Bacterial Acute Gastroenteritis: A 6 Year Study in a Tertiary Hospital

Background: Acute gastroenteritis (AGE) is an important cause of morbidity in developed countries. Indications for coprocultures are restricted and symptomatic therapy is indicated in most cases. However, the knowledge of epidemiology is fundamental in guiding therapeutic decisions. The objective of this study is to know the evolution of the local epidemiology of acute intestinal bacterial infections of children observed in a level III hospital in the last 5 years.

Objective and Methods: A total of 247 positive stool samples were obtained, between 2012 to 2017. The peak of positive tests occurred during Summer, most of them in preschool age. Campylobacter spp. was the most prevalent agent (55.1%), followed by Salmonella spp. (34.8%), Yersinia (4%) and Shigella sonnei (3.6%). Faeces with blood have been detected frequently in Campylobacter spp. and the duration of diarrhea were prolonged in Salmonella spp cases. Fever were present in 69.1%. Vomits were frequent (41.1%). Bacterial co-infections were in 2% of the cases and viral ones in 12.6%, mostly due to rotavirus. References of a familiar context of AGE were present in 51%. Dehydration was the main cause of complication. Hospital admissions (39%) were superior compared with other studies, mainly due to Salmonella spp infections. Antibiotics were given in 32 cases, with resistance profile pattern similar to other national studies.

Conclusion: The aetiology of AGE has been changing, depending on the country. There is a lack of studies giving us a local pattern of bacterial AGE, allowing the possibility to initiate targeted preventive measures. It is also a concern to know the principal clinical features of bacterial AGE, in order to minimize unnecessary tests or treatments, once antibiotics are still used in a high percentage of cases.