Evaluation of gastroenteritis causes in the 0-17 age group by multiplex PCR method

Aim: While acute respiratory tract infections are the first cause of morbidity and mortality in childhood, the second most common cause is acute infectious diarrhoea. History and clinical examination may be guiding in the diagnosis, but laboratory support is needed to make a definitive diagnosis. In this study, it was aimed to evaluate viral, bacterial and parasitic agents together and to determine the frequency of agents by using molecular methods together with classical tests based on microscopic and macroscopic examination, immunochromatographic method and culture method in children with acute diarrhoea. Methods: A total of 101 patients aged 0-17 years who were referred to Gaziantep University Medical Faculty Medical Microbiology laboratory with suspected diarrhoea were included in the study. All samples were analysed macroscopically and microscopically. The samples were tested for rotavirus, enteric adenovirus, cryptosporidium, G. intestinalis, E. histolytica by immunochromatographic rapid anigen test. The samples were cultured bacteriologically. Multiplex PCR method was also used to evaluate the samples holistically in terms of causative agents. Results: Similar rates of infection were observed in boys and girls and no significant difference was found in terms of gender. The group with the highest infection rate is the group aged 2-5 years with a rate of 100%. Multiplex PCR detected bacterial agents in 84 (83.2%), viral agents in 48 (47.5%) and protozoal agents in 12 (11.9%) patients. When the multiplex PCR results of viral agents were analyzed, it was reported that rotavirus ranked first, adenovirus and neurovirus were observed at similar rates and ranked second together. When the results of multiplex PCR method of bacterial agents were analyzed, diarogenic E. coli was observed in 84 patients (83.2%), campylobacter spp in 7 patients (6.9%), Salmonella in 3 patients (3%) and Shigella in 1 patient (1%). Salmonella was detected in 3 patients and Shigella in 1 patient by conventional culture method. When the results of protozoal agents by multiplex PCR method were analyzed, Cryptosporidium and Giardia lamblia were found in 2 (2%) and 2 (2%) patients, respectively. Cryptosporidium was detected in 2 (2%), Giardia in 1 (1%) and E. histoytica in 8 (8%) patients by immunochromatographic method. Conclusions: When the causative agent of acute gastroenteritis is a virus or parasite, treatment consists of supportive care. Gastroenteritis requiring antibiotic treatment is diarrhea caused by Shigella from bacteria and E. histolytica from parasites. In our study, we see that there will be no significant loss in terms of diagnosis and treatment of gastroenteritis when the diagnosis is made by classical methods without molecular methods.