A Study on the Epidemiology and Aetiology of Acute Gastroenteritis in Adult Patients Presenting at the Infectious Diseases Hospital in Tirana, Albania

Stroni, Gentian; Dhimolea, Majlinda; Pipero, Pellumb; Kraja, Dhimitër; Sallavaci, Suela; Bino, Silva

doi:10.5152/balkanmedj.2014.13142

Cited by 5 publications

(8 citation statements)

References 20 publications

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“…C. coli was identified in 12.3% patients and C. lari was not detected at all. This species distribution of Campylobacter is similar with that existing in our neighboring countries, as well as in many countries worldwide [7,9]. This variation might be attributed to demographic, geographic and study period differences between these studies.…”

Section: Discussionsupporting

confidence: 85%

“…in the last two years of the study increased for more than 2 times in comparison with the isolation rate during the previous four years. With the isolation rate of 2.53 our results are comparable with the results revealed in the reports from some Balkan countries [7], but it is much lower than the isolation rates in many European countries [8]. Several factors such as consumer awareness, severity of a disease and its surveillance by the clinicians, affect the degree of isolation rate of Campylobacter as a food borne pathogen.…”

Section: Discussionsupporting

confidence: 83%

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Antimicrobial Susceptibility of Campylobacter isolates in the Capital of North Macedonia

Trajkovska-Dokic

Mihajlov

Mirchevska

et al. 2019

Prilozi

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Background: Campylobacter infections are typically self-limited, but in cases with severe enteritis, immuno-compromised system and bacteremia, an appropriate antimicrobial treatment is demanding. Our study aim was to determine the isolation rate of Campylobacter among patients with acute enteritis in the capital of North Macedonia and its antimicrobial susceptibility. Material and methods: A total number of 3820 patients clinically diagnosed as acute enteritis, were included in the study. Stool samples were collected and Campylobacter was isolated and identified by classical microbiological methods. Antimicrobial susceptibility of all isolates to Ceftriaxone, Amoxicillin-clavulonic acid, Erythromycin, Ciprofloxacin, Tetracycline and Gentamicin was determined by disc-diffusion technique. Additionally, minimal inhibitory concentrations of all Campylobacter isolates against erythromycin, ciprofloxacin and tetracycline were determined by Epsilon gradient tests. Results: Campylobacter species was isolated in 97 patients. Although the mean isolation rate of Campylobacter spp. during the whole study period was 2.53%, a statistically significant increase was detected in 2016 and 2017, in comparison with the data from previous four years of the study. The isolation rate of Campylobacter spp. didn’t reveal statistically significant difference between males and females (p > 0.05). 46.4 % of patients with Campylobacter enteritis were children at the age under 15 years. Forty-three C. jejuni isolates were susceptible to all six antibiotics, but the remaining 44 isolates revealed resistance to at least one antibiotic. C. coli isolates were resistant to 3 antibiotics simultaneously. Two C. coli isolates only, were susceptible to all 6 antibiotics. 40.90% of C. jejuni and 50% of C. coli isolates were resistant to beta-lactams, fluoroquinolones and tetracyclines, simultaneously. Conclusion: The increase of the isolation rate of Campylobacter from patients with acute enteritis indicates the need for permanent isolation and identification of Campylobacter from every clinically diagnosed patient, as acute enteritis. Erythromicin is the most effective antibiotic for treatment of Campylobacter enteritis in our patients. The high level of Campylobacter resistance to beta-lactams, fluoroquinolones and tetracyclines requires more rational approach in the treatment of Campylobacter enteritis

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 83%

Antimicrobial Susceptibility of Campylobacter isolates in the Capital of North Macedonia

Trajkovska-Dokic

Mihajlov

Mirchevska

et al. 2019

Prilozi

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“…Viral diarrhea in developing countries is associated with hygienic habits of the population but also with consumption of food in restaurants and takeaways [4]. Only one fifth (11.8-22.4%) of our patients consumed food outside home immediately before the onset of symptoms.…”

Section: Discussionmentioning

confidence: 74%

“…The practical importance of differentiation between causes of viral gastroenteritis is often overlooked by general practitioners [3]. The reasons for this include primarily the treatment approach that is symptomatic in all cases of viral gastroenteritis, as well as the cost of diagnostic tests, which are still based on molecu-lar techniques and therefore usually unaffordable for patients in developing countries [4]. However, literature data indicate that there are differences in the incidence of individual causes of viral gastroenteritis, as well as in the severity of clinical symptoms, and it has been observed that these differences depend on geographic area, as well as socioeconomic status and hygienic habits of the study population [1,[3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

