A prospective etiological and clinical study on gastroenteritis in Italian children.

Stool cultures of 188 children hospitalized for gastroenteritis in a two-year period (1981-1982) yielded Salmonella in 25.5%, Campylobacter in 16.0%, and Y. enterocolitica in 3.7% of cases. Rotavirus was identified in 22.3% of cases. Out of 82 lactose-positive microorganisms isolated from as many cases, three (one E. coli and two Klebsiella) produced heat-labile enterotoxin and two E. coli strains a "cytotoxic" toxin (in an HEp-2 in vitro model); two other E. coli strains possessed adhesive properties for HEp-2 cells in vitro; none revealed enteroinvasive for HEp-2 cells. Two out of 70 E. coli strains were EPEC. From stools of 643 childhood out-patients Salmonella was isolated in 9.6% of cases; Campylobacter and Y. enterocolitica in 9.0% and in 0.6% of cases respectively. Rotavirus was not looked for. Shigella strains were not isolated. Among 622 children without gastrointestinal symptoms, five (0.8%) excreted campylobacters and one (0.16%) salmonella. Children of 18-24 months of age were significantly more often infected with Campylobacter. Gross blood in feces, body temperature greater than 38 degrees C, and peripheral leukocytosis were significantly more often associated with Salmonella infection; vomiting and absence of blood in stools and of leukocytosis with rotavirus infection. Other features were not significantly associated with the etiological agent of the illness. Except for Salmonella infections, the enteritis cases did not show any pronounced seasonal pattern.