Related Experiment Videos
Enteropathogens associated with acute diarrhea in hospitalized infants
Insights
Enteropathogenic bacteria and rotavirus were common causes of acute diarrhea in hospitalized infants in Santiago. Enteropathogenic E. coli (EPEC) was frequently found, with some strains showing antibiotic resistance, highlighting the need for routine pathogen surveillance.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Acute diarrhea is a significant cause of hospitalization in infants, particularly in low socioeconomic settings.
- Malnutrition is prevalent in infants with acute diarrhea, potentially prolonging hospital stays.
Purpose of the Study:
- To identify enteropathogens causing acute diarrhea in hospitalized infants from urban Santiago.
- To assess the relationship between pathogen detection, nutritional status, and antibiotic resistance.
Main Methods:
- Prospective evaluation of 35 hospitalized infants with acute diarrhea.
- Microbiological analysis to detect bacteria, rotavirus, and parasites.
- Assessment of infant nutritional status and antibiotic resistance patterns of isolated pathogens.
Main Results:
- Enteropathogens were detected in 60% of cases, with bacteria (48.6%) being more common than rotavirus (11.4%).
- Enteropathogenic E. coli (EPEC) was the most frequent bacterial isolate (34.3%), followed by Shigella and Campylobacter jejuni (5.7% each).
- Half of EPEC strains exhibited multidrug resistance, with resistance to ampicillin and kanamycin being common. Recovery of pathogens was independent of nutritional status, but EPEC detection age differed between well-nourished and malnourished infants.
Conclusions:
- Bacterial pathogens, particularly EPEC, and rotavirus are key causes of acute diarrhea in this population.
- The high prevalence of antibiotic-resistant EPEC strains necessitates careful antibiotic stewardship.
- Routine inclusion of Campylobacter jejuni in diagnostic workups for infantile diarrhea is recommended for this setting.
Abstract:
Thirty-five infants of low socioeconomic status who were living in urban Santiago were hospitalized for acute diarrhea were prospectively evaluated for the presence of enteropathogens associated with the episode. Some degree of malnutrition was evident in 20 infants (57.1%); 15 of these (75%) were under 6 months of age. Mean duration of the hospital stay was 11.8 days for well-nourished patients and 15.7 days for the malnourished patients. One or more enteropathogens were found in 60% of the cases studied: in 17 cases (48.6%) these were bacteria and in four cases (11.4%) it was rotavirus. Parasites were not detected. In three patients, two different pathogens were demonstrated. Among the bacteria, 12 isolates (34.3%) were enteropathogenic E. coli (EPEC) and two (5.7%) were Shigella. Campylobacter jejuni was also isolated from two different cases (5.7%) and Salmonella from one case (2.9%). The recovery of pathogens was independent of the nutritional status. Mean age of detection of EPEC was 3.2 months among well-nourished infants and 6.2 months among the malnourished (p less than 0.001). Half of the EPEC strains isolated were multiresistant to antibiotics. One of these strains transferred some of its resistance in vitro to E. coli K12. Ampicillin and kanamycin were the antibiotics to which EPEC showed the greatest resistance. The other bacterial pathogens were mostly sensitive to antibiotics. Campylobacter jejuni, together with Shigella, was the second most frequent pathogen isolated during episodes of diarrhea. Campylobacter should be included in the routine study of diarrheal episodes in our setting.