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. 2017 Oct;55(5):513-521.
doi: 10.3347/kjp.2017.55.5.513. Epub 2017 Oct 31.

High Frequency of Enteric Protozoan, Viral, and Bacterial Potential Pathogens in Community-Acquired Acute Diarrheal Episodes: Evidence Based on Results of Luminex Gastrointestinal Pathogen Panel Assay

Yousry A Hawash  1   2 , Khadiga A Ismail  1   3 , Mazen Almehmadi  1
Affiliations

High Frequency of Enteric Protozoan, Viral, and Bacterial Potential Pathogens in Community-Acquired Acute Diarrheal Episodes: Evidence Based on Results of Luminex Gastrointestinal Pathogen Panel Assay

Yousry A Hawash et al. Korean J Parasitol. 2017 Oct.

Abstract

Infectious diarrhea is endemic in most developing countries. We aimed to investigate the protozoan, viral, and bacterial causes of acute diarrhea in Taif, Saudi Arabia. A cross-sectional prospective 1-year study was conducted on 163 diarrheal patients of various ages. Stool samples were collected, 1 per patient, and tested for 3 protozoa, 3 viruses, and 9 bacteria with the Luminex Gastrointestinal Pathogen Panel. Overall, 53.4% (87/163) of samples were positives (20.8% protozoa, 19.6% viruses, 2.8% bacteria, and 9.8% mixed). Rotavirus (19.6%), Giardia duodenalis (16.5%), and Cryptosporidium spp. (8.5%) were the mostly detected pathogens. Adenovirus 40/41 (4.2%), Salmonella (3%), Shiga toxin-producing Escherichia coli (3%), and Entamoeba histolytica (2.4%) were also detected. Norovirus GI/II, Vibrio cholerae, Yersinia enterocolitica, and Clostridium difficile toxin A/B were not detected in any patients. All pathogens were involved in coinfections except E. histolytica. Giardia (5.5%) and rotavirus (3%) were the most commonly detected in co-infections. Enterotoxigenic E. coli (2.4%), Campylobacter spp. (2.4%), E. coli 0157 (1.8%), and Shigella spp. (1.2%) were detected in patients only as co-infections. Infections were more in children 0-4 years, less in adults <40 years, and least >40 years, with statistically significant differences in risk across age groups observed with rotavirus (P<0.001), Giardia (P=0.006), and Cryptosporidium (P=0.036) infections. Lastly, infections were not significantly more in the spring. This report demonstrates the high burden of various enteropathogens in the setting. Further studies are needed to define the impact of these findings on the clinical course of the disease.

Keywords: Cryptosporidium; Entamoeba histolytica; Giardia duodenalis; co-infection; diarrhea; enteropathogen; mono-infection; xTAG™ GPP.

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Conflict of interest statement

CONFLICT OF INTEREST

We have no conflict of interest related to this study.

Figures

Fig. 1
Fig. 1
Saudi Arabia map showing the location of Taif region and the nearby cities.
Fig. 2
Fig. 2
The results of xTAG GPP assay of 163 diarrheal stool samples.
Fig. 3
Fig. 3
Distribution of gastrointestinal pathogens (mono-infections and co-infections) relative to the patients’ age groups.
Fig. 4
Fig. 4
Monthly distribution of the detected gastrointestinal pathogens.
See this image and copyright information in PMC

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