The Etiology of Severe Acute Gastroenteritis Among Adults Visiting Emergency Departments in the United States
| Autor: | Joseph S, Bresee, Ruthanne, Marcus, Richard A, Venezia, William E, Keene, Dale, Morse, Mark, Thanassi, Patrick, Brunett, Sandra, Bulens, R Suzanne, Beard, Leslie A, Dauphin, Laurence, Slutsker, Cheryl, Bopp, Mark, Eberhard, Aron, Hall, Jan, Vinje, Stephan S, Monroe, Roger I, Glass, John, Jui |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Diarrhea Male medicine.medical_specialty Salmonella Adolescent medicine.disease_cause Specimen Handling Interviews as Topic Feces Young Adult fluids and secretions Surveys and Questionnaires Rotavirus Internal medicine Prevalence medicine Humans Immunology and Allergy Prospective Studies Aged Caliciviridae Infections Aged 80 and over biology business.industry Emergency department Middle Aged biology.organism_classification United States Caliciviridae Gastroenteritis Hospitalization Infectious Diseases Acute Disease Salmonella Infections Immunology Etiology Norovirus Female medicine.symptom Emergency Service Hospital business |
| Zdroj: | The Journal of Infectious Diseases. 205:1374-1381 |
| ISSN: | 1537-6613 0022-1899 |
| Popis: | Background. Acute gastroenteritis (AGE) remains a common cause of clinic visits and hospitalizations in the United States, but the etiology is rarely determined. Methods. We performed a prospective, multicenter emergency department–based study of adults with AGE. Subjects were interviewed on presentation and 3–4 weeks later. Serum samples, rectal swab specimens, and/or whole stool specimens were collected at presentation, and serum was collected 3–4 weeks later. Fecal specimens were tested for a comprehensive panel of viral, bacterial, and parasitic pathogens; serum was tested for calicivirus antibodies. Results. Pathogens were detected in 25% of 364 subjects, including 49% who provided a whole stool specimen. The most commonly detected pathogens were norovirus (26%), rotavirus (18%), and Salmonella species (5.3%). Pathogens were detected significantly more often from whole stool samples versus a rectal swab specimen alone. Nine percent of subjects who provided whole stool samples had .1 pathogen identified. Conclusions. Viruses, especially noroviruses, play a major role as agents of severe diarrhea in adults. Further studies to confirm the unexpectedly high prevalence of rotaviruses and to explore the causes of illness among patients from whom a pathogen cannot be determined are needed. Studies of enteric pathogens should require the collection of whole stool samples. |
| Databáze: | OpenAIRE |
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