Incidence and Distribution of the Pathogens Causing GI Infections at a University Hospital of Korea

Gastrointestinal (GI) infections, caused by various pathogens such as bacteria, viruses, protozoa, and parasites, are the second most common infectious diseases. Molecular diagnostics that can simultaneously detect these pathogens are commonly used in syndromic approaches. The authors aimed to identify the causative pathogens of GI infections to provide clinically useful information.

This retrospective study used molecular diagnostic methods to determine the incidence and distribution of GI pathogens according to gender, age, and season and analyze their coinfection from August 2020 to December 2022.

The overall incidence of at least one GI pathogen was 40.1% (991/2, 471). The positivity rates for bacteria and viruses were 33.1% (817/2, 471) and 9.2% (227/2,471), respectively; the positivity rate for bacteria was significantly higher than that for viruses (p < 0.001). The incidence of GI pathogens according to age group was highest in group 3 (59.9%), followed by group 4 (57.0%). The most common bacterial pathogen associated with GI infections was C. difficile, followed by diarrheagenic E. coli, Campylobacter spp., and Salmonella spp. Enteropathogenic E. coli accounted for a large percentage of diarrheagenic E. coli (63.6%, 157/247). Among the viral pathogens, norovirus GI/GII was the most commonly detected virus, followed by adenovirus F40/41 and rotavirus A. For bacterial- or viral-positive cases, the distribution of GI pathogens according to age group showed the highest proportion of C. difficile in all groups, except for group 2. In group 2, rotavirus A accounted for the highest percentage (61.1%, 22/36). The incidence of GI pathogens was the highest in summer (36.1%), followed by autumn (32.7%), and winter (18.0%). The co-infection rate with two or more pathogens was 16.9% (167/991). The rates of co-infection with two or more bacteria, bacteria and viruses, and two viruses were 58.1%, 31.7%, and 10.2%, re-spectively.

Information on the incidence and distribution of GI pathogens might be clinically useful; however, unlike the distribution of other infectious pathogens, it is necessary to consider that microorganisms identified through molecular diagnostics can be detected even in healthy people without clinical symptoms.