidemiology;
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1 Vernacchio L, Vezina RM, Mitchell AA, Lesko SM, Plaut AG, Acheson DW. Diarrhea in American infants and young children in the community setting: incidence, clinical presentation and microbiology. Pediatr Infect Dis J 2006;25:2-7.   DOI   ScienceOn
2 Barreto ML, Milroy CA, Strina A, Prado MS, Leite JP, Ramos EA, et al. Community-based monitoring of diarrhea in urban Brazilian children: incidence and associated pathogens. Trans R Soc Trop Med Hyg 2006;100:234-42.   DOI   ScienceOn
3 Becker-Dreps S, Bucardo F, Vilchez S, Zambrana LE, Liu L, Weber DJ, et al. Etiology of childhood diarrhea following rotavirus vaccine introduction: a prospective, population-based study in Nicaragua. Pediatr Infect Dis J 2014. [Epub ahead of print]
4 So CW, Kim DS, Yu ST, Cho JH, Kim JD. Acute viral gastroenteritis in children hospitalized in Iksan, Korea during December 2010-June 2011. Korean J Pediatr 2013;56:383-8.   DOI   ScienceOn
5 Bucardo F, Reyes Y, Svensson L, Nordgren J. Predominance of norovirus and sapovirus in Nicaragua after implementation of universal rotavirus vaccination. PLoS One 2014;9:e98201.   DOI   ScienceOn
6 Korea Centers for Disease Control and Prevention, Korea National Institute of Health, The Korean Society of Clinical Microbiology. The Practice Guideline of Diagnosis of the Waterborne and Food Related Diseases. Cheongju: Korea Centers for Disease Control and Prevention, 2013:1-127.
7 Asao T, Kumeda Y, Kawai T, Shibata T, Oda H, Haruki K, et al. An extensive outbreak of staphylococcal food poisoning due to low-fat milk in Japan: estimation of enterotoxin A in the incriminated milk and powdered skim milk. Epidemiol Infect 2003;130:33-40.   DOI   ScienceOn
8 Flemming K, Ackermann G. Prevalence of enterotoxin producing Staphylococcus aureus in stools of patients with nosocomial diarrhea. Infection 2007;35:356-8.   DOI
9 Vael C, Desager K. The importance of the development of the intestinal microbiota in infancy. Curr Opin Pediatr 2009;21:794-800.   DOI   ScienceOn
10 Akinkunmi EO, Lamikanra A. A study of the intestinal carriage of antibiotic resistant Staphylococcus aureus by Nigerian children. Afr Health Sci 2012;12:381-7.
11 Grzeskowiak L, Collado MC, Mangani C, Maleta K, Laitinen K, Ashorn P, et al. Distinct gut microbiota in southeastern African and northern European infants. J Pediatr Gastroenterol Nutr 2012;54:812-6.   DOI
12 Efuntoye MO, Adetosoye AI. Enterotoxigenicity and drug sensitivity of staphylococci from children aged five years and below with sporadic diarrhoea. East Afr Med J 2003;80:656-9.
13 Becker K, Friedrich AW, Peters G, von Eiff C. Systematic survey on the prevalence of genes coding for staphylococcal enterotoxins SElM, SElO, and SElN. Mol Nutr Food Res 2004;48:488-95.   DOI   ScienceOn
14 Chen TR, Chiou CS, Tsen HY. Use of novel PCR primers specific to the genes of staphylococcal enterotoxin G, H, I for the survey of Staphylococcus aureus strains isolated from food-poisoning cases and food samples in Taiwan. Int J Food Microbiol 2004;92:189-97.   DOI   ScienceOn
15 Pinchuk IV, Beswick EJ, Reyes VE. Staphylococcal enterotoxins. Toxins (Basel) 2010;2:2177-97.   DOI
16 Omoe K, Ishikawa M, Shimoda Y, Hu DL, Ueda S, Shinagawa K. Detection of seg, seh, and sei genes in Staphylococcus aureus isolates and determination of the enterotoxin productivities of S. aureus isolates Harboring seg, seh, or sei genes. J Clin Microbiol 2002;40:857-62.   DOI   ScienceOn
17 Naik S, Smith F, Ho J, Croft NM, Domizio P, Price E, et al. Staphylococcal enterotoxins G and I, a cause of severe but reversible neonatal enteropathy. Clin Gastroenterol Hepatol 2008;6:251-4.   DOI   ScienceOn
18 Forward LJ, Tompkins DS, Brett MM. Detection of Clostridium difficile cytotoxin and Clostridium perfringens enterotoxin in cases of diarrhoea in the community. J Med Microbiol 2003;52:753-7.   DOI   ScienceOn
19 Valentini D, Vittucci AC, Grandin A, Tozzi AE, Russo C, Onori M, et al. Coinfection in acute gastroenteritis predicts a more severe clinical course in children. Eur J Clin Microbiol Infect Dis 2013;32:909-15.   DOI   ScienceOn
20 Ahn SH, Lim HC, Kim HM, Uh Y, Seok SW. Comparing the cause and symptom severity of children with acute gastroenteritis. Korean J Pediatr Infect Dis 2008;15:138-45.