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Diarrhoeagenic microbes by real-time PCR in Rwandan children under 5 years of age with acute gastroenteritis.

Jean-Claude Kabayiza ; E. M. Andersson ; Staffan Nilsson (Institutionen för matematiska vetenskaper, matematisk statistik) ; C Baribwira ; G Muhirwa ; Tomas Bergström ; Magnus Lindh
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases (1469-0691). Vol. 20 (2014), 12, p. O1128-35.
[Artikel, refereegranskad vetenskaplig]

Acute gastroenteritis is a main cause of disease and death among children in low-income countries. The causality rates and pathogenic characteristics of putative aetiological agents remain insufficiently known. We used real-time PCR targeting 16 diarrhoeagenic agents to analyse stool samples from children ≤5.0 years old with acute diarrhoea in Rwanda. Among the 880 children (median age 14.2 months; 41% female) at least one pathogen was detected in 92% and two or more agents in 63% of cases. Rotavirus was detected in 36.9%, adenovirus in 39.7%, enterotoxigenic Escherichia coli (ETEC) with genes for labile (eltB) or stable (estA) toxin in 31.3% and 19.0%, E. coli with eae or bfpA genes in 25.2% and 14.2%, Shigella in 17.5% and Cryptosporidium in 7.8%. Rotavirus and ETEC-estA were associated with more severe dehydration than diarrhoea due to other causes. Shigella was associated with bloody stools and higher CRP. Microbial loads (Ct values) of rotavirus, ETEC-estA and Shigella were associated with severity of symptoms. Rotavirus, ETEC-estA and E. coli with bfpA were associated with younger age, Shigella with older age. Antibiotic treatment was given to 42% and was associated with dehydration, fever and CRP, but not with pathogen. We conclude that rotavirus and ETEC-estA were the most important causes of diarrhoea with dehydration, that Shigella caused bloody diarrhoea but less severe dehydration, that microbial loads of rotavirus, ETEC-estA and Shigella were associated with severity of symptoms, and that antibiotic use was frequent and in poor agreement with microbiological findings.

Nyckelord: Diarrhoea; epidemiology; faeces; gastroenteritis; real-time PCR

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Denna post skapades 2015-01-18. Senast ändrad 2015-01-29.
CPL Pubid: 210948


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Institutioner (Chalmers)

Institutionen för biomedicin, avdelningen för infektionssjukdomar (GU)
Institutionen för matematiska vetenskaper, matematisk statistik (2005-2016)



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