• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.4
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• pp.346-356
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• 2021

Purpose: Campylobacter species are currently the most common cause of bacterial gastroenteritis. In Lebanon, Campylobacter infection occurrence is underdiagnosed owing to the lack of specific culture and rapid test kits, particularly among children. This study aimed to evaluate the prevalence, laboratory findings, and clinical characteristics of Campylobacter infection in hospitalized children with acute gastroenteritis in South Lebanon. Methods: We conducted a 6-month retrospective cohort study between January and June 2018, including 291 children aged between 1 month and 12 years, who were admitted to a tertiary healthcare center in South Lebanon. The medical files of the patients were reviewed to retrieve the required clinical information, including clinical and laboratory data. Results: The prevalence of campylobacteriosis agents in pediatric patients with acute gastroenteritis is 12.02%. Patients infected with Campylobacter had more severe acute gastroenteritis than Campylobacter-negative patients and often presented with high-grade fever, diarrhea episodes more than six times per day, diarrhea lasting for more than five days, and dehydration. Indeed, children with high-grade fever (≥38.5℃) were five times more likely to test positive for Campylobacter than those with low-grade fever. In addition, the results showed a higher Vesikari score for the majority of Campylobacter-positive patients with severe acute gastroenteritis compared to a moderate profile for Campylobacter-negative patients. Conclusion: The present study findings highlight that Campylobacter infection is frequent among children with acute gastroenteritis. Therefore, the detection of Campylobacter should be carried out for the diagnosis of human gastroenteritis in Lebanon, along with the detection of routine enteropathogens.

• Journal of Environmental Health Sciences
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• v.38 no.1
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• pp.57-65
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• 2012

Objectives: For our survey of the incidence of norovirus infections and the genogroup distribution of norovirus in Seoul, Republic of Korea, we evaluated through regular surveillance the prevalence of norovirus infections in patients with acute gastroenteritis occurring in Seoul from January 2007 to July 2011. Methods: For norovirus detection, we conducted epidemiological analyses on the basis of the junction of ORF1 and ORF2 (approximately 314 bp). 11,202 fecal specimens were collected from patients in Seoul with acute gastroenteritis between January 2007 and July 2011 and then tested for the presence of NoV via reverse transcription (RT) - polymerase chain reaction (PCR). Results: 16.6% (1,861/11,202) of the fecal specimens were determined to be positive for noroviruses. The incidences of norovirus infection in Seoul in the case of acute gastroenteritis with regular surveillance were 28.0% in 2007, 14.6% in 2008, 9.1% in 2009, 14.1% in 2010, and 12.9% in 2011, which shows that noroviruses constituted a major causative agent of acute gastroenteritis. Also, the incidence of noroviral infection in patients with acute gastroenteritis increased after the large-scale new influenza in 2009. Conclusions: The genetic characteristics of norovirus and the epidemiologic patterns of a viral pathogen in acute gastroenteritis patients may provide potentially effective data for epidemiological studies in Seoul, Korea.

• Clinical and Experimental Pediatrics
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• v.64 no.6
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• pp.260-268
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• 2021

Since the 2000s, the major causes of acute gastroenteritis in children in Korea have been identified by classifying the pathogens into viruses, bacteria, and protozoa. For viruses, the detection rate is 20%-30%, and norovirus is being increasingly detected to account for the majority of viral gastroenteritis cases. In addition, despite the dissemination of the rotavirus vaccine, many rotavirus infections persist, and its seasonal distribution is changing. The detection rate of bacterial pathogens is 3%-20%, with Escherichia coli and Salmonella spp. infections being the most common, while the incidences of Bacillus cereus and Campylobacter spp. infections are gradually increasing. Owing to intermittent outbreaks of gastroenteritis caused by individual bacteria as well as the inflow of causative bacteria, such as E. coli, Vibrio spp., and Campylobacter spp., from overseas, continuous surveillance of and research into the characteristics and serotypes of each bacterium are needed.

