Detection of enteric pathogens in young children before and during acute gastroenteritis: results from a prospective German birth cohort study (LoewenKIDS).

IF 3.6 2区医学 Q1 INFECTIOUS DISEASES

Infection Pub Date : 2025-10-20 DOI:10.1007/s15010-025-02670-1

Chiara Lincetto, Felipe Romero-Saavedra, Diana Laverde, Riccardo Lincetto, Melanie Meyer-Buehn, Bianca Klee, Cornelia Gottschick, Rafael Mikolajczyk, Johannes Huebner, Tilmann Schober

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引用次数: 0

Abstract

Purpose: To identify enteric pathogens in pediatric acute gastroenteritis (AGE) and assess their etiological relevance by comparison with samples during asymptomatic period.

Methods: Children < 2 years of age (n = 89) were prospectively enrolled as part of the population-based birth cohort LoewenKIDS. Asymptomatic stool samples were collected regularly, and symptomatic samples were collected after the occurrence of > 3 loose stools and/or one vomiting in 24 h. Intraindividual pairs of symptomatic and preceding asymptomatic samples for each child were analyzed for 25 enteric pathogens via multiplex real-time RT-PCR.

Results: Enteric viruses were detected in 64% (57/89) of symptomatic samples and significantly associated with gastrointestinal symptoms (Odds Ratio [OR] 3.9; 95% Confidence Interval [CI] 2.1-7.3). The most common viruses in AGE were norovirus (Genogroups GI and GII) (36%, 32/89) and adenovirus (27%, 24/89). Bacteria were detected in 46% (41/89) of symptomatic samples and 43% (38/89) of asymptomatic ones, with no association to symptoms (OR 1.1; 95% CI 0.6-2). The most common bacteria in AGE were Enteropathogenic Escherichia coli (28%, 25/89) and Clostridium difficile (16%, 14/89). Dientamoeba fragilis was the only detected parasite in AGE (7%, 6/89), and was not associated with symptoms (OR 1.4; 95% CI 0.4-5.5). Pathogen loads in symptomatic and asymptomatic pairs correlated with symptoms for norovirus GII, astrovirus and sapovirus (each p < 0.01), but not for other pathogens.

Conclusion: This study supports the clinical significance of detection of viral pathogens in young children with acute gastroenteritis and without relevant comorbidities in high-income countries, but limits the significance of enteric bacterial and parasitic pathogens detection, partly due to constraints in their specific identification.

Trial registration: Clinicaltrials.Gov Identifier: NCT02654210.

查看原文本刊更多论文

幼儿急性胃肠炎前和急性胃肠炎期间肠道病原体的检测：一项前瞻性德国出生队列研究的结果（LoewenKIDS）。

目的：鉴定小儿急性胃肠炎（AGE）的肠道病原体，并与无症状期的样本进行比较，评估其病因学相关性。方法：患儿24 h内出现3次稀便和/或1次呕吐。采用多重实时实时RT-PCR对每例患儿有症状和无症状前的个体对样本进行25种肠道病原体分析。结果：64%（57/89）的有症状样本中检出肠道病毒，且与胃肠道症状显著相关（优势比[OR] 3.9； 95%可信区间[CI] 2.1-7.3）。AGE中最常见的病毒是诺如病毒（GI和GII基因组）（36%,32/89）和腺病毒（27%,24/89）。有症状样本中检出细菌的比例为46%(41/89)，无症状样本中检出细菌的比例为43%(38/89)，与症状无相关性（OR 1.1; 95% CI 0.6-2）。AGE中最常见的细菌是肠致病性大肠杆菌（28%,25/89）和艰难梭菌（16%,14/89）。脆弱双阿米巴是AGE中唯一检测到的寄生虫（7%,6/89），与症状无关（OR 1.4; 95% CI 0.4-5.5）。结论：本研究支持在高收入国家无相关合并症的急性胃肠炎幼儿中检测病毒性病原体的临床意义，但限制了肠道细菌和寄生虫病原体检测的意义，部分原因是它们的特异性鉴定受到限制。试验注册：临床试验。Gov标识符：NCT02654210。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.