Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul;110(7):2240-2245.
doi: 10.1111/apa.15854. Epub 2021 Apr 11.

Polymicrobial gastroenteritis in children

Eleni Vergadi  1 , Sofia Maraki  2 , Evangelia Dardamani  1 , Fani Ladomenou  3 , Emmanouil Galanakis  1
Affiliations

Polymicrobial gastroenteritis in children

Eleni Vergadi et al. Acta Paediatr. 2021 Jul.

Abstract

Aim: Co-infections with viral and bacterial enteropathogens often augment severity of diarrhoea, however, there is limited evidence on the clinical importance of bacterial enteric co-infections. We investigated the rate, type and impact of bacterial enteropathogens and their associations in children with gastroenteritis.

Methods: Retrospective cohort study that included children 0-18 years old with acute bacterial diarrhoea during a 27-year period (1993-2019), in Crete, Greece. Differences in clinical characteristics and pathogen associations were investigated between single and multiple infections.

Results: Two or more bacteria were isolated in stool culture in 53 out of 1932 children (2.74%). Patients with co-infections were younger (p 0.0001) and had higher hospitalisation rates (p 0.03). Escherichia coli (E. coli) was the most prevalent pathogen associated with co-infections, in particular the E. coli enteropathogenic strains O127 and O111 (p 0.001), and Salmonella spp the least (p 0.001). Co-occurrence analysis revealed two positively associated pathogen pairs, E. coli with Campylobacter spp and E. coli (p 0.001) with Salmonella spp (p 0.04).

Conclusion: Bacterial enteropathogen co-infection was most common with E. coli strains and related to higher hospitalisation rates and younger age.

Keywords: co-infection; diarrhoea; enteropathogens; gastroenteritis; polymicrobial.

PubMed Disclaimer

References

REFERENCES

    1. Das JK, Salam RA, Bhutta ZA. Global burden of childhood diarrhea and interventions. Curr Opin Infect Dis. 2014;27:451-458.
    1. Zhang SX, Zhou YM, Xu W, et al. Impact of co-infections with enteric pathogens on children suffering from acute diarrhea in southwest China. Infect Dis Poverty. 2016;5:64.
    1. Bhavnani D, Goldstick JE, Cevallos W, Trueba G, Eisenberg JN. Synergistic effects between rotavirus and coinfecting pathogens on diarrheal disease: evidence from a community-based study in northwestern Ecuador. Am J Epidemiol. 2012;176:387-395.
    1. Bonkoungou IJ, Haukka K, Osterblad M, et al. Bacterial and viral etiology of childhood diarrhea in Ouagadougou, Burkina Faso. BMC Pediatr. 2013;13(1):36.
    1. Andersson M, Kabayiza JC, Elfving K, et al. Coinfection with enteric pathogens in east African children with acute gastroenteritis-associations and interpretations. Am J Trop Med Hyg. 2018;98:1566-1570.

LinkOut - more resources