Herranz-Ulldemolins Sara, Sellarès-Crous Anna, Álvarez-Martínez Miriam J, Valls M Eugenia, Aldea Novo Marta, Vilella Morató Anna, Rodriguez Laura, Navarro Mireia, Vendrell Roser, Barrachina Josep, Martínez Miguel J, Marcos M Ángeles
Department of Preventive Medicine and Epidemiology, Hospital Clínic, Barcelona, Spain.
Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.
Infect Dis Ther. 2025 Jan;14(1):121-132. doi: 10.1007/s40121-024-01076-0. Epub 2024 Nov 26.
Acute gastroenteritis (AGE) represents a significant global health burden, with enteric viruses being a leading cause of gastroenteritis worldwide. Despite advances in diagnosis and treatment, there are limited data on adults seeking care due to AGE of viral etiology. This study aimed to describe the etiological, clinical, and epidemiological characteristics of viral AGE in adult patients presenting for medical consultation in a tertiary hospital over a 2-year period.
A retrospective cross-sectional study was conducted, with 8886 stool samples from 8356 adult patients presenting acute diarrhea between January 2021 and December 2022. A molecular real-time RT-PCR panel was used to screen for common bacterial, parasitic, and viral pathogens. Clinical and demographic data were collected, and statistical analysis was performed to evaluate possible associations.
Enteric viruses constituted 10.3% (307 cases) of all AGE of known etiology, with norovirus being the predominant pathogen (196, 63.8%), followed by rotavirus (82, 26.7%) and adenovirus (29, 9.4%). The different viruses showed a distinct seasonal predominance. Coinfection with other microorganisms was common. Most cases exhibited a self-limiting course. Mortality and hospitalization rates were high in patients with higher comorbidity indices, mainly in individuals with immunosuppression.
Viruses are an important cause of acute gastroenteritis in adults presenting for medical consultation. The new multiplex molecular tests with high sensitivity and specificity allow early differential diagnosis in AGE. It is therefore necessary to identify which special populations particularly with higher comorbidity indices, would benefit from the implementation of these techniques, to guide decision-making related to appropriate treatments and avoid unnecessary interventions.
急性胃肠炎(AGE)是一项重大的全球健康负担,肠道病毒是全球范围内胃肠炎的主要病因。尽管在诊断和治疗方面取得了进展,但关于因病毒病因导致的急性胃肠炎而寻求治疗的成年人的数据有限。本研究旨在描述在一家三级医院就诊的成年患者中,为期两年的病毒性急性胃肠炎的病因、临床和流行病学特征。
进行了一项回顾性横断面研究,收集了2021年1月至2022年12月期间8356例出现急性腹泻的成年患者的8886份粪便样本。使用分子实时逆转录聚合酶链反应(RT-PCR)检测板筛查常见的细菌、寄生虫和病毒病原体。收集临床和人口统计学数据,并进行统计分析以评估可能的关联。
肠道病毒占所有已知病因的急性胃肠炎病例的10.3%(307例),其中诺如病毒是主要病原体(196例,63.8%),其次是轮状病毒(82例,26.7%)和腺病毒(29例,9.4%)。不同病毒呈现出明显的季节性优势。与其他微生物的合并感染很常见。大多数病例呈现自限性病程。合并症指数较高的患者死亡率和住院率较高,主要是免疫抑制患者。
病毒是前来就医的成年患者急性胃肠炎的重要病因。具有高灵敏度和特异性的新型多重分子检测可实现急性胃肠炎的早期鉴别诊断。因此,有必要确定哪些特殊人群,特别是合并症指数较高的人群,将从这些技术的应用中受益,以指导与适当治疗相关的决策并避免不必要的干预。