Enteropathogens associated with acute diarrheal disease in urban infants in S?o Paulo, Brazil |
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| Authors: | T A Gomes V Rassi K L MacDonald S R Ramos L R Trabulsi M A Vieira B E Guth J A Candeias C Ivey M R Toledo |
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| Institution: | Department of Microbiology, Immunology, and Parasitology, Escola Paulista de Medicina, Hospital Infantil Menino Jesus, Brazil. |
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| Abstract: | To determine the prevalence and epidemiology of enteropathogens in acute infantile diarrhea, 500 infants less than or equal to 12 months of age with diarrhea and 500 age-matched control subjects coming to a S?o 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 S?o Paulo infants, EAF+ classic EPEC equaled or exceeded rotavirus throughout the year as a cause of diarrhea bringing children to medical attention. |
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