title: Etiology of acute diarrhea due to enteropathogenic bacteria in Beijing, China.
abstract: OBJECTIVE
  Acute diarrhea is of great concern due to considerable morbidity and mortality worldwide. The causative bacteria leading to acute diarrhea in general population remains unclear in China. This study was conducted to determine the etiology of acute diarrhea using a sentinel hospital-based surveillance network in Beijing.
  
  
  METHODS
  Active surveillance was implemented from April 2010 to December 2011 on two random days per week by enrolling every tenth diarrheal patients admitted to seventeen intestinal clinics. Shigella spp., Vibrio spp, Salmonella spp., diarrheagenic Escherichia coli and other genera of bacteria, were investigated from 4803 outpatients with acute diarrhea by microbiological methods.
  
  
  RESULTS
  The pathogenic bacteria recovered out from fecal samples of 968 (20.2%) patients had the following profile: Shigella spp. (5.9%) was the most prevalent pathogen, Vibrio parahaemolyticus (5.2%), Salmonella spp. (3.9%) and enteropathogenic E. coli (EPEC) (0.9%) had from the second to fourth highest prevalence, respectively. Of the 55 co-infections detected, V. parahaemolyticus was the most common pathogen from 28 cases (50.9%), with the main combination of V. parahaemolyticus and Salmonella. The highest proportion of all causative bacteria was found in adults aged 20-39 year and in summer as well as early autumn. The clinical symptoms associated with specific bacterial infection, such as fever, abdominal pain, tenesmus, nausea, vomiting, and watery and bloody stool, were observed frequently in diarrheal patients.
  
  
  CONCLUSIONS
  Shigella spp., V. parahaemolyticus, Salmonella spp., and EPEC are important enteropathogenic bacteria causing acute diarrhea in Beijing. To execute reasonable interventions, the comprehensive and continuous surveillance is needed to identify the prevalence of different enteropathogeic bacteria.
authors.affiliation: Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, No.16, He Pingli Middle Street, Beijing 100013, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Qu
authors.forename: Ying
authors.initials: Y
authors.lastname: Deng
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.forename: Guirong
authors.initials: G
authors.lastname: Liu
authors.forename: Ying
authors.initials: Y
authors.lastname: Huang
authors.forename: Changying
authors.initials: C
authors.lastname: Lin
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.forename: Hanqiu
authors.initials: H
authors.lastname: Yan
authors.forename: Xitai
authors.initials: X
authors.lastname: Li
authors.forename: Lei
authors.initials: L
authors.lastname: Jia
authors.forename: Biao
authors.initials: B
authors.lastname: Kan
authors.forename: Fang
authors.initials: F
authors.lastname: Huang
authors.forename: Quanyi
authors.initials: Q
authors.lastname: Wang
mesh_terms: D000208:Acute Disease / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D060085:Coinfection / Q000453:epidemiology / Q000382:microbiology; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology*; D004755:Enterobacteriaceae / Q000302:isolation & purification; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012621:Seasons; D018571:Sentinel Surveillance; D014733:Vibrio / Q000302:isolation & purification