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Bacterial and viral etiology of childhood diarrhea in Ouagadougou, Burkina Faso

机译：布基纳法索瓦加杜古儿童期腹泻的细菌和病毒病因学

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Background Diarrhea is the most frequent health problem among children in developing countries. This study investigated the bacterial and viral etiology and related clinical and epidemiological factors in children with acute diarrhea in Ouagadougou, Burkina Faso. Methods Stool specimens were collected from 283 children under 5?years of age visiting hospital due to acute diarrhea and from 60 healthy controls of similar age. Pathogens were investigated by using conventional culture techniques, PCR and immunochromatographic testing. Salmonella and Shigella strains were serotyped and their susceptibility to 23 antimicrobial agents was determined by the agar dilution method. Results At least one pathogen was detected in 64% of the 283 patients and in 8% of the 60 controls (p?Escherichia coli (24%), Salmonella enterica ssp. enterica (9%), Shigella spp. (6%), adenovirus (5%) and Campylobacter spp. (2%). Multiple pathogens were found in 11% of the patients and in 2% of the controls (p?=?0.028). Viruses were found mainly in children of?≤?2?years of age, whereas bacteria were equally prevalent among all the age groups. Viral infections occurred mostly during the cool dry season and the bacterial infections during the rainy season. Fever (64%) and vomiting (61%) were the most common symptoms associated with diarrhea. Only one Salmonella strain was resistant to nalidixic acid and ciprofloxacin. Of the Shigella strains, one was resistant to nalidixic acid but 81% to trimethoprim- sulfamethoxazole, 63% to streptomycin and 50% to ampicillin. Most of all the other Salmonella and Shigella strains were sensitive to all antimicrobials tested. Conclusion Rotaviruses and diarrheal E. coli were the most predominant pathogens associated with acute diarrhea in Burkinabe children. Constant antimicrobial surveillance is warranted to observe for the emergence of enteric bacteria resistant to antimicrobials that are important in treatment also of severe infections.
机译：背景技术腹泻是发展中国家儿童中最常见的健康问题。这项研究调查了布基纳法索瓦加杜古儿童急性腹泻的细菌和病毒病因学及相关的临床和流行病学因素。方法收集283例5岁以下因急性腹泻而来医院就诊的儿童粪便标本，并从60名年龄相似的健康对照者中收集粪便标本。通过使用常规培养技术，PCR和免疫色谱测试研究病原体。对沙门氏菌和志贺氏菌菌株进行血清分型，并通过琼脂稀释法确定其对23种抗菌剂的敏感性。结果283例患者中有64％和60例对照中有8％检出至少一种病原体（p？大肠杆菌（24％），肠炎沙门氏菌（Salmonella enterica ssp。enterica）（9％），志贺氏菌（Shigella spp。（6％）），腺病毒（5％）和弯曲杆菌属（2％），在11％的患者和2％的对照中发现多种病原体（p？=？0.028），病毒主要在？≤？2的儿童中发现。年岁，而细菌在所有年龄组中均普遍存在，病毒感染主要发生在凉爽的干燥季节和雨季的细菌感染，最常见的症状是发烧（64％）和呕吐（61％）与腹泻相关的只有一种沙门氏菌菌株对萘啶酸和环丙沙星有抗药性;在志贺菌菌株中，一种菌株对萘啶酸有抗药性，但对甲氧苄氨磺胺甲恶唑有81％的抗药性，对链霉素的抗药性是63％，对氨苄西林的抗药性是50％沙门氏菌和志贺氏菌菌株对所有测试的抗生素敏感。腹泻性大肠杆菌是布基纳法索儿童与急性腹泻有关的最主要病原体。有必要进行持续的抗菌素监测，以观察对抗菌素有抗药性的肠道细菌的出现，这对于治疗严重感染也很重要。

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