The investigation of viral and bacterial enteropathogens in children with acute gastroenteritis by conventional and molecular methods

Objectives: Acute gastroenteritis is significant health problem and causes death in infants and young children in the world, especially in developing countries. The aim of this study is investigation of viral and bacterial agents in children with acute gastroenteritis by conventional and molecular methods in our region.Materials and Methods: Total 136 stool specimens obtained from children 1-12 years of aged with acute gastroenteritis who admitted to policlinics and emergency service of the Adana Children?s Healthcare and Obstetric Hospital between July 2009 to October 2009. Conventional culture method was used for isolation of bacterial enteropathogens and enzyme-linked immunosorbent assay (ELISA) was performed to detect viral agents as rotavirus, norovirus, astrovirus and adenovirus antigens in stool specimens. VP4 and VP7 rotavirus genomes were detected by reverse transcription-polymerase chain reaction (RT-PCR) test in rotavirus grup A antigen positive stool samples, thereafter rotavirus G and P genotypes were determined by multiplex semi-nested PCR test.Results: Gastrointestinal agent was found in 28,7 % of total 136 cases; viruses in 20,6 % (28 cases) and bacteria in 8,1 % (11cases). Of acute gastroenteritis agents, norovirus was detected in 11 % (15 cases), rotavirus 7,3 % (10 cases), Shigella sonnei 6,6 % (9 cases), adenovirus 2,2 % (3 cases), Salmonella newport 0,7 % (1 case) and Campylobacter jejuni 0,7 % (1 case), respectively. Mixed infection occurred in 2 cases (1,5 %). In rotavirus antigen positive 10 samples, the most prevalent genotype was G9P[8] with the rate of 30 %, followed by G9P[11] 20 % and G4P[8] 10 %. Among G and P genotypes, G9 with 60 % and P[8] 50 % were the most common rotavirus genotypes.Conclusion: During the 2009 summer period of the study, the most common agents found were norovirus (11 %), rotavirus (7,3 %) and Shigella sonnei (6,6 %) in children with acute gastroenteritis. The etiologic diagnosis of acute gastroenteritis will provide appropriate patient management by detection of viral agents which need supportive therapy and bacteria as Shigella and Campylobacter which need antimicrobial therapy.Keywords: Akut gastroenteritis, bacteria, children, ELISA, PCR, viruses