Enteropathogens in adult patients with diarrhea and healthy control subjects: a 1-year prospective study in a Swedish clinic for infectious diseases.
A 1-year prospective study was conducted to identify enteropathogens in adults with diarrhea (n=851) and in healthy control subjects (n=203) by use of conventional laboratory methods. Virulence factor genes for diarrheagenic Escherichia coli were detected by polymerase chain reaction. Enteropathogens were identified in 56% of patients and 16% of control subjects. The isolation rate was 65% for patients with symptoms for <1 week and for travelers; >1 pathogen was found in 11% of patients. The most frequent enteropathogens were Campylobacter (13% of patients), Clostridium difficile (13%), enterotoxigenic Escherichia coli (8%), Salmonella (7%), Shigella (4%), Blastocystis hominis (4%), calicivirus (3%), rotavirus (3%), enteroaggregative E. coli (2%), Aeromonas (2%), Giardia intestinalis (2%), Cryptosporidium (2%), and astrovirus (2%). Less frequently isolated (< or =1% of patients) were verotoxigenic E. coli, enteropathogenic E. coli, enteroinvasive E. coli, Entamoeba histolytica/Entamoeba dispar, microsporidia, and adenovirus. Fifty percent of the patients were hospitalized, and 43% needed intravenous fluids. The median duration of diarrhea was 14 days. Clinical features were not helpful for predicting the etiology of diarrhea.
Svenungsson
B
B
Karolinska Institute, Huddinge University Hospital, Sweden. bo.svenungsson@medhs.ki.se
Lagergren
A
A
Ekwall
E
E
Evengård
B
B
Hedlund
K O
KO
Kärnell
A
A
Löfdahl
S
S
Svensson
L
L
Weintraub
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification; D001424:Bacterial Infections / Q000453:epidemiology / Q000382:microbiology; D016022:Case-Control Studies; D003967:Diarrhea / Q000382:microbiology* / Q000469:parasitology* / Q000821:virology; D056890:Eukaryota / Q000145:classification / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology* / Q000469:parasitology* / Q000821:virology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011528:Protozoan Infections / Q000453:epidemiology / Q000469:parasitology; D013548:Sweden / Q000453:epidemiology; D014777:Virus Diseases / Q000453:epidemiology / Q000821:virology; D014780:Viruses / Q000145:classification / Q000302:isolation & purification