The etiology of viral gastroenteritis in patients requiring hospitalization: Differences between rotavirus and norovirus infections - practical or only academic significance?

et al. 2017

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Introduction/Objective Viral gastroenteritides (VGEs) have great infectious potential and may occur in all age groups. Loss of fluid due to vomiting and diarrhea represent a special risk, and may result in a more severe clinical presentation in children, the elderly, and people with chronic diseases. The aim of the study was to explore the causes of VGEs among hospitalized patients, as well as to evaluate the severity of clinical symptoms in rotavirus and norovirus infections. Methods The observational prospective study included 191 patients aged 2-88 years who were treated at the Clinic for Infectious Diseases, Clinical Center of Vojvodina, Novi Sad, over a two-year period. Testing of stool samples for viral agents was done by the reverse-transcription polymerase chain reaction method. Positive findings were found in 59 patients. Results Of 59 patients with confirmed viral gastroenteritis, in 31 (52.5%) it was caused by rotavirus, in 17 (28.8%) by norovirus, three patients (5.1%) had other viral causes, while co-infection with two viruses was found in eight (13.5%) patients. The severity of clinical manifestations as expressed with Vesikari score did not differ with regard to infectious agents (p = 0.353). However, patients with rotavirus infection had a higher incidence of fever (p = 0.043), longer duration of diarrhea (p = 0.015) and dehydration (p = 0.014), and longer need for hospital treatment (p = 0.030). Conclusion The most common cause of VGEs in our hospitalized patients was rotavirus. There was no difference in the severity of clinical symptoms between rotavirus and norovirus infections.

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“…These findings suggest that a significant correlation exists between stool bacterial multiplex PCR test results and the severe symptoms of acute diarrhea. Vomiting tended to be more frequent in the negative group (p = 0.08), per-haps because vomiting is common in diarrheal diseases of viral origin [23,24] and the multiplex PCR test used in this study did not include viral genera. The presence of WBCs in stool suggests an inflammatory process caused by bacterial spp., such as Salmonella spp., Shigella spp., C. jejuni, or C. difficile.…”

Section: Discussionmentioning

confidence: 92%

Outcomes and clinical relevance of stool multiplex bacterial polymerase chain reaction in patients with acute diarrhea: single center experience

Kwack

Lim

Kwon

et al. 2020

Korean J Intern Med

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Background/Aims: Diagnostic stool multiplex polymerase chain reaction (PCR) testing has attracted considerable interest, because of its high sensitivity, short turnaround time, and ability to detect multiple organisms simultaneously. This study investigates the clinical usefulness of a stool multiplex bacterial PCR in patients with acute diarrhea. Methods: We retrospectively evaluated the stool multiplex bacterial PCR results, clinical parameters, and clinical courses of patients hospitalized because of acute diarrhea between August 2014 and November 2016. Results: A total of 725 patients (male, 372; mean age, 30.9 ± 29.3 years) underwent stool multiplex bacterial PCR. A total of 243 pathogens were detected in 226 patients. The detection rate of multiplex PCR testing was higher than that of stool culture (32.7% vs. 3.3%, p < 0.01). Severe symptoms of acute diarrhea (bloody diarrhea, frequent diarrhea) and prescribed empirical antibiotics were significantly more common in the positive multiplex PCR group (p = 0.02, p < 0.01, p < 0.01, respectively). However, mean durations of hospital stay were similar in the 2 groups according to the multiplex PCR results (p = 0.32). In addition, Campylobacter spp., which was the most commonly detected pathogen (97/243, 39.9%), was significantly associated with frequent diarrhea and prescribed empirical antibiotics (p < 0.01), but not with duration of hospital stay (p = 0.09). Conclusions: We concluded that stool multiplex bacterial PCR might be a useful tool for identifying bacterial etiology in patients with acute diarrhea, especially in those with Campylobacter spp. infection.

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A Study on the Epidemiology and Aetiology of Acute Gastroenteritis in Adult Patients Presenting at the Infectious Diseases Hospital in Tirana, Albania

Cited by 5 publications

References 20 publications

Antimicrobial Susceptibility of Campylobacter isolates in the Capital of North Macedonia

Antimicrobial Susceptibility of Campylobacter isolates in the Capital of North Macedonia

The etiology of viral gastroenteritis in patients requiring hospitalization: Differences between rotavirus and norovirus infections - practical or only academic significance?

Outcomes and clinical relevance of stool multiplex bacterial polymerase chain reaction in patients with acute diarrhea: single center experience

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