Prevalence and factors associated with different pathogens of acute diarrhea in adults in Beijing, China

Only a small proportion of patients with diarrhea are diagnosed with laboratory tests in China, and most are diagnosed based on clinical symptoms. Therefore, understanding the prevalence of different diarrheal pathogens and their specific symptoms is important.

Data from a prospective study in Beijing of acute diarrhea and the related pathogens were used to study the association between different pathogen groups and the infected patients' characteristics. A total of 355 patients with acute diarrhea, clinically diagnosed with infectious or noninfectious diarrhea by general practitioners (GPs), were recruited from three districts.

Different species of diarrheal pathogens were detected in 133 (37.5%) patients. The most prevalent pathogen was calicivirus (42.9%), followed by rotavirus (30.1%), Vibrio parahaemolyticus (13.5%), and Salmonella spp. (10.5%). The detection rates in patients diagnosed with infectious or noninfectious diarrhea by GPs did not differ significantly (c2 = 0.026, p = 0.873). Abdominal pain correlated negatively with viral pathogens, whereas nausea, living in the suburbs, and winter infection correlated positively with viral infection. Abdominal pain and leukocytosis were positively associated with bacterial infections, whereas winter infection correlated negatively with them.

In this study, we found that the detection rates in patients diagnosed with infectious or noninfectious diarrhea by GPs was the same. We also revealed the improper prescription of antibiotics by GPs based simply on clinical diagnoses. A further analysis of diagnostic accuracy and methods is required to assist GPs in improving their diagnoses when insufficient laboratory tests are available and budgets are limited.