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Purpose <p>To identify enteric pathogens in pediatric acute gastroenteritis (AGE) and assess their etiological relevance by comparison with samples during asymptomatic period.</p> Methods <p>Children &lt; 2 years of age (<i>n</i> = 89) were prospectively enrolled as part of the population-based birth cohort LoewenKIDS. Asymptomatic stool samples were collected regularly, and symptomatic samples were collected after the occurrence of &gt; 3 loose stools and/or one vomiting in 24&#xa0;h. Intraindividual pairs of symptomatic and preceding asymptomatic samples for each child were analyzed for 25 enteric pathogens via multiplex real-time RT-PCR.</p> Results <p>Enteric viruses were detected in 64% (57/89) of symptomatic samples and significantly associated with gastrointestinal symptoms (Odds Ratio [OR] 3.9; 95% Confidence Interval [CI] 2.1–7.3). The most common viruses in AGE were norovirus (Genogroups GI and GII) (36%, 32/89) and adenovirus (27%, 24/89). Bacteria were detected in 46% (41/89) of symptomatic samples and 43% (38/89) of asymptomatic ones, with no association to symptoms (OR 1.1; 95% CI 0.6-2). The most common bacteria in AGE were Enteropathogenic <i>Escherichia coli</i> (28%, 25/89) and <i>Clostridium difficile</i> (16%, 14/89). <i>Dientamoeba fragilis</i> was the only detected parasite in AGE (7%, 6/89), and was not associated with symptoms (OR 1.4; 95% CI 0.4–5.5). Pathogen loads in symptomatic and asymptomatic pairs correlated with symptoms for norovirus GII, astrovirus and sapovirus (each <i>p</i> &lt; 0.01), but not for other pathogens.</p> Conclusion <p>This study supports the clinical significance of detection of viral pathogens in young children with acute gastroenteritis and without relevant comorbidities in high-income countries, but limits the significance of enteric bacterial and parasitic pathogens detection, partly due to constraints in their specific identification.</p> Trial registration <p>Clinicaltrials.Gov Identifier: NCT02654210.</p>

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Detection of enteric pathogens in young children before and during acute gastroenteritis: results from a prospective German birth cohort study (LoewenKIDS)

  • 期刊论文

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  • 发表日期：

    2025年10月20日

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  • Chiara Lincetto,
  • Felipe Romero-Saavedra,
  • Diana Laverde,
  • Riccardo Lincetto,
  • Melanie Meyer-Buehn,
  • Bianca Klee,
  • Cornelia Gottschick,
  • Rafael Mikolajczyk,
  • Johannes Huebner,
  • Tilmann Schober

摘要

Purpose

To identify enteric pathogens in pediatric acute gastroenteritis (AGE) and assess their etiological relevance by comparison with samples during asymptomatic period.

Methods

Children < 2 years of age (n = 89) were prospectively enrolled as part of the population-based birth cohort LoewenKIDS. Asymptomatic stool samples were collected regularly, and symptomatic samples were collected after the occurrence of > 3 loose stools and/or one vomiting in 24 h. Intraindividual pairs of symptomatic and preceding asymptomatic samples for each child were analyzed for 25 enteric pathogens via multiplex real-time RT-PCR.

Results

Enteric viruses were detected in 64% (57/89) of symptomatic samples and significantly associated with gastrointestinal symptoms (Odds Ratio [OR] 3.9; 95% Confidence Interval [CI] 2.1–7.3). The most common viruses in AGE were norovirus (Genogroups GI and GII) (36%, 32/89) and adenovirus (27%, 24/89). Bacteria were detected in 46% (41/89) of symptomatic samples and 43% (38/89) of asymptomatic ones, with no association to symptoms (OR 1.1; 95% CI 0.6-2). The most common bacteria in AGE were Enteropathogenic Escherichia coli (28%, 25/89) and Clostridium difficile (16%, 14/89). Dientamoeba fragilis was the only detected parasite in AGE (7%, 6/89), and was not associated with symptoms (OR 1.4; 95% CI 0.4–5.5). Pathogen loads in symptomatic and asymptomatic pairs correlated with symptoms for norovirus GII, astrovirus and sapovirus (each p < 0.01), but not for other pathogens.

Conclusion

This study supports the clinical significance of detection of viral pathogens in young children with acute gastroenteritis and without relevant comorbidities in high-income countries, but limits the significance of enteric bacterial and parasitic pathogens detection, partly due to constraints in their specific identification.

Trial registration

Clinicaltrials.Gov Identifier: NCT02654210.