ACUTE GASTROENTERITIS IN CHILDREN

  • Sonja Bojadzieva University Children Hospital, Skopje, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia
  • Aspazija Sofijanova University Children Hospital, Skopje, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia
  • Olivera Jordanova University Children Hospital, Skopje, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia

Abstract

The aim of the study was to investigate the most frequent etiology of AGE in children admitted аt our hospital, and the correlation with severity of clinical manifestation. The study was designed as a prospective study, and we examined 219 pediatric patients with AGE admitted at the University Children’s Hospital–Skopje. The diagnosis of AGE was based by the definition for AGE as a decrease in the consistency of stools (loose or liquid), and/or an increase in the frequency of evacuations (typically >3 in 24 hours), with or without fever or vomiting. The stool specimens were examined using the new multiplex polymerase chain reaction–based rapid diagnostic test–Film Array Gastrointestinal panel test. White blood cell levels (10^3/ul) and hemoglobin levels (g/dL), were determined by using the flow citometry method on Sysmex xs 800i/1000i. Iron levels (µmol/L) were determined by using the biochemistry analyzer Architect c4000 Abbott. Statistical analysis confirmed significantly different values of stool isolation: viruses and bacteria in the groups  p<0.001. The stool parasites were insignificant p>0.05. Statistical analysis confirmed significantly different values ​​of WBC levels in the groups  p<0.001. Statistical analysis confirmed significantly different values of iron levels in the groups  p<0.001. Statistical analysis confirmed significantly different values of h​emoglobin levels in the groups p<0.001. Film Array Gastrointestinal panel test is a useful tool in the rapid diagnosis of gastrointestinal pathogens in pediatric patients with acute gastroenteritis. 


Keywords: Acute gastroenteritis (AGE), pediatric patients immunocomtentence, pediatric patients, immunocompromised, Film Array Gastrointestinal panel test.

