Retrospective analysis of patients admitted to OUR pediatrics outpatient clinic between 2011 and 2015 with A complaint of diarrhea with adenovirus and/or rotavirus positivity

Childhood diarrheas are mostly caused by viruses in developed and developing countries, and by bacteria in less developed countries. It has been reported that enteric viruses (particularly rotavirus and adenovirus) are the most common culprits of acute gastroenteritis. Detection of the causes of gastroenteritis is of utmost importance for the treatment and prediction of the disease prognosis. Unnecessary and wrong treatment applications, particularly the use of unnecessary antibiotics, may cause financial loss and may increase mortality and morbidity rates. In this study, demographic data, laboratory data, rotavirus and adenovirus type 40/41 antigen results of the patients aged between 0 and 16 years who were admitted with complaints of diarrhea, abdominal pain, vomiting, and dehydration between January 2011 and December 2015 to the outpatient clinic of Dicle University, School of Medicine, Department of Pediatrics were retrospectively analyzed using the hospital records. A total of 259 children were included in the study, and the patients were divided into two groups: rotavirus and/or adenovirus positive serology group (n = 129) (Group 1) and negative viral serology group (n = 130) (Group 2). Demographic data, comorbidities, clinical conditions, and laboratory results were recorded. Patients in group 1 was also sub-divided in three as rotavirus positivity, adenovirus positivity, and both rotavirus + adenovirus positivity. Clinical and laboratory parameters of these three groups were compared statistically. The mean age of the patients in group 1 was 21.7 ± 30.0 months, and 60.5% were males. The mean age of the group 2 was 23.6 ± 32.2 months, and 63.8% were males. The mean length of hospital stay was 5.4 ± 2.9 days for the patients in group 1 and 4.6 ± 2.4 days for the patients in group 2. Most patients were hospitalized in summer session. The most common complaints were diarrhea, vomiting, and fever for both groups. While the presence of diarrhea (p = 0.023) and the number of diarrhea between 0 and 10 (p = 0.001) were statistically higher in the group 2 than group 1, the number of diarrhea between 11 and 15 was statistically higher in the group 1 than group 2. The most common comorbidities for the group 1 were lung infection, acute lymphoblastic leukemia and cystic fibrosis. Rotavirus was positive for 71.3%, adenovirus was positive for 20.2%, both rotavirus + adenovirus were positive for 8.5% in the group 1. There was a statistically strong and significant relation with white blood cell, urea, albumin and C-reactive protein (CRP) values for the patients with rotavirus positivity (p < 0.05). There was a statistically strong and significant relation with diarrhea, vomiting, abdominal pain, and lack of appetite for both three subgroups with rotavirus positivity, adenovirus positivity, and both rotavirus + adenovirus positivity (p < 0.05). However, no significant difference in the neurological findings, use of probiotics, and use of antibiotics was observed among the subgroups (p > 0.05). In conclusion, rotavirus and adenovirus, as a cause of viral gastroenteritis, can be easily detected using stool antigen tests. Detection of these viruses which can cause gastroenteritis would reduce unnecessary use of antibiotics. Based on our study results, we believe that patients with viral gastroenteritis caused by rotavirus and/or adenovirus should be monitored for the development of secondary infections, considering urea, albumin levels, white blood cells, and CRP values. Key words: adenovirus; child; gastroenteritis; rotavirus