title: Community acquired diarrhea--the incidence of Astrovirus infections in Germany.
abstract: Astroviruses are increasingly recognized as a cause of human gastroenteritis. Electron microscopy (EM) has been considered the "gold standard" method for diagnosis, but this approach is limited to a few laboratories. We evaluated a commercial enzyme immunoassay (EIA) (IDEIA Astrovirus, DAKO Diagnostika, Hamburg, Germany) for the direct detection of antigen in fecal samples. In comparison to EM, the assay scored 100% in sensitivity and specificity (n = 213; 26 positive samples) and reacted with strains representing all known serotypes. Over an 11-month period 4,211 stool samples from unselected German patients suffering from acute gastroenteritis were examined. Etiologically responsible microorganisms were found in 13.0% of cases, with astrovirus the third most common pathogen (1.2%) behind Salmonella spp. (2.9%) and Rotavirus (2.5%), representing 13.5% of all positive specimens. Norwalk-like viruses (NLV), fungi, and protozoa were not tested. In infants of < 2 years of age (n = 458) the incidence of astrovirus infection was significantly higher (2.8%) compared to children of 2-7 years of age (n = 578; 1.7%) and those of > 7 years of age (n = 3,175; 0.9%). The frequency revealed a peak in winter (mean November-February: 2.0% versus other months: 0.8%).
authors.affiliation: Hygiene Institute, Siegen, Germany. m.putzker@gmx.net
authors.forename: M
authors.initials: M
authors.lastname: Putzker
authors.forename: H
authors.initials: H
authors.lastname: Sauer
authors.forename: G
authors.initials: G
authors.lastname: Kirchner
authors.forename: O
authors.initials: O
authors.lastname: Keksel
authors.forename: A
authors.initials: A
authors.lastname: Malic
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019350:Astroviridae Infections / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology / Q000821:virology*; D004797:Enzyme-Linked Immunosorbent Assay / Q000191:economics / Q000379:methods / Q000592:standards; D005069:Evaluation Studies as Topic; D005243:Feces / Q000821:virology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008403:Mass Screening; D008854:Microscopy, Electron; D008875:Middle Aged; D011933:Reagent Kits, Diagnostic / Q000592:standards; D012621:Seasons; D012680:Sensitivity and Specificity
chemical_list: D011933:Reagent Kits, Diagnostic