References

1. Guarino A, Aguilar J, Berkley J, Broekaert I, Vazquez-Frias R, Holtz L, et al. Acute Gastroenteritis in children of the world: what needs to be done? JPGN. 2020; 70(5)- p 694-701 doi: 10.1097/MPG.0000000000002669.
2. Lopez-Medina E, Parra B, Davalos DM, Lopez P, Villamarin E, Pelaez M.Acute gastroenteritis in a pediatric population from Cali, Colombia in the post rotavirus vaccine era. IJID. 2018;73:52-9 doi10.1016/j.ijid.2018.06.006.
3. Mathew S, Smatti MK, Ansari K, Nasrallah GK, Thani AA, Yassine HM. Mixed viral-bacterial infections and their effects on gut microbiota and clinical illnesses in children. Sci Rep. 2019;9(1):865 doi: 10.1038/s41598-018-37162-w.
4. Farfan-Garcia AE, Imdad A, Zhang C, Arias-Guerrero MY, Sanchez-Alvarez NT, Iqbal J, et al. Etiology of acute gastroenteritis among children less than 5 years of age in Bucaramanga, Colombia: A case-control study. PLoS Negl Trop Dis. 2020;14(6): e0008375. doi: 10.1371/journal.pntd.0008375.
5. Aktaş O, Aydin H, Timurkan MO. A molecular study on the prevalence and coinfections of Rotavirus, Norovirus, Astrovirus and Adenovirus in children with gastroenteritis. Minerva Pediatr. 2019;71(5):431-7.
doi: 10.23736/S0026-4946.16.04304-X.
6. Gnocchi M, Gagliardi M, Gismondi P, Gaiani F, de’Angelis GL, Esposito S. Updated management guidelines for Clostridioides difficile in paediatrics. Pathogens. 2020;9(4):291 DOI: 10.3390/pathogens9040291.
7. Mhaissen MN, Rodriguez A, Gu Z, Zhu H, Tang L, Sun Y, et al. Epidemiology of diarrheal illness in pediatric oncology patients. Journal of the Pediatric Infect Dis Soc. 2017;6(3):275-80. DOI: 10.1093/jpids/piw050.
8. O'Connor O, Cooke RP, Cunliffe NA, Pizer B. Clinical value of stool culture in paediatric oncology patients: hospital evaluation and UK survey of practice. J Hosp Infect. 2017;95(1):123-5. DOI: 10.1016/j.jhin.2016.10.005.
9. Amjad M. An overview of the molecular methods in the diagnosis of gastrointestinal infectious diseases. Int J Microbiol. 2020;2020:8135724. doi: 10.1155/2020/8135724.
10. Tilmanne A, Martiny D, Quach C, Wautier M, Vandenberg O, Lepage P, et al. Enteropathogens in paediatric gastroenteritis: comparison of routine diagnostic and molecular methods. Clin Microbiol Infect. 2019;25:1519–24. doi: 10.1016/j.cmi.2019.07.021.
11. Kanwar N, Jackson J, Duffy S, Chapin K, Cohen D, Leber A, et al. FilmArray® gastrointestinal panel for viral acute gastroenteritis detection in pediatric patients. Open Forum Infect Dis. 2017;4(1):S604 doi:10.1093/ofid/ofx163.1583.
12. Buss SN, Leber A, Chapin K, Fey PD, Bankowski MJ, Jones MK, et al. Multicenter evaluation of the BioFire FilmArray gastrointestinal panel for etiologic diagnosis of infectious gastroenteritis. Journal of clinical microbiology. 2015;53(3):915-25.
13. Operario DJ, Platts-Mills JA, Nadan S, Page N, Seheri M, Mphahlele J, et al. Etiology of severe acute watery diarrhea in children in the global rotavirus surveillance network using quantitative polymerase chain reaction. J Infect Dis. 2017;216:220–7. doi: 10.1093/infdis/jix294.
14. Qiu FZ, Shen XX, Li GX, Zhao L, Chen C, Duan SX, et al. Adenovirus associated with acute diarrhea: a case-control study. BMC Infect Dis. 2018;18:450. doi: 10.1186/s12879-018-3340-1
15. Jayaweera JA, Reyes M, Joseph A. Childhood iron deficiency anemia leads to recurrent respiratory tract infections and gastroenteritis. Scientific reports. 2019;9(1):1-8.
16. Hiyoshi H, Tiffany CR, Bronner DN, Bäumler AJ. Typhoidal Salmonella serovars: ecological opportunity and the evolution of a new pathovar. FEMS Microbiol Rev. 2018; 42(4):527-41. doi: 10.1093/femsre/fuy024.
17. Sciandra I, Piccioni L, Coltella L, Ranno S, Giannelli G, Falasca F, et al. Comparative analysis of 2 commercial molecular tests for the detection of gastroenteric viruses on stool samples. Diagn Microbiol Infect Dis. 2020;96:114893. doi: 10.1016/j.diagmicrobio.2019.114893.
18. Castano-Rodriguez N, Underwood AP, Merif J, Riordan SM, Rawlinson WD, Mitchell HM, et al. Gut Microbiome analysis identifies potential etiological factors in acute gastroenteritis. Infect Immun.2018;86(7):e00060-18. doi:10.1128/IAI.00060-18.
19. Hemming M, Rasanen S, Huhti L, Paloniemi M, Salminen M, Vesikari T. Major reduction of rotavirus, but not norovirus, gastroenteritis in children seen in hospital after the introduction of RotaTeq vaccine into the National Immunization Programme in Finland. European journal of pediatrics. 2013; 172(6):739-46.
20. Revolinski SL, Munoz-Price LS. Clostridium difficile in immunocompromised hosts: a review of epidemiology, risk factors, treatment, and prevention. Clin Infect Dis. 2019;68(12):2144-53.
21. Konate A, Dembele R, Guessennd NK, Kouadio FK, Kouadio IK, Ouattara MB, et al. Epidemiology and antibiotic resistance phenotypes of diarrheagenic Escherichia coli responsible for infantile gastroenteritis in Ouagadougou. Eur J Microbiol Immunol, 2017;7(3):168-75.
22. Riera-Montes M, O’Ryan M, Verstraeten T. Norovirus and rotavirus disease severity in children: systematic review and meta-analysis. Pediatr Infect Dis J. 2018;37(6): 501-5.
23. Gaspard P, Pothier P, Roth C, Larocca S, Heck B, Ambert-Balay K. Viral prevalence and laboratory investigations of gastroenteritis in institutions for dependent people. .Med Mal Infect. 2017;47(8):546-53. doi: 10.1016/j.medmal.2017.09.007.
24. Cannon JL, Bonifacio J, Bucardo F, Buesa J, Bruggink L, Fumian TM, et al. Global trends in norovirus genotype distribution among children with acute gastroenteritis. Emerg Infect Dis. 2021;27(5):1438-45. doi: 10.3201/eid2705.204756.
Published
2021-12-26
How to Cite
BOJADZIEVA, Sonja; SOFIJANOVA, Aspazija; JORDANOVA, Olivera. ACUTE GASTROENTERITIS IN CHILDREN. Journal of Morphological Sciences, [S.l.], v. 4, n. 3, p. 40-48, dec. 2021. ISSN 2545-4706. Available at: <https://jms.mk/jms/article/view/277>. Date accessed: 20 jan. 2022.
Section
Articles