1887

Journal of Medical Microbiology logo

Volume 64, Issue 3

Aetiology of acute paediatric gastroenteritis in Bulgaria during summer months: prevalence of viral infections Free

Abstract

Paediatric acute gastroenteritis is a global public health problem. Comprehensive laboratory investigation for viral, bacterial and parasitic agents is helpful for improving management of acute gastroenteritis in health care settings and for monitoring and controlling the spread of these infections. Our study aimed to investigate the role of various pathogens in infantile diarrhoea in Bulgaria outside the classical winter epidemics of rotavirus and norovirus. Stool samples from 115 hospitalized children aged 0–3 years collected during summer months were tested for presence of 14 infectious agents – group A rotavirus, astrovirus, , and using ELISAs; norovirus by real-time RT-PCR; picobirnavirus and sapovirus by RT-PCR; adenovirus using PCR, and , , , and using standard bacterial cultures. Infectious origin was established in a total of 92 cases and 23 samples remained negative. A single pathogen was found in 67 stools, of which rotaviruses were the most prevalent (56.7 %), followed by noroviruses (19.4 %), enteric adenoviruses (7.5 %), astroviruses (6.0 %), bacteria and parasites (4.5 % each) and sapoviruses (1.4 %). Rotavirus predominant genotypes were G4P[8] (46.3 %) and G2P[4] (21.4 %); for astroviruses, type 1a was the most common, while the GII.4/2006b variant was the most prevalent among noroviruses. Bacteria were observed in five cases, with sp. as the most prevalent, while parasites were found in ten stool samples, with in five cases. The results demonstrated high morbidity associated with viral infections and that rotavirus and norovirus remain the most common pathogens associated with severe gastroenteritis during summer months in Bulgaria, a country with a temperate climate, and significant molecular diversity among circulating virus strains.

  • Received:
  • Accepted:
  • Published Online:
© 2015 The Authors
Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.000018
2015-03-01
2024-04-16
Loading full text...

Full text loading...

/deliver/fulltext/jmm/64/3/272.html?itemId=/content/journal/jmm/10.1099/jmm.0.000018&mimeType=html&fmt=ahah

