DOI QR코드

DOI QR Code

Epidemiologic Changes in Over 10 Years of Community-Acquired Bacterial Enteritis in Children

  • Yang, Jae Jin (Department of Pediatrics, Dankook University College of Medicine) ;
  • Lee, Kunsong (Department of Pediatrics, Dankook University College of Medicine)
  • Received : 2021.06.09
  • Accepted : 2021.10.03
  • Published : 2022.01.15

Abstract

Purpose: Community-acquired bacterial enteritis (CABE) is a common problem in developed countries. It is important to understand the epidemiologic changes in bacterial pathogens for prevention and treatment. Therefore, we studied the epidemiologic changes in CABE in Korean children. Methods: A total of 197 hospitalized pediatric patients aged <19 years that presented with dysentery symptoms and showed positive polymerase chain reaction results for bacterial species in stool samples, were enrolled in this study for 10 years (June 2010 to June 2020). We classified patients in phase I (06, 2010-06, 2015) and phase II (07, 2015-06, 2020) and analyzed their epidemiologic and clinical characteristics. Results: The most common pathogens were Campylobacter species (42.6%) and Salmonella species were the second most common pathogens (23.9%). The abundance of pathogens decreased in the following order: Clostridium difficile (9.6%), Shigella (5.6%), and Clostridium perfringens (5.6%). Escherichia coli O157:H7 was found to be the rarest pathogen (2.0%). Campylobacter species showed an increase in the infection rate from 32.1% in phase I to 49.6% in phase II (p=0.0011). Shigella species showed a decline in the infection rate in phase I from 14.1% to 0.0% in phase II (p<0.001). C. difficile and C. perfringens showed an increase in infection rate in phase II compared to phase I, but the difference was not statistically significant. Conclusion: The infection rate of Campylobacter species in CABE has been rising more recently, reaching almost 50%. This study may help establish policies for prevention and treatment of CABE in Korean children.

