[Acute Gastroenteritis in hospitalized children. 14-Year evolution]

To analyze the etiology and evolution of patients with acute gastroenteritis hospitalized in our pediatric department and to study the clinical and laboratory differences between acute viral and bacterial gastroenteritis.

We studied the children with a diagnosis of acute gastroenteritis, aged between 0 and 14 years, who were consecutively admitted between 1987 and 2000. Differences were considered statistically significant if p < 0.05.

A total of 2,613 patients diagnosed with acute gastroenteritis were hospitalized (10.4 % of hospital admissions). The most common pathogens isolated were rotaviruses (46.5 %), followed by Salmonella (32.6 %) and Campylobacter (19.3 %). Hospital admissions due to Salmonella (p < 0.0001), other bacteria (Escherichia coli and Shigella) (p < 0.002) and adenoviruses (p < 0.01) significantly decreased. Rotaviruses were the most frequently detected pathogens in winter and in children aged less than 1 year (p < 0.0001). The incidence of Salmonella spp was greater in summer and in children older than 2 years (p < 0.0001). The incidence of hyperthermia (rectal temperature higher than 38.5 degreeC) (p < 0.0001), dehydration (p < 0.0005) and fecal blood (p < 0.0001) was higher in bacterial diarrheas. Erythrocyte sedimentation rate (p < 0.001) and leukocyte counts were higher in bacterial gastroenteritis (p < 0.01).

Rotaviruses were the most frequently isolated enteropathogens. The features that best distinguished between bacterial and viral diarrhea were hyperthermia and fecal blood. Hospital admissions due to Salmonella Shigella E. coli, and adenoviruses significantly decreased.