Journal of the Formosan Medical Association
Volume 105, Issue 12 , Pages 964-970, 2006

Microbial Etiology of Acute Gastroenteritis in Hospitalized Children in Taiwan

  • Shan-Ming Chen

      Affiliations

    • Department of Pediatrics, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan
    • Department of Pediatrics, Chung Shan Medical University Hospital, Taipei, Taiwan
    • ,
  • Yen-Hsuan Ni

      Affiliations

    • Department of Pediatrics, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Yen-Hsuan Ni, Department of Pediatrics, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan
    • ,
  • Huey-Ling Chen

      Affiliations

    • Department of Pediatrics, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan
    • ,
  • Mei-Hwei Chang

      Affiliations

    • Department of Pediatrics, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan

Received 16 March 2006; received in revised form 24 April 2006; accepted 6 June 2006.

Article Outline

Background/purpose

Viral infections are the most common causes of acute infectious diarrhea in the pedi-atric population. To explore any possible microbial etiologies of acute gastroenteritis in children, we detected stool viral antigen including rotavirus, adenovirus, norovirus and astrovirus. We also studied the possible precipitating factors.

Methods

During a period of 1 year (from October 2003 to September 2004), children from birth to 15 years old admitted to the pediatric ward were prospectively surveyed. Stool specimens were collected within 48 hours after admission and then frozen at −40°C until analysis. Enzyme immunoassay was used to detect rotavirus, astrovirus, norovirus and adenovirus. Bacterial culture was performed at the same time.

Results

During the study period, 82 stool samples were collected due to acute gastroenteritis and fit the definition of a diarrhea episode. Forty-two (51.2%) patients with viral infection, 11 (13.4%) with bacterial infection, and six (7.3%) with mixed viral and bacterial infection were detected. The most prevalent virus was rotavirus (35.4%), followed by norovirus (29.3%). The most prevalent cause of bacterial infection was Salmonella (19.5%). With regard to clinical severity, rotavirus resulted in longer hospital stay, higher rate of vomiting, stool occult blood, leukocytosis, lower rate in stool pus cell, and C-reactive protein elevation more than 5 mg/dL as compared with norovirus. Only the difference in hospital stay reached significant statistical difference.

Conclusion

Norovirus is an important cause of acute gastroenteritis in children, although rotavirus is still the leading cause of pediatric acute gastroenteritis.

Key Words:  diarrhea , gastroenteritis , norovirus , rotavirus

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PII: S0929-6646(09)60280-1

doi:10.1016/S0929-6646(09)60280-1

Journal of the Formosan Medical Association
Volume 105, Issue 12 , Pages 964-970, 2006

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