This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Olesen, B. Articles by Gerner-Smidt, P. Search for Related Content PubMed PubMed Citation Articles by Olesen, B. Articles by Gerner-Smidt, P.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, August 2005, p. 3636-3641, Vol. 43, No. 8
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.8.3636-3641.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Etiology of Diarrhea in Young Children in Denmark: a Case-Control Study

Department of Bacteriology, Mycology, and Parasitology, Department of Virology, and Department of Epidemiology, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark,¹ Department of Clinical Microbiology, Hillerød Hospital, Helsevej 2, DK-3400 Hillerød, Denmark,² Danish Zoonosis Centre, Danish Institute for Food and Veterinary Research, Mørkhøj Bygade 19, DK-2860 Søborg, Denmark³

Received 17 December 2004/ Returned for modification 1 April 2005/ Accepted 14 April 2005

Infectious gastroenteritis is one of the most common diseases in young children. To clarify the infectious etiology of diarrhea in Danish children less than 5 years of age, we conducted a 2-year prospective case-control study. Stools from 424 children with diarrhea and 870 asymptomatic age-matched controls were examined, and their parents were interviewed concerning symptoms. Rotavirus, adenovirus, and astrovirus were detected by enzyme-linked immunosorbent assay, and norovirus and sapovirus were detected by PCR. Salmonella, thermotolerant Campylobacter, Yersinia, Shigella, and Vibrio spp. were detected by standard methods. Shiga toxin-producing (STEC), attaching-and-effacing (A/EEC), enteropathogenic (EPEC), enterotoxigenic, enteroinvasive, and enteroaggregative Escherichia coli were detected by using colony hybridization with virulence gene probes and serotyping. Parasites were detected by microscopy. Overall, a potential pathogen was found in 54% of cases. More cases than controls were infected with rotavirus, Salmonella, norovirus, adenovirus, Campylobacter, sapovirus, STEC, classical EPEC, Yersinia, and Cryptosporidium strains, whereas A/EEC, although common, was not associated with illness. The single most important cause of diarrhea was rotavirus, which points toward the need for a childhood vaccine for this pathogen, but norovirus, adenovirus, and sapovirus were also major etiologies. Salmonella sp. was the most common bacterial pathogen, followed by Campylobacter, STEC, Yersinia, and classical EPEC strains. A/EEC not belonging to the classical EPEC serotypes was not associated with diarrhea, underscoring the importance of serotyping for the definition of EPEC.

This article has been cited by other articles:

• Boisen, N., Struve, C., Scheutz, F., Krogfelt, K. A., Nataro, J. P. (2008). New Adhesin of Enteroaggregative Escherichia coli Related to the Afa/Dr/AAF Family. Infect. Immun. 76: 3281-3292 [Abstract] [Full Text]  
• Afset, J. E., Anderssen, E., Bruant, G., Harel, J., Wieler, L., Bergh, K. (2008). Phylogenetic Backgrounds and Virulence Profiles of Atypical Enteropathogenic Escherichia coli Strains from a Case-Control Study Using Multilocus Sequence Typing and DNA Microarray Analysis. J. Clin. Microbiol. 46: 2280-2290 [Abstract] [Full Text]  
• Sdiri-Loulizi, K., Gharbi-Khelifi, H., de Rougemont, A., Chouchane, S., Sakly, N., Ambert-Balay, K., Hassine, M., Guediche, M. N., Aouni, M., Pothier, P. (2008). Acute Infantile Gastroenteritis Associated with Human Enteric Viruses in Tunisia. J. Clin. Microbiol. 46: 1349-1355 [Abstract] [Full Text]  
• Hien, B. T. T., Trang, D. T., Scheutz, F., Cam, P. D., Molbak, K., Dalsgaard, A. (2007). Diarrhoeagenic Escherichia coli and other causes of childhood diarrhoea: a case control study in children living in a wastewater-use area in Hanoi, Vietnam. J Med Microbiol 56: 1086-1096 [Abstract] [Full Text]  
• Afset, J. E., Bruant, G., Brousseau, R., Harel, J., Anderssen, E., Bevanger, L., Bergh, K. (2006). Identification of Virulence Genes Linked with Diarrhea Due to Atypical Enteropathogenic Escherichia coli by DNA Microarray Analysis and PCR.. J. Clin. Microbiol. 44: 3703-3711 [Abstract] [Full Text]  
• Reisner, A., Krogfelt, K. A., Klein, B. M., Zechner, E. L., Molin, S. (2006). In Vitro Biofilm Formation of Commensal and Pathogenic Escherichia coli Strains: Impact of Environmental and Genetic Factors.. J. Bacteriol. 188: 3572-3581 [Abstract] [Full Text]