• Journal of Microbiology and Biotechnology
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• v.28 no.3
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• pp.465-472
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• 2018

Our aim was to determine the detection rate of respiratory viruses (RVs) in feces of patients with acute viral respiratory infection (AVRI) and the detection rate of diarrheal viruses (DVs) in nasopharyngeal samples from patients with acute viral gastroenteritis. The relationships between the presence of fecal RVs or nasopharyngeal DVs and their impacts on the clinical severity were also investigated. A total of 144 fecal specimens were collected from AVRI patients and 95 nasopharyngeal specimens were collected from acute viral gastroenteritis patients. Clinical characteristics and laboratory profiles were compared between subgroups on the basis of the presence or absence of virus in the specimens. The detection rate of RVs in feces was 17.4% (25/144), whereas the detection rate for viruses identical to the respiratory pathogen was 10.4% (identical group, 15/144). Within the identical group, adenovirus (86.7%, 13/15) was most commonly found. Patients in the identical group showed statistically higher values for C-reactive protein, mean age, increased frequency of vomiting, and decreased frequency of chest film involvement and cough (p < 0.05). The detection rate of nasopharyngeal DVs among acute viral gastroenteritis patients was 19.0% (18/95), and in the identical group it was 15.8% (15/95). Norovirus group II and enteric adenovirus were the major pathogens detected in the identical group. There were no significant differences in clinical characteristics and laboratory profiles between the subgroups. In conclusion, the major pathogens of fecal RV and nasopharyngeal DV were adenovirus and norovirus group II, respectively. However, their relationship with the clinical symptoms or disease severity is unclear.

• Pediatric Infection and Vaccine
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• v.15 no.2
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• pp.138-145
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• 2008

Purpose : Acute gastroenteritis is a frequent childhood disease. The purpose of this study is to determine if certain pathogens are related to more severe clinical disease in children with acute gastroenteritis. Methods : Two hundred seventy one stool samples were obtained from pediatric patients with acute gastroenteritis that was associated with virus, bacteria and protozoa infection between January 2006 and December 2006. The clinical severity was assessed by using the 24 point scale Clark score. We evaluate the Clark score according to the pathogens. Results : One hundred thirty seven children were noted to have virus, bacteria or protozoal infection. Rotavirus was the most common pathogen found in the children with gastroenteritis (20.6%). Other frequent pathogens were norovirus (10.7%) and E. coli (12.9%). Vomiting (P=0.049) and diarrhea (P=0.003) symptoms were more frequent in the rotavirus group than that in the rotavirus negative group. There were no statistical differences in the Clark score between the virus positive group and the virus negative group. Conclusion : We concluded that rotavirus was the most common pathogen in children with gastroenteritis, yet the clinical severity was not dependent on the presence of viral or bacterial pathogens.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.5
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• pp.464-471
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• 2020

Purpose: Some probiotic strains reduce the duration of acute diarrhea. Because of strain and product specificity, each product needs to be supported by clinical data. This study aimed to test the efficacy of the synbiotic food supplement Probiotical (Streptococcus thermophilus, Lactobacillus rhamnosus, Lactobacillus acidophilus, Bifidobacterium lactis, Bifidobacterium infantis, fructo-oligosaccharides) in children with acute gastroenteritis of likely infectious origin. The primary endpoint was the number of children with normal stool consistency during the treatment duration. Methods: A total of 46 children (aged 3.6 months to 12 years) with acute gastroenteritis that started less than 48 hours prior to their visit at a hospital-based emergency department were included in this prospective, randomized, placebo-controlled trial. All children were treated with oral rehydration solution and placebo (n=20) or the test product (n=26). Results: Significantly more children had a normal stool consistency on days 1 and 2 in the probiotic group: 5 children (20%) on day 1 in the probiotic group compared with none in the placebo group (p=0.046). On day 2, 11 children in the probiotic group (46%) and 3 (16%) in the placebo group (p=0.024) had a normal stool consistency. The mean duration of diarrhea was shorter in the probiotic group compared with that in the placebo group (3.04±1.36 vs. 4.20±1.34 days) (p=0.018). Conclusion: The test product was shown to normalize stool consistency significantly more rapidly than the placebo. These data confirm the findings from a previous study in a larger group of children performed in a primary healthcare setting.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.4
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• pp.263-265
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• 2014