References

  1. Ahmed S. M., Hall A. J., Robinson A. E., Verhoef L., Premkumar P., Parashar U. D., Koopmans M., Lopman B. A. 2014; Global prevalence of norovirus in cases of gastroenteritis: a systematic review and meta-analysis. Lancet Infect Dis 14:725–730 [View Article][PubMed]
     [Google Scholar]
  2. Akhter S., Turegun B., Kiyan M., Gerceker D., Guriz H., Sahin F. 2014; [Investigation of seven different RNA viruses associated with gastroenteritis in children under five years old]. Mikrobiyol Bul 48:233–241 (in Turkish) [View Article][PubMed]
     [Google Scholar]
  3. Amar C. F., East C. L., Gray J., Iturriza-Gomara M., Maclure E. A., McLauchlin J. 2007; Detection by PCR of eight groups of enteric pathogens in 4,627 faecal samples: re-examination of the English case-control Infectious Intestinal Disease Study (1993–1996). Eur J Clin Microbiol Infect Dis 26:311–323 [View Article][PubMed]
     [Google Scholar]
  4. Belliot G., Laveran H., Monroe S. S. 1997; Detection and genetic differentiation of human astroviruses: phylogenetic grouping varies by coding region. Arch Virol 142:1323–1334 [View Article][PubMed]
     [Google Scholar]
  5. Bhattacharya R., Sahoo G. C., Nayak M. K., Saha D. R., Sur D., Naik T. N., Bhattacharya S. K., Krishnan T. 2006; Molecular epidemiology of human picobirnaviruses among children of a slum community in Kolkata, India. Infect Genet Evol 6:453–458 [View Article][PubMed]
     [Google Scholar]
  6. Boga J. A., Melón S., Nicieza I., De Diego I., Villar M., Parra F., De Oña M. 2004; Etiology of sporadic cases of pediatric acute gastroenteritis in Asturias, Spain, and genotyping and characterization of norovirus strains involved. J Clin Microbiol 42:2668–2674 [View Article][PubMed]
     [Google Scholar]
  7. Cascio A., Bosco M., Vizzi E., Giammanco A., Ferraro D., Arista S. 1996; Identification of picobirnavirus from faeces of Italian children suffering from acute diarrhea. Eur J Epidemiol 12:545–547 [View Article][PubMed]
     [Google Scholar]
  8. Chikhi-Brachet R., Bon F., Toubiana L., Pothier P., Nicolas J. C., Flahault A., Kohli E. 2002; Virus diversity in a winter epidemic of acute diarrhea in France. J Clin Microbiol 40:4266–4272 [View Article][PubMed]
     [Google Scholar]
  9. Chiu T. F., Lee C. N., Lee P. I., Kao C. L., Lin H. C., Lu C. Y., Tseng H. Y., Hsu H. L., Lee C. Y., Huang L. M. 2000; Rotavirus gastroenteritis in children: 5-year experience in a medical center. J Microbiol Immunol Infect 33:181–186[PubMed]
     [Google Scholar]
  10. Colomba C., De Grazia S., Giammanco G. M., Saporito L., Scarlata F., Titone L., Arista S. 2006; Viral gastroenteritis in children hospitalised in Sicily, Italy. Eur J Clin Microbiol Infect Dis 25:570–575 [View Article][PubMed]
     [Google Scholar]
  11. de Wit M. A., Koopmans M. P., Kortbeek L. M., van Leeuwen N. J., Vinjé J., van Duynhoven Y. T. 2001; Etiology of gastroenteritis in sentinel general practices in The Netherlands. Clin Infect Dis 33:280–288 [View Article][PubMed]
     [Google Scholar]
  12. Fabiana A., Donia D., Gabrieli R., Petrinca A. R., Cenko F., Bebeci D., Altan A. M., Buonomo E., Divizia M. 2007; Influence of enteric viruses on gastroenteritis in Albania: epidemiological and molecular analysis. J Med Virol 79:1844–1849 [View Article][PubMed]
     [Google Scholar]
  13. Ganesh B., Nataraju S. M., Rajendran K., Ramamurthy T., Kanungo S., Manna B., Nagashima S., Sur D., Kobayashi N., Krishnan T. 2010; Detection of closely related picobirnaviruses among diarrhoeic children in Kolkata: evidence of zoonoses?. Infect Genet Evol 10:511–516 [View Article][PubMed]
     [Google Scholar]
  14. Ganesh B., Bányai K., Martella V., Jakab F., Masachessi G., Kobayashi N. 2012; Picobirnavirus infections: viral persistence and zoonotic potential. Rev Med Virol 22:245–256 [View Article][PubMed]
     [Google Scholar]
  15. Giammanco G. M., Rotolo V., Medici M. C., Tummolo F., Bonura F., Chezzi C., Martella V., De Grazia S. 2012; Recombinant norovirus GII.g/GII.12 gastroenteritis in children. Infect Genet Evol 12:169–174 [View Article][PubMed]
     [Google Scholar]
  16. Giordano M. O., Masachessi G., Martinez L. C., Barril P. A., Ferreyra L. J., Isa M. B., Nates S. V. 2008; Two instances of large genome profile picobirnavirus occurrence in Argentinian infants with diarrhea over a 26-year period (1977–2002). J Infect 56:371–375 [View Article][PubMed]
     [Google Scholar]
