Documento consenso SEIP/AEPap/SEPEAP/SEGHNP/SEUP sobre el diagnóstico y tratamiento etiológico de las gastroenteritis agudas de origen infeccioso

Abstract

Acute gastroenteritis (AGE) is a leading cause of morbidity and mortality in pediatric patients worldwide. Microbiological testing of AGE is reserved for prolonged or complicated cases and for patients with certain risk factors. Diagnostic tests should be selected based on availability and the clinical and epidemiological context. The following tests could be requested, depending on the suspected diagnosis: stool or blood culture, rapid tests, molecular tests, ova and parasite test or serology. Complete blood counts and acute phase reactant (APR) tests are indicated in patients with signs of severe disease. Sociodemographic and climate changes have led to an increase in the incidence of pathogens previously rare in our region (emerging pathogens), which must also be considered. Microorganisms of uncertain significance may also be detected, which should either not be treated or treated only under specific circumstances. In general, empirical antibiotherapy should not be initiated for management of AGE except in specific situations: infants aged less than 3 to 6 months with suspected bacterial AGE, patients with underlying disease, signs of sepsis, institutionalized patients or settings with risk of dissemination. In cases of AGE caused by non-Typhi Salmonella and Shiga toxin-producing Escherichia coli (STEC), targeted antibiotherapy is restricted to patients at risk of systemic infection or with prolonged diarrhea. In Spain, complications of AGE are rare, and dehydration and post-enteritis syndrome are most common.