Case-control comparison of bacterial and protozoan microorganisms associated with gastroenteritis: application of molecular detection.

Autor:	Bruijnesteijn van Coppenraet LE; Laboratory for Medical Microbiology and Infectious Diseases, Isala, Zwolle, The Netherlands. Electronic address: e.s.bruijnesteijn@isala.nl., Dullaert-de Boer M; Laboratory for Medical Microbiology and Public Health, Hengelo, The Netherlands., Ruijs GJ; Laboratory for Medical Microbiology and Infectious Diseases, Isala, Zwolle, The Netherlands., van der Reijden WA; Regional Laboratory for Medical Microbiology and Public Health, Haarlem, The Netherlands., van der Zanden AG; Laboratory for Medical Microbiology and Public Health, Hengelo, The Netherlands., Weel JF; Centre for Infectious Diseases Friesland, Izore, Leeuwarden, The Netherlands., Schuurs TA; Centre for Infectious Diseases Friesland, Izore, Leeuwarden, The Netherlands.
Jazyk:	angličtina
Zdroj:	Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases [Clin Microbiol Infect] 2015 Jun; Vol. 21 (6), pp. 592.e9-19. Date of Electronic Publication: 2015 Feb 18.
DOI:	10.1016/j.cmi.2015.02.007
Abstrakt:	The introduction of molecular detection of infectious organisms has led to increased numbers of positive findings, as observed for pathogens causing gastroenteritis (GE). However, because little is known about the prevalence of these pathogens in the healthy asymptomatic population, the clinical value of these additional findings is unclear. A case-control study was carried out in a population of patients served by general practitioners in the Netherlands. A total of 2710 fecal samples from case and matched control subjects were subjected to multiplex real-time PCR for the 11 most common bacterial and four protozoal causes of GE. Of 1515 case samples, 818 (54%) were positive for one or more target organisms. A total of 49% of the controls were positive. Higher positivity rates in cases compared to controls were observed for Campylobacter spp., Salmonella spp., Clostridium difficile, enteroinvasive Escherichia coli/Shigella spp., enterotoxigenic E. coli, enteroaggregative E. coli, atypical enteropathogenic E. coli (EPEC), Cryptosporidium parvum/hominis, and Giardia lamblia. However, Dientamoeba fragilis and Shiga-like toxigenic E. coli were detected significantly less frequent in cases than in controls, while no difference in prevalence was found for typical EPEC and enterohemorrhagic E. coli. The association between the presence of microorganisms and GE was the weakest in children aged 0 to 5 years. Higher relative loads in cases further support causality. This was seen for Campylobacter spp., Salmonella spp., enterotoxigenic E. coli, and C. parvum/hominis, and for certain age categories of those infected with C. difficile, enteroaggregative E. coli, and atypical EPEC. For D. fragilis and Shiga-like toxigenic E. coli/enterohemorrhagic E. coli, pathogen loads were lower in cases. Application of molecular diagnostics in GE is rapid, sensitive and specific, but results should be interpreted with care, using clinical and additional background information. (Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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