  17. González G. G., Liprandi F., Ludert J. E. 2011; Molecular epidemiology of enteric viruses in children with sporadic gastroenteritis in Valencia, Venezuela. J Med Virol 83:1972–1982 [View Article][PubMed]
     [Google Scholar]
  18. Green K. Y. 2013; Caliciviridae: the noroviruses. In Field’s Virology, 6th edn. pp. 582–608 Edited by Knipe D. M., Howley P. M. Philadelphia: Lippincott Williams and Wilkins;
     [Google Scholar]
  19. Guarino A., Albano F., Ashkenazi S., Gendrel D., Hoekstra J. H., Shamir R., Szajewska H.European Society for Paediatric Gastroenterology, Hepatology, and NutritionEuropean Society for Paediatric Infectious Diseases 2008; European Society for Paediatric Gastroenterology, Hepatology, and Nutrition/European Society for Paediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe. J Pediatr Gastroenterol Nutr 46:Suppl. 2S81–S122 [View Article][PubMed]
     [Google Scholar]
  20. Hansman G. S., Oka T., Sakon N., Takeda N. 2007; Antigenic diversity of human sapoviruses. Emerg Infect Dis 13:1519–1525 [View Article][PubMed]
     [Google Scholar]
  21. Hilmarsdóttir I., Baldvinsdóttir G. E., Harðardóttir H., Briem H., Sigurðsson S. I. 2012; Enteropathogens in acute diarrhea: a general practice-based study in a Nordic country. Eur J Clin Microbiol Infect Dis 31:1501–1509 [View Article][PubMed]
     [Google Scholar]
  22. Iturriza-Gómara M., Dallman T., Bányai K., Böttiger B., Buesa J., Diedrich S., Fiore L., Johansen K., Koopmans M. et al. 2011; Rotavirus genotypes co-circulating in Europe between 2006 and 2009 as determined by EuroRotaNet, a pan-European collaborative strain surveillance network. Epidemiol Infect 139:895–909 [View Article][PubMed]
     [Google Scholar]
  23. Jakab F., Varga L., Nyul Z., Walter J., Berke T., Mitchell D. K., Matson D. O., Szucs G. 2009; Acute viral gastroenteritis among hospitalized children between 2003 and 2005 in Baranya County, Hungary. J Clin Virol 44:340–341 [View Article][PubMed]
     [Google Scholar]
  24. Kageyama T., Kojima S., Shinohara M., Uchida K., Fukushi S., Hoshino F. B., Takeda N., Katayama K. 2003; Broadly reactive and highly sensitive assay for Norwalk-like viruses based on real-time quantitative reverse transcription-PCR. J Clin Microbiol 41:1548–1557 [View Article][PubMed]
     [Google Scholar]
  25. Kojima S., Kageyama T., Fukushi S., Hoshino F. B., Shinohara M., Uchida K., Natori K., Takeda N., Katayama K. 2002; Genogroup-specific PCR primers for detection of Norwalk-like viruses. J Virol Methods 100:107–114 [View Article][PubMed]
     [Google Scholar]
  26. Levidiotou S., Gartzonika C., Papaventsis D., Christaki C., Priavali E., Zotos N., Kapsali E., Vrioni G. 2009; Viral agents of acute gastroenteritis in hospitalized children in Greece. Clin Microbiol Infect 15:596–598 [View Article][PubMed]
     [Google Scholar]
  27. Martella V., Pinto P., Tummolo F., De Grazia S., Giammanco G. M., Medici M. C., Ganesh B., L’Homme Y., Farkas T. et al. 2014; Analysis of the ORF2 of human astroviruses reveals lineage diversification, recombination and rearrangement and provides the basis for a novel sub-classification system. Arch Virol 159:3185–3196 [View Article][PubMed]
     [Google Scholar]
  28. Matthijnssens J., Ciarlet M., McDonald S. M., Attoui H., Bányai K., Brister J. R., Buesa J., Esona M. D., Estes M. K. et al. 2011; Uniformity of rotavirus strain nomenclature proposed by the Rotavirus Classification Working Group (RCWG). Arch Virol 156:1397–1413 [View Article][PubMed]
     [Google Scholar]
  29. Mendéz E., Arias C. F. 2007; Astroviruses. In Fields Virology, 5th edn. pp. 982–984 Edited by Knipe D. M., Howley P. M., Griffin D. E. Philadelphia: Lippincott Williams & Wilkins;
     [Google Scholar]
  30. Mladenova Z., Korsun N., Geonova T., Di Bartolo I., Fiore L., Ruggeri F. M. 2008; Viral agents detected in hospitalized pediatric gastroenteritis cases. Second Congress of Virology (Days of Virology in Bulgaria) Sofia, 28–31 May, Proceeding and abstract book pp. 191–198
     [Google Scholar]
  31. Mladenova Z., Korsun N., Geonova T., Iturriza-Gómara M.Rotavirus Study Group 2010; Molecular epidemiology of rotaviruses in Bulgaria: annual shift of the predominant genotype. Eur J Clin Microbiol Infect Dis 29:555–562 [View Article][PubMed]
     [Google Scholar]
  32. Nenonen N. P., Hannoun C., Larsson C. U., Bergström T. 2012; Marked genomic diversity of norovirus genogroup I strains in a waterborne outbreak. Appl Environ Microbiol 78:1846–1852 [View Article][PubMed]
     [Google Scholar]
