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Detection of enteric pathogens in young children before and during acute gastroenteritis: results from a prospective

Chiara Lincetto1, Felipe Romero-Saavedra2, Diana Laverde2

  • 1Division of Pediatric Infectious Diseases, Dr. von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany. chiara.lincetto@med.uni-muenchen.de.

Infection
|October 20, 2025
PubMed

Insights

Viral pathogens are significantly linked to acute gastroenteritis in young children, unlike bacterial or parasitic infections. This study highlights the importance of viral detection for accurate diagnosis in pediatric cases.

Area of Science:

  • Pediatric infectious diseases
  • Gastroenterology
  • Molecular diagnostics

Background:

  • Acute gastroenteritis (AGE) is a common illness in young children.
  • Identifying the causative agents of AGE is crucial for effective management.
  • Distinguishing between viral, bacterial, and parasitic pathogens is important for clinical decisions.

Purpose of the Study:

  • To identify enteric pathogens in pediatric acute gastroenteritis (AGE).
  • To assess the etiological relevance of detected pathogens by comparing symptomatic and asymptomatic stool samples.
  • To determine the association of specific pathogens with gastrointestinal symptoms in children under 2 years old.

Main Methods:

  • Prospective enrollment of 89 children under 2 years old from the LoewenKIDS birth cohort.
  • Collection of paired asymptomatic and symptomatic stool samples.
  • Analysis of 25 enteric pathogens using multiplex real-time RT-PCR.

Main Results:

  • Enteric viruses were detected in 64% of symptomatic samples and significantly associated with AGE (OR 3.9).
  • Norovirus and adenovirus were the most common viruses.
  • Bacteria were detected in 46% of symptomatic and 43% of asymptomatic samples, with no significant association to symptoms (OR 1.1).
  • Enteropathogenic E. coli and Clostridium difficile were the most common bacteria.
  • Dientamoeba fragilis was the only detected parasite, not associated with symptoms (OR 1.4).
  • Pathogen loads correlated with symptoms for norovirus GII, astrovirus, and sapovirus.

Conclusions:

  • Viral pathogens are clinically significant in pediatric AGE in high-income countries.
  • Detection of enteric bacterial and parasitic pathogens has limited clinical significance in this context.
  • Further research may be needed to improve the identification of bacterial and parasitic causes of AGE.
Abstract

Keywords:
Acute gastroenteritis in childrenDiarrheaEnteric virusesGastrointestinal pathogens

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