To observe the occurrence of different etiological agents of acute diarrhea (AD) in stool specimens of patients and children in a control group. Material and Methods: We studied 100 children younger than 3 years with AD and 100 controls, from November 1993 to May 1994. We collected stool specimens from both groups and investigated the presence of the following enteropathogens: Rotavirus, Escherichia coli (EPEC, ETEC, EIEC, EHEC), Salmonella sp, Shigella sp, Campylobacter jejuni, Campylobacter coli, Ÿersinia enterocolitica, Cryptosporidium sp, Giardia lamblia, Entamoeba histolytica. Statistical analysis was performed with the exact Fisher test (at significance level P<0.05). The mean age was 12.5 months, with more cases in patients younger than 6 months (35%). Children were seen at the emergency room on an average fifth day after the start of diarrhea. Most came from homes with basic sanitary conditions. Watery diarrhea was more frequent than bloody diarrhea with mucus, at a rate of 4:1. Results: Rotavirus was the most frequent agent: 21% in the AD group and 3% in the control group (P=0.0001). Shigella sp was isolated in 7% of the AD group and in none of the control group (P=0.0140). EPEC was detected in 13% of AD cases and 7% in the control group (P=0.2381) but the classical subgroups O55, O111, O119 were only isolated from the patients with AD. The other enteropathogens were rarely detected, or detected at the same rate in both groups. Rotavirus and EPEC were the most frequently isolated agents in watery diarrhea, while Shigella sp was the predominant agent found in bloody stools with mucus. Conclusions: Rotavirus was the most common causative agent in AD. The detection of Rotavirus and Shigella sp nearly exclusively in patients with AD confirms the high pathogenicity of these etiological agents when compared with the others. Escherichia coli (EPEC) diagnosed by polyvalent sera did not confirm its respective diarrheogenic property, since it was isolated at the same rate in both patients with AD and controls. Monovalent antisera detected classical subgroups of EPEC (O111, O119, O55) isolated only from AD patients, confirming the already-known high pathogenicity of these strains.
Material and MethodsWe studied 100 children younger than 3 years with AD and 100 controls, from November 1993 to May 1994. We collected stool specimens from both groups and investigated the presence of the following enteropathogens: Rotavirus, Escherichia coli (EPEC, ETEC, EIEC, EHEC), Salmonella sp, Shigella sp, Campylobacter jejuni, Campylobacter coli, Ÿersinia enterocolitica, Cryptosporidium sp, Giardia lamblia, Entamoeba histolytica. Statistical analysis was performed with the exact Fisher test (at significance level P<0.05). The mean age was 12.5 months, with more cases in patients younger than 6 months (35%). Children were seen at the emergency room on an average fifth day after the start of diarrhea. Most came from homes with basic sanitary conditions. Watery diarrhea was more frequent than bloody diarrhea with mucus, at a rate of 4:1. Results: Rotavirus was the most frequent agent: 21% in the AD group and 3% in the control group (P=0.0001). Shigella sp was isolated in 7% of the AD group and in none of the control group (P=0.0140). EPEC was detected in 13% of AD cases and 7% in the control group (P=0.2381) but the classical subgroups O55, O111, O119 were only isolated from the patients with AD. The other enteropathogens were rarely detected, or detected at the same rate in both groups. Rotavirus and EPEC were the most frequently isolated agents in watery diarrhea, while Shigella sp was the predominant agent found in bloody stools with mucus. Conclusions: Rotavirus was the most common causative agent in AD. The detection of Rotavirus and Shigella sp nearly exclusively in patients with AD confirms the high pathogenicity of these etiological agents when compared with the others. Escherichia coli (EPEC) diagnosed by polyvalent sera did not confirm its respective diarrheogenic property, since it was isolated at the same rate in both patients with AD and controls. Monovalent antisera detected classical subgroups of EPEC (O111, O119, O55) isolated only from AD patients, confirming the already-known high pathogenicity of these strains.