Keywords

References

  1. Mokomane M, Kasvosve I, de Melo E, Pernica JM, Goldfarb DM. The global problem of childhood diarrhoeal diseases: emerging strategies in prevention and management. Ther Adv Infect Dis 2018;5:29-43. https://doi.org/10.1177/2049936117744429
  2. Hawash YA, Ismail KA, Almehmadi M. High frequency of enteric protozoan, viral, and bacterial potential pathogens in community-acquired acute diarrheal episodes: evidence based on results of Luminex Gastrointestinal Pathogen Panel assay. Korean J Parasitol 2017;55:513-21. https://doi.org/10.3347/kjp.2017.55.5.513
  3. Faour-Klingbeil D, C D Todd E. Prevention and control of foodborne diseases in Middle-East North African countries: review of national control systems. Int J Environ Res Public Health 2019;17:70. https://doi.org/10.3390/ijerph17010070
  4. Pedersen SK, Wagenaar JA, Vigre H, Roer L, Mikoleit M, Aidara-Kane A, et al. Proficiency of WHO Global Foodborne Infections Network External Quality Assurance System participants in identification and susceptibility testing of thermotolerant Campylobacter spp. from 2003 to 2012. J Clin Microbiol 2018;56:e01066-18.
  5. Lake IR, Barker GC. Climate change, foodborne pathogens and illness in higher-income countries. Curr Environ Health Rep 2018;5:187-96. https://doi.org/10.1007/s40572-018-0189-9
  6. Sire JM, Garin B, Chartier L, Fall NK, Tall A, Seck A, et al. Community-acquired infectious diarrhoea in children under 5 years of age in Dakar, Senegal. Paediatr Int Child Health 2013;33:139-44. https://doi.org/10.1179/2046905512Y.0000000046
  7. Tian L, Zhu X, Chen Z, Liu W, Li S, Yu W, et al. Characteristics of bacterial pathogens associated with acute diarrhea in children under 5 years of age: a hospital-based cross-sectional study. BMC Infect Dis 2016;16:253. https://doi.org/10.1186/s12879-016-1603-2
  8. Tack DM, Ray L, Griffin PM, Cieslak PR, Dunn J, Rissman T, et al. Preliminary incidence and trends of infections with pathogens transmitted commonly through food - Foodborne Diseases Active Surveillance Network, 10 U.S. sites, 2016-2019. MMWR Morb Mortal Wkly Rep 2020;69:509-14. https://doi.org/10.15585/mmwr.mm6917a1
  9. Kutsuna S, Hayakawa K, Mezaki K, Yamamoto K, Ohmagari N. Spectrum of enteropathogens in cases of traveler's diarrhea that were detected using the FilmArray GI panel: new epidemiology in Japan. J Infect Chemother 2021;27:49-54. https://doi.org/10.1016/j.jiac.2020.08.009
  10. Wang M, Qazi IH, Wang L, Zhou G, Han H. Salmonella virulence and immune escape. Microorganisms 2020;8:407. https://doi.org/10.3390/microorganisms8030407
  11. Beier RC, Foley SL, Harvey RB. Editorial for the special issue: foodborne pathogen distribution, ecology, inactivation, and methods of differentiation. Microorganisms 2019;7:701. https://doi.org/10.3390/microorganisms7120701
  12. Abdoli A, Maspi N. Commentary: estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases: a systematic analysis for the Global Burden of Disease Study 2015. Front Med (Lausanne) 2018;5:11. https://doi.org/10.3389/fmed.2018.00011
  13. Marder Mph EP, Griffin PM, Cieslak PR, Dunn J, Hurd S, Jervis R, et al. Preliminary incidence and trends of infections with pathogens transmitted commonly through food - Foodborne Diseases Active Surveillance Network, 10 U.S. sites, 2006-2017. MMWR Morb Mortal Wkly Rep 2018;67:324-8. https://doi.org/10.15585/mmwr.mm6711a3
  14. Pai H. History and epidemiology of bacillary dysentery in Korea: from Korean War to 2017. Infect Chemother 2020;52:123-31. https://doi.org/10.3947/ic.2020.52.1.123
  15. Kuhn KG, Nygard KM, Guzman-Herrador B, Sunde LS, Rimhanen-Finne R, Tronnberg L, et al. Campylobacter infections expected to increase due to climate change in Northern Europe. Sci Rep 2020;10:13874. https://doi.org/10.1038/s41598-020-70593-y
  16. Schmutz C, Mausezahl D, Jost M, Baumgartner A, Mausezahl-Feuz M. Inverse trends of Campylobacter and Salmonella in Swiss surveillance data, 1988-2013. Euro Surveill 2016;21:30130.
  17. Gu B, Cao Y, Pan S, Zhuang L, Yu R, Peng Z, et al. Comparison of the prevalence and changing resistance to nalidixic acid and ciprofloxacin of Shigella between Europe-America and Asia-Africa from 1998 to 2009. Int J Antimicrob Agents 2012;40:9-17. https://doi.org/10.1016/j.ijantimicag.2012.02.005
  18. De Roo AC, Regenbogen SE. Clostridium difficile infection: an epidemiology update. Clin Colon Rectal Surg 2020;33:49-57. https://doi.org/10.1055/s-0040-1701229
  19. Hafiz RA, Wong C, Paynter S, David M, Peeters G. The risk of community-acquired enteric infection in proton pump inhibitor therapy: systematic review and meta-analysis. Ann Pharmacother 2018;52:613-22. https://doi.org/10.1177/1060028018760569
  20. Son KJ, Kim YA, Park YS. The trend of Clostridioides difficile infection in Korean hospitals with the analysis of nationwide sample cohort. Ann Clin Microbiol 2020;23:241-9.
  21. Jeong H, Kang JM, Ahn JG. Incidence and characteristics of Clostridioides difficile infection in children. Pediatr Infect Vaccine 2020;27:158-70. https://doi.org/10.14776/piv.2020.27.e24
  22. Mora ZV, Macias-Rodriguez ME, Arratia-Quijada J, Gonzalez-Torres YS, Nuno K, Villarruel-Lopez A. Clostridium perfringens as foodborne pathogen in broiler production: pathophysiology and potential strategies for controlling necrotic enteritis. Animals (Basel) 2020;10:1718. https://doi.org/10.3390/ani10091718
  23. Nielsen HL, Dalager-Pedersen M, Nielsen H. Risk of inflammatory bowel disease after Campylobacter jejuni and Campylobacter concisus infection: a population-based cohort study. Scand J Gastroenterol 2019;54:265-72. https://doi.org/10.1080/00365521.2019.1578406
  24. Kalischuk LD, Buret AG. A role for Campylobacter jejuni-induced enteritis in inflammatory bowel disease? Am J Physiol Gastrointest Liver Physiol 2010;298:G1-9. https://doi.org/10.1152/ajpgi.00193.2009
  25. Bronowski C, James CE, Winstanley C. Role of environmental survival in transmission of Campylobacter jejuni. FEMS Microbiol Lett 2014;356:8-19. https://doi.org/10.1111/1574-6968.12488
  26. Trompette M, Le Guilloux L, Souply L, Denis B, Tsouria A, Garrec H, et al. Increased incidence of Campylobacter enteritis and their quinolone resistance between 2010 and 2015: results of a French national observatory conducted in 21 general hospitals (CHG). Clin Res Hepatol Gastroenterol 2019;43:338-45. https://doi.org/10.1016/j.clinre.2018.10.015
  27. Jang WT, Jo NH, Song MO, Eun BW, Ahn YM. Campylobacter enteritis: clinical features and laboratory findings in children treated at a single hospital. Pediatr Infect Vaccine 2019;26:22-31. https://doi.org/10.14776/piv.2019.26.e3
  28. Chen J, Wan CM, Gong ST, Fang F, Sun M, Qian Y, et al. Chinese clinical practice guidelines for acute infectious diarrhea in children. World J Pediatr 2018;14:429-36. https://doi.org/10.1007/s12519-018-0190-2
  29. Dahiya S, Malik R, Sharma P, Sashi A, Lodha R, Kabra SK, et al. Current antibiotic use in the treatment of enteric fever in children. Indian J Med Res 2019;149:263-9. https://doi.org/10.4103/ijmr.ijmr_199_18
  30. Peretz A, Tkhawkho L, Pastukh N, Brodsky D, Halevi CN, Nitzan O. Correlation between fecal calprotectin levels, disease severity and the hypervirulent ribotype 027 strain in patients with Clostridium difficile infection. BMC Infect Dis 2016;16:309. https://doi.org/10.1186/s12879-016-1618-8
  31. Casanovas-Moreno-Torres I, Gutierrez-Soto B, Modovan TD, Exposito-Ruiz M, Navarro-Mari JM, Gutierrez-Fernandez J. Potential clinical use of azithromycin against gastroenteritis-causing pathogens other than Campylobacter. New Microbiol 2020;43:198-200.