Epiploic appendagitis is an inflammation of the epiploic appendage in which the small sacs projecting from the serosal layer of the colon are positioned longitudinally from the caecum to the rectosigmoid area. Epiploic appendagitis is rare and self-limiting; however, it can cause sudden abdominal pain in children. Epiploic appendagitis does not typically accompany other gastrointestinal diseases. Here, we report on a healthy eight-year-old girl who presented with abdominal pain, fever, vomiting, and diarrhea. Based on these symptoms, she was diagnosed with acute gastroenteritis, but epiploic appendagitis in the ascending colon was revealed in contrast computed tomography (CT). The patient was treated successfully with conservative management. CT is beneficial in diagnosis and further assessment of epiploic appendagitis. Pediatricians need to be aware of this self-limiting disease and consider it as a possible alternate diagnosis in cases of acute abdominal pain.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.2
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• pp.130-133
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• 2017

Noroviruses have been recognized as the leading cause of epidemic and sporadic gastroenteritis since the advent of molecular diagnostic technique. They have been documented in 5-31% of pediatric patients hospitalized with gastroenteritis. Although norovirus gastroenteritis is typically mild and self-limited, it causes severe, but sometimes fatal, conditions in the vulnerable population such as immunocompromised patients, young children, and the elderly. Bowel perforation due to norovirus infection is rare. We report a case of small bowel perforation with norovirus gastroenteritis in the infant with Down syndrome during the hospitalization with pneumonia. Severe dehydration may cause bowel ischemia and could have triggered bowel perforation in this case. Physicians should be alert to the potential surgical complications followed by severe acute diarrhea, especially in high risk groups.

• Journal of Dairy Science and Biotechnology
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• v.41 no.3
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• pp.87-102
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• 2023

Globally, acute gastroenteritis is responsible for two million pediatric deaths. In particular, viral gastroenteritis is the most common cause of acute diarrhea, and most children aged <5 years are infected at least once. The common symptoms include profuse watery diarrhea, vomiting, abdominal pain, and fever. Viral gastroenteritis is generally caused by rotavirus, norovirus, astrovirus, and adenovirus. Recently, probiotics use has increased rapidly worldwide due to its inhibitory effect against viral gastroenteritis. In addition, probiotics are known to have anti-inflammatory and anti-allergic effects and enhance immunity without any side effects. Therefore, this review focuses on the anti-viral effects of probiotics on viral gastroenteritis. Furthermore, this review would provide basic data that could be used for developing new products that have improved functionality by addition of probiotics to milk and dairy food.

• Microbiology and Biotechnology Letters
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• v.49 no.1
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• pp.120-129
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• 2021

Rotavirus A (RVA) is recognized as a major etiology responsible for the development of acute gastroenteritis in children worldwide. The purpose of the present study was to perform the molecular characterization of RVA. A total of 323 stool specimens collected from hospitalized children with acute gastroenteritis in Chiang Rai, Thailand, in 2016-2018 were identified for G- and P-genotypes through RT-PCR analysis. RVA was more prevalent in 2017-2018 (37.8%) than in 2016-2017 (23.2%). The seasonal peak of RVA occurred from March to April. G3P[8] was predominant in 2016-2017 (90.6%) and 2017-2018 (58.6%). Other genotypes including G1P[8], G8P[8], G9P[8], and mixed infections were also identified. G3P[8] strains clustered together in the same lineage with other novel human equine-like G3P[8] strains previously identified in multiple countries and presented a genotype 2 constellation (G3-P[8]-I2-R2-C2-M2-A2-N2-T2-E2-H2). Several amino acid differences were observed in the antigenic epitopes of the VP7 and VP8* capsid proteins of the equine-like G3P[8] compared with those of the RVA vaccine strains. The homology modeling of the VP7 and VP8* capsid proteins of the equine-like G3P[8] strains evidently exhibited that these residue differences were present on the surface-exposed area of the capsid structure. The emergence of the equine-like G3P[8] strains in Thailand indicates the rapid spread of strains with human and animal gene segments. Continuous surveillance for RVA is essential to monitor genotypes and genetic diversity, which will provide useful information for selecting rotavirus strains to develop a safe and effective RVA vaccine that is efficacious against multiple genotypes and variants.