Related Experiment Video
Updated: Jun 16, 2026
Detection of Helicobacter pylori Infection and Antibiotic Resistance via Stool Quantitative Polymerase Chain Reaction Analysis
Published on: May 16, 2025
Detection of Enteropathogens in Human Immunodeficiency Virus and Non-Human Immunodeficiency Virus-Infected Children
Dewi Wulandari1, Rivaldi Febrian2, Pramita Gayatri Dwipoerwantoro3
1Department of Clinical Pathology, Immunoserological and Oncological Division, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Insights
Diarrhea pathogen patterns differ between HIV-infected and non-HIV children with acute diarrhea. Multiplex RT-PCR identified more viral and parasitic infections in HIV-infected children, unlike non-HIV children who predominantly had bacterial infections.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Pediatrics
Background:
- Acute diarrhea is a major cause of mortality in children in developing nations.
- Enteropathogen profiles vary significantly by location, time, and patient population.
- Understanding these variations is crucial for effective treatment.
Purpose of the Study:
- To identify and compare enteropathogen patterns in children with acute diarrhea.
- To differentiate pathogen profiles between human immunodeficiency virus (HIV)-infected and non-HIV-infected children.
- To utilize multiplex real-time reverse transcriptase polymerase chain reaction (RT-PCR) for comprehensive pathogen detection.
Main Methods:
- A cross-sectional study was conducted at Dr. Cipto Mangunkusumo National Hospital.
- The study period spanned from March 2019 to April 2020.
- Multiplex real-time RT-PCR was employed to detect a wide range of enteropathogens.
Main Results:
- Multiplex RT-PCR detected pathogens in 58.9% of specimens, with higher positivity in HIV-infected children (70%) versus non-HIV children (54.7%).
- Non-HIV children predominantly had bacterial infections (70.6%), notably enteroaggregative E. coli and Campylobacter spp.
- HIV-infected children showed a higher prevalence of viral (57.1%) and parasitic (14.3%) infections, including Norovirus GII and Cryptosporidium spp., with Cryptosporidium spp. exclusively found in this group.
Conclusions:
- The etiological patterns of acute diarrhea differ between HIV-infected and non-HIV-infected children.
- Identifying specific enteropathogens aids clinicians in selecting appropriate diagnostic examinations.
- Knowledge of pathogen prevalence can guide the selection of empirical antimicrobial therapy.
Purpose:
Diarrhea is one of the leading causes of mortality in children living in developing countries. The etiology of acute diarrhea in each healthcare center varies depending on place, time, and population. This study aimed to identify pathogen patterns in human immunodeficiency virus (HIV)-infected and non-HIV children suffering from acute diarrhea, using multiplex real time reverse transcriptase polymerase chain reaction (RT-PCR), in an Indonesian tertiary hospital.
Methods:
This cross-sectional study was conducted at Dr. Cipto Mangunkusumo National Hospital from March 2019 to April 2020.
Results:
The study showed that multiplex RT-PCR results were positive in 58.9% of the specimens, with more positive results in HIV-infected children than in non-HIV-infected children (70% vs. 54.7%). Altogether 72 enteropathogens were detected from all specimens. Enteropathogens in non-HIV children with acute diarrhea consisted of bacteria (70.6%) and viruses (29.4%) with a predominance of enteroaggregative Escherichia coli (25.4%), followed by Campylobacter spp. (11.8%), enteropathogenic E. coli (9.8%), Norovirus GII (7.8%), and Clostridium difficile (7.8%). Enteropathogens in HIV-infected children consisted of viruses (57.1%), bacteria (28.6%), and parasites (14.3%) comprising Norovirus GII (24%), Cryptosporidium spp. (14.3%), Campylobacter spp. (14.3%), Norovirus GI (14.3%), and Astrovirus (14.3%). Cryptosporidium spp. was the only parasite found in this study and was found only in HIV-infected children. In non-HIV children with acute diarrhea, most pathogens were invasive bacteria, while in HIV-infected children, more viral and parasite infections occurred, primarily caused by opportunistic pathogens.
Conclusion:
The pattern of enteropathogens can help clinicians determine further examinations and appropriate empirical antimicrobial therapy for the patient.