ResultsRotavirus was the most frequent agent: 21% in the AD group and 3% in the control group (P=0.0001). Shigella sp was isolated in 7% of the AD group and in none of the control group (P=0.0140). EPEC was detected in 13% of AD cases and 7% in the control group (P=0.2381) but the classical subgroups O55, O111, O119 were only isolated from the patients with AD. The other enteropathogens were rarely detected, or detected at the same rate in both groups. Rotavirus and EPEC were the most frequently isolated agents in watery diarrhea, while Shigella sp was the predominant agent found in bloody stools with mucus. Conclusions: Rotavirus was the most common causative agent in AD. The detection of Rotavirus and Shigella sp nearly exclusively in patients with AD confirms the high pathogenicity of these etiological agents when compared with the others. Escherichia coli (EPEC) diagnosed by polyvalent sera did not confirm its respective diarrheogenic property, since it was isolated at the same rate in both patients with AD and controls. Monovalent antisera detected classical subgroups of EPEC (O111, O119, O55) isolated only from AD patients, confirming the already-known high pathogenicity of these strains.
ConclusionsRotavirus was the most common causative agent in AD. The detection of Rotavirus and Shigella sp nearly exclusively in patients with AD confirms the high pathogenicity of these etiological agents when compared with the others. Escherichia coli (EPEC) diagnosed by polyvalent sera did not confirm its respective diarrheogenic property, since it was isolated at the same rate in both patients with AD and controls. Monovalent antisera detected classical subgroups of EPEC (O111, O119, O55) isolated only from AD patients, confirming the already-known high pathogenicity of these strains.
Observar a ocorrência dos diferentes agentes etiológicos de diarréia aguda (DA) comparando a excreção fecal dos mesmos em pacientes e crianças do grupo controle.
Material e métodosForam estudadas 100 crianças com DA e 100 controles menores de 3 anos de idade no período de novembro de 93 a maio de 94. Foram colhidas amostras de fezes em ambos os grupos, pesquisando-se os seguintes enteropatógenos: Rotavirus, Escherichia coli (EPEC, ETEC, EIEC, EHEC), Salmonella sp, Shigella sp, Campylobacter jejuni, C.coli, Ÿersinia enterocolitica, Cryptosporidium sp, Giardia lamblia e Entamoeba histolytica. A análise estatística foi realizada pelo Teste exato de Fisher (nível de significância p<0,05). A idade média foi de 12,5 meses, com maior prevalência de DA nos menores de seis meses(35%). As crianças foram atendidas em Pronto Socorro no quinto dia, em média, após o início do evento diarréico. Procediam em sua maioria de residências dotadas de saneamento básico. Predominou diarréia aquosa sobre mucossanguinolenta na razão de 4:1.
ResultadosO Rotavirus foi o agente mais detectado, 21% no grupo com diarréia e 3% nos controles (p = 0,0001). A Shigela sp foi isolada em 7% no grupo com diarréia e em nenhum caso nos controles (p = 0,0140). A Escherichia coli enteropatogênica (EPEC) foi detectada em 13% dos casos de DA e em 7% nos controles (p = 0,2381), porém os sorogrupos clássicos O55,0111,0119 foram isolados apenas nos portadores de diarréia. Os demais enteropatógenos não atingiram freqüências elevadas, ou foram detectados na mesma proporção em ambos os grupos. O Rotavirus e EPEC foram os agentes mais detectados nas diarréias aquosas, enquanto a Shigella sp foi o agente predominante nas diarréias mucossanguinolentas.
ConclusõesO Rotavirus foi o agente mais comum determinante de DA. A detecção de Rotavirus e Shigella sp quase exclusivamente em pacientes com DA confirmam a maior patogenicidade desses agentes etiológicos, em relação aos demais pesquisados. A pesquisa de Escherichia coli enteropatogênica (EPEC) por soros polivalentes não confirma o respectivo potencial diarreiogênico, por ser isoladada em proporção não significativamente superior nos pacientes com DA. A utilização dos antisoros monovalentes possibilitou a detecção dos clássicos sorogrupos de EPEC (O111, O119, O55) exclusivamente nas amostras de pacientes com DA, confirmando a característica patogenicidade das mesmas.
