Using Multiplex Molecular Testing to Determine the Etiology of Acute Gastroenteritis in Children - 25/08/16
, Gerald T. Van Horn, PhD 2, Yi-Wei Tang, MD, PhD 3, Jan Vinjé, PhD 4, Daniel C. Payne, PhD 4, Kathryn M. Edwards, MD 5, James D. Chappell, MD, PhD 6Abstract |
Objective |
To detect the etiologic agents of acute gastroenteritis (AGE) in children using broad molecular-based techniques, and compare clinical presentations among etiologies.
Study design |
This was a prospective population-based surveillance study of children aged <6 years with AGE conducted between 2008 and 2011 as part of the New Vaccine Surveillance Network. Stools from patients and healthy controls were tested for 21 gastrointestinal pathogens using the analyte-specific reagent Gastrointestinal Pathogen Panel and an additional reverse transcription real-time polymerase chain reaction assay for sapovirus and astrovirus.
Results |
Of the 216 stool samples from patients with AGE, 152 (70.4%) tested positive for a pathogen, with norovirus genogroup II (n = 78; 36.1%) and Clostridium difficile (n = 35; 16.2%) the most common pathogens detected. Forty-nine patients (22.7%) tested positive for more than 1 pathogen, including 25 (71%) with a C difficile detection. There were no significant clinical differences among the patients with no pathogen detected, those with a single pathogen detected, and those with ≥2 pathogens detected.
Conclusion |
Using a broad molecular testing approach, high rates of enteropathogens were detected in children with AGE, dominated by norovirus genogroup II and C difficile. Coinfections were common but had no identifiable impact on clinical manifestations. As routine diagnostics of AGE progressively evolve toward nucleic acid–based pathogen detection, ongoing systematic studies are needed to better analyze the clinical significance of results.
Le texte complet de cet article est disponible en PDF.Keywords : Clostridium difficile, diarrhea, norovirus, colonization, coinfections
Abbreviations : AGE, CDC, CDI, EIA, GII, GPP, MCJCHV, NVSN, RT-rtPCR
Plan
| Supported by Luminex Molecular Diagnostics (J.C.). Specimens were obtained through a cooperative agreement between Vanderbilt University and the US Centers for Disease Control and Prevention (CDC) as part of the New Vaccine Surveillance Network. Luminex Corporation provided the reagents and supplies necessary to perform specimen testing, as well as funds supporting the statistical analysis of study data. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the CDC. Names of specific vendors, manufacturers, or products are included for public health and informational purposes; inclusion does not imply endorsement of the vendors, manufacturers, or products by the CDC or the US Department of Health and Human Services. J.C. has served as a consultant to Luminex Molecular Diagnostics on the xTAG Gastrointestinal Pathogen Panel, and currently collaborates with Luminex Corporation in the evaluation of new technology for the diagnosis of C difficile infection. The other authors declare no conflicts of interest. |
Vol 176
P. 50 - septembre 2016 Retour au numéro
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