Division of Infection Diagnostics, Department Biomedicine - Haus Petersplatz, University of Basel, Basel, Switzerland.
University of Basel Children's Hospital, Pediatric Infectious Diseases and Vaccinology, Basel, Switzerland.
J Med Virol. 2018 Apr;90(4):685-691. doi: 10.1002/jmv.25005. Epub 2018 Jan 4.
Acute gastroenteritis (GE) has a major impact on morbidity and mortality worldwide, yet comprehensive data regarding infectious agents including enteroviruses are scarce. We hypothesized that enteroviruses constitute a significant cause of acute GE. We analyzed 677 stool samples from 504 patients, which had been submitted for suspected infectious GE. 0.2 mL of stool suspension was extracted using the Abbott m2000 robot and analysed by multiplex nucleic acid testing (NAT) using the Luminex xTAG gastrointestinal pathogen panel (GPP) as well as by specific NATs detecting enteroviruses and polioviruses. Median age of the patients was 6.6 years (IQR 1.1-50.6; pediatric <18 years). 292 of 677 (43%) samples were positive for at least one pathogen. Enterovirus was detected in 5.3% (36/677) as sole pathogen (67%), and more frequently in children (P = 0.0054). Only rotavirus (18.6%) and norovirus (12.1%) were more frequent. Clostridium difficile and Campylobacter jejuni were detected in 5.5% and 2.2% of stools, respectively. Adenovirus, E. coli O157, Salmonella, Shiga toxin-producing E. coli (STEC), Shigella, Giardia lamblia, Cryptosporidium, and Entamoeba histolytica were rare (<1% of samples). Vibrio cholerae, Yersinia enterocolitica, enterotoxigenic E. coli (ETEC) and poliovirus were not detected. Thus, non-polio enteroviruses are the third most frequent pathogen in acute GE suggesting that enteroviruses may play an important role in GE even in developed, industrial health care settings.
急性肠胃炎（GE）在全球范围内对发病率和死亡率有重大影响，但有关包括肠病毒在内的感染病原体的综合数据却很少。我们假设肠病毒是急性 GE 的一个重要原因。我们分析了 504 名疑似感染性 GE 患者的 677 份粪便样本。使用 Abbott m2000 机器人提取 0.2 毫升粪便悬液，使用 Luminex xTAG 胃肠道病原体检测试剂盒（GPP）进行多重核酸检测（NAT），并使用特定的 NAT 检测肠病毒和脊髓灰质炎病毒。患者的中位年龄为 6.6 岁（IQR 1.1-50.6；儿科<18 岁）。677 份样本中有 292 份（43%）至少有一种病原体阳性。肠病毒作为唯一病原体的检出率为 5.3%（36/677）（67%），在儿童中更为常见（P=0.0054）。仅轮状病毒（18.6%）和诺如病毒（12.1%）更为常见。艰难梭菌和空肠弯曲菌分别在 5.5%和 2.2%的粪便中检出。腺病毒、大肠杆菌 O157、沙门氏菌、产志贺毒素大肠埃希菌（STEC）、志贺菌、蓝氏贾第鞭毛虫、隐孢子虫和溶组织内阿米巴较少见（<1%的样本）。霍乱弧菌、耶尔森菌、肠产毒性大肠埃希菌（ETEC）和脊髓灰质炎病毒未检出。因此，非脊髓灰质炎肠病毒是急性 GE 的第三大常见病原体，这表明即使在发达的工业医疗环境中，肠病毒也可能在 GE 中发挥重要作用。
