Enteropathogens Associated with Acute Diarrheal Disease in Urban Infants in São Paulo, Brazil

To determine the prevalence and epidemiology of enteropathogens in acute infantile diarrhea, 500 infants ⩾12 months of age with diarrhea and 500 age-matched control subjects coming to a São Paulo emergency room were studied. Enteropathogens were identified in 55% of case infants and 10% of controls;...

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Bibliographic Details
Published in:	The Journal of infectious diseases Vol. 164; no. 2; pp. 331 - 337
Main Authors:	Tardelli Gomes, Tania A., Rassi, Vilma, MacDonald, Kristine L., Silva Ramos, Sonia R. T., Trabulsi, Luiz R., Vieira, Monica A. M., Guth, Beatriz E. C., Candeias, Jose A. N., Ivey, Cecile, Toledo, Maria Regina F., Blake, Paul A.
Format:	Journal Article
Language:	English
Published:	Chicago, IL The University of Chicago Press 01-08-1991 University of Chicago Press
Subjects:	Acute Disease Age Factors Antimicrobials Bacterial diseases Bacterial diseases of the digestive system and abdomen Biological and medical sciences Brazil Campylobacter Infections - epidemiology Campylobacter Infections - microbiology Case-Control Studies Children Diarrhea Diarrhea, Infantile - epidemiology Diarrhea, Infantile - microbiology Dysentery, Bacillary - epidemiology Dysentery, Bacillary - microbiology Epidemiology Escherichia coli Escherichia coli Infections - epidemiology Escherichia coli Infections - microbiology Feces - microbiology Human bacterial diseases Humans Infant Infections Infectious diseases Major Articles Medical sciences Pathogens Poverty Prevalence Prospective Studies Rotavirus Rotavirus Infections - epidemiology Rotavirus Infections - microbiology Salmonella Salmonella Infections - epidemiology Salmonella Infections - microbiology Salmonella typhimurium - isolation & purification Seasons Shigella Tropical medicine Urban Population Yersinia enterocolitica South America Brazil America Brazil, Sao Paulo Human Prevalence Pathogenesis Acute Colibacillosis Diarrhea Urban area Epidemiology Shigellosis Infection Microbiological investigation Bacteriosis Digestive diseases Salmonellosis Feces Child
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Summary:	To determine the prevalence and epidemiology of enteropathogens in acute infantile diarrhea, 500 infants ⩾12 months of age with diarrhea and 500 age-matched control subjects coming to a São Paulo emergency room were studied. Enteropathogens were identified in 55% of case infants and 10% of controls; enteropathogenic Escherichia coli (EPEC) of classic EPEC serotypes producing EPEC adherence factor (EAF) (26% of case infants), rotavirus (14%), Salmonella species (8%), enterotoxigenic E. coli (7%), and Shigella species (5%) were associated with diarrhea. Isolation of EAF+ classic EPEC decreased with increasing age of cases and peaked in spring, whereas rotavirus was least common in early infancy and peaked in fall and winter. Bloody stool had a 36% positive predictive value for Shigella infection. EAF+ classic EPEC were highly resistant to antimicrobial drugs. Among poor São Paulo infants, EAF+ classic EPEC equaled or exceeded rotavirus throughout the year as a cause of diarrhea bringing children to medical attention.
Bibliography:	istex:DBE6A7EFE10980C2D1DF634F3B9684C7330D1E79 Present address: Acute Disease Epidemiology, Minnesota Department of Health, Minneapolis Reprints or correspondence: Dr. Tania A. Tardelli Gomes. Escola Paulista de Medicina, Rua Botucatu, 862-3° andar, 04023 São Paulo, Brazil ark:/67375/HXZ-PDBS8W5J-N ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2
ISSN:	0022-1899 1537-6613
DOI:	10.1093/infdis/164.2.331