title: Tropheryma whipplei associated with diarrhoea in young children.
abstract: Tropheryma whipplei was detected in preliminary studies in faeces of young children with diarrhoea and also in faeces of asymptomatic persons, not only in Europe but also in Africa. In this study, the link between this bacterium and the presence of acute diarrhoea was evaluated in a large group of children. From December 2009 to January 2013, rectal swabs collected from 3796 children in the emergency departments of university hospitals in Marseille, France, were analysed: 555 children (245 female and 310 male, from 6 days to 6 years old) with acute diarrhoea defined as at least three loose stools per day for <1 week and 3241 children (1444 female and 1797 male, from 22 days to 6 years old) without diarrhoea. Specific quantitative real-time PCR was performed to detect the presence of T. whipplei and of two enteric pathogens Clostridium difficile and Giardia duodenalis. Tropheryma whipplei was significantly more common in children with diarrhoea (22/555, 4%) than without (56/3241, 1.7%; p 0.001). Neither C. difficile nor G. duodenalis showed this association. For C. difficile, 39 of 531 (7.3%) children with diarrhoea were positive versus 184 of 3119 (5.9%) of children without diarrhoea (p 0.25). For G. duodenalis, 2 of 529 (0.37%) children with diarrhoea were positive versus 5 of 3119 (0.16%) children without diarrhoea (p 0.26). Tropheryma whipplei was found more commonly in autumn. Tropheryma whipplei is significantly associated with diarrhoea in children, suggesting that the bacterium may be a cause of acute diarrhoea.
authors.affiliation: Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM63, CRNS7278, IRD198, InsermU1095, Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, Marseille, France.
authors.forename: F
authors.initials: F
authors.lastname: Fenollar
authors.affiliation: Paediatric Emergency Unit, Hôpital Nord, Marseille, France.
authors.forename: P
authors.initials: P
authors.lastname: Minodier
authors.affiliation: Paediatric Emergency Unit, Hôpital Timone, Marseille, France.
authors.forename: A
authors.initials: A
authors.lastname: Boutin
authors.affiliation: Paediatric Emergency Unit, Hôpital Nord, Marseille, France.
authors.forename: R
authors.initials: R
authors.lastname: Laporte
authors.affiliation: Paediatric Emergency Unit, Hôpital Timone, Marseille, France.
authors.forename: V
authors.initials: V
authors.lastname: Brémond
authors.affiliation: Paediatric Emergency Unit, Hôpital Nord, Marseille, France.
authors.forename: G
authors.initials: G
authors.lastname: Noël
authors.affiliation: Paediatric Emergency Unit, Hôpital Timone, Marseille, France.
authors.forename: S
authors.initials: S
authors.lastname: Miramont
authors.affiliation: Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM63, CRNS7278, IRD198, InsermU1095, Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, Marseille, France.
authors.forename: H
authors.initials: H
authors.lastname: Richet
authors.affiliation: Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM63, CRNS7278, IRD198, InsermU1095, Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, Marseille, France.
authors.forename: S
authors.initials: S
authors.lastname: Benkouiten
authors.affiliation: Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM63, CRNS7278, IRD198, InsermU1095, Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, Marseille, France.
authors.forename: J-C
authors.initials: JC
authors.lastname: Lagier
authors.affiliation: Aix-Marseille University, UMR912 SESSTIM (INSERM-IRD-AMU), Marseille, France.
authors.forename: J
authors.initials: J
authors.lastname: Gaudart
authors.affiliation: Paediatric Emergency Unit, Hôpital Timone, Marseille, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Jouve
authors.affiliation: Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM63, CRNS7278, IRD198, InsermU1095, Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, Marseille, France. Electronic address: didier.raoult@gmail.com.
authors.forename: D
authors.initials: D
authors.lastname: Raoult
mesh_terms: D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000382:microbiology*; D005243:Feces / Q000382:microbiology; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012621:Seasons; D054851:Tropheryma / Q000235:genetics / Q000302:isolation & purification*; D008061:Whipple Disease / Q000175:diagnosis* / Q000453:epidemiology*
keywords: Clostridium difficile; Diarrhoea; Gastroenteritis; Giardia duodenalis; Tropheryma whipplei; Whipple's disease