  33. Noel J. S., Lee T. W., Kurtz J. B., Glass R. I., Monroe S. S. 1995; Typing of human astroviruses from clinical isolates by enzyme immunoassay and nucleotide sequencing. J Clin Microbiol 33:797–801[PubMed]
     [Google Scholar]
  34. Oh D. Y., Gaedicke G., Schreier E. 2003; Viral agents of acute gastroenteritis in German children: prevalence and molecular diversity. J Med Virol 71:82–93 [View Article][PubMed]
     [Google Scholar]
  35. Olesen B., Neimann J., Böttiger B., Ethelberg S., Schiellerup P., Jensen C., Helms M., Scheutz F., Olsen K. E. et al. 2005; Etiology of diarrhea in young children in Denmark: a case-control study. J Clin Microbiol 43:3636–3641 [View Article][PubMed]
     [Google Scholar]
  36. Parashar U. D., Gibson C. J., Bresee J. S., Glass R. I. 2006; Rotavirus and severe childhood diarrhea. Emerg Infect Dis 12:304–306 [View Article][PubMed]
     [Google Scholar]
  37. Parmakova K., Asseva G., Ivanova K., Petrov P. 2012; [Surveillance of bacterial gastrointestinal infections in Bulgaria during 2007–2011]. Medinfo 11:36–38 (in Bulgarian)
    [Google Scholar]
  38. Parmakova K., Petrov P., Asseva G., Mladenova Z., Harizanov R. 2013; [Gastrointestinal infections in childhood]. Medinfo 8:1–4 (in Bulgarian)
    [Google Scholar]
  39. Pereira H. G., Flewett T. H., Candeias J. A., Barth O. M. 1988; A virus with a bisegmented double-stranded RNA genome in rat (Oryzomys nigripes) intestines. J Gen Virol 69:2749–2754 [View Article][PubMed]
     [Google Scholar]
  40. Rimoldi S. G., Stefani F., Pagani C., Chenal L. L., Zanchetta N., Di Bartolo I., Lombardi A., Ruggeri F. M., Di Lillo D. et al. 2011; Epidemiological and clinical characteristics of pediatric gastroenteritis associated with new viral agents. Arch Virol 156:1583–1589 [View Article][PubMed]
     [Google Scholar]
  41. Sánchez-Fauquier A., Montero V., Colomina J., González-Galán V., Aznar J., Aisa M. L., Gutierrez C., Sainz de Baranda C., Wilhelmi I. 2011; Global study of viral diarrhea in hospitalized children in Spain: results of structural surveillance of viral gastroenteritis net work (VIGESS-net) 2006–2008. J Clin Virol 52:353–358 [View Article][PubMed]
     [Google Scholar]
  42. Sethi S. K., Khuffash F. A., al-Nakib W. 1989; Microbial etiology of acute gastroenteritis in hospitalized children in Kuwait. Pediatr Infect Dis J 8:593–597 [View Article][PubMed]
     [Google Scholar]
  43. Shoja Z., Jalilvand S., Mollaei-Kandelous Y., Validi M. 2014; Epidemiology of viral gastroenteritis in Iran. Pediatr Infect Dis J 33:218–220 [View Article][PubMed]
     [Google Scholar]
  44. Soriano-Gabarró M., Mrukowicz J., Vesikari T., Verstraeten T. 2006; Burden of rotavirus disease in European Union countries. Pediatr Infect Dis J 25:Suppl.S7–S11 [View Article][PubMed]
     [Google Scholar]
  45. Tam C. C., O’Brien S. J., Tompkins D. S., Bolton F. J., Berry L., Dodds J., Choudhury D., Halstead F., Iturriza-Gómara M. et al. 2012; Changes in causes of acute gastroenteritis in the United Kingdom over 15 years: microbiologic findings from 2 prospective, population-based studies of infectious intestinal disease. Clin Infect Dis 54:1275–1286 [View Article][PubMed]
     [Google Scholar]
  46. Tamura K., Dudley J., Nei M., Kumar S. 2007; MEGA4: molecular evolutionary genetics analysis (MEGA) software version 4.0. Mol Biol Evol 24:1596–1599 [View Article][PubMed]
     [Google Scholar]
  47. Tiemessen C. T., Nel M. J. 1996; Detection and typing of subgroup F adenoviruses using the polymerase chain reaction. J Virol Methods 59:73–82 [View Article][PubMed]
     [Google Scholar]
  48. Vinjé J., Deijl H., van der Heide R., Lewis D., Hedlund K. O., Svensson L., Koopmans M. P. 2000; Molecular detection and epidemiology of Sapporo-like viruses. J Clin Microbiol 38:530–536[PubMed]
     [Google Scholar]
  49. Youssef M., Shurman A., Bougnoux M., Rawashdeh M., Bretagne S., Strockbine N. 2000; Bacterial, viral and parasitic enteric pathogens associated with acute diarrhea in hospitalized children from northern Jordan. FEMS Immunol Med Microbiol 28:257–263 [View Article][PubMed]
     [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.000018
Loading
Aetiology of acute paediatric gastroenteritis in Bulgaria during summer months: prevalence of viral infections
J. Med. Microbiol. 64, 272 (2015); https://doi.org/10.1099/jmm.0.000018
/content/journal/jmm/10.1099/jmm.0.000018
/content/journal/jmm/10.1099/jmm.0.000018
Loading

Data & Media loading...

Most cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error