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Polymicrobial gastroenteritis in children
Author(s) -
Vergadi Eleni,
Maraki Sofia,
Dardamani Evangelia,
Ladomenou Fani,
Galanakis Emmanouil
Publication year - 2021
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.15854
Subject(s) - pathogen , medicine , salmonella , microbiology and biotechnology , cohort , escherichia coli , enteropathogenic escherichia coli , campylobacter , diarrhea , acute gastroenteritis , bacteria , virology , immunology , biology , biochemistry , genetics , gene
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.