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Relationship between enteric pathogens and acute gastroenteritis disease severity: a prospective cohort study
J Xie1, A Nettel-Aguirre2, B E Lee3
1Section of Pediatric Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.
Summary
Rotavirus and Salmonella were linked to severe acute gastroenteritis in children. Viral pathogens were most common, but Salmonella was the only bacterium associated with severe illness in this study.
Area of Science:
- Pediatric Infectious Diseases
- Gastroenterology
- Microbiology
Background:
- Acute gastroenteritis is a common cause of pediatric emergency department visits.
- Identifying specific pathogens is crucial for understanding disease severity and guiding treatment.
- Viral pathogens are frequently implicated in pediatric gastroenteritis, but bacterial roles require further elucidation.
Purpose of the Study:
- To investigate the association between specific bacterial and viral pathogens and the severity of acute gastroenteritis in children.
- To quantify disease severity using the Modified Vesikari Scale (MVS) across different illness timeframes.
Main Methods:
- A cohort of children under 18 years with severe vomiting or diarrhea was enrolled in Canadian pediatric emergency departments.
- Molecular panels were used to identify pathogens in patient specimens.
- Disease severity was assessed using the Modified Vesikari Scale (MVS) at enrollment and over a 14-day follow-up period.
Main Results:
- Rotavirus (26.4%) and norovirus (23.6%) were the most frequently detected pathogens.
- Severe disease was significantly associated with rotavirus (OR=9.60), Salmonella (OR=6.61), adenovirus (OR=2.53), and norovirus (OR=1.43).
- During the follow-up period, rotavirus and adenovirus were associated with increased disease severity.
Conclusions:
- Viral pathogens are predominant in pediatric acute gastroenteritis presenting to emergency departments.
- Rotavirus, adenovirus, and norovirus were associated with severe disease, with rotavirus showing the strongest association.
- Salmonella was the only bacterium independently linked to severe disease in this pediatric cohort.
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