Exploring Acute Diarrhea in Infants: A Comprehensive Review of Infectious Agents and Laboratory Diagnostic Techniques
DOI:
https://doi.org/10.56294/saludcyt20241100Keywords:
Acute diarrea, Infectious agents, Dehydration, Clinical laboratory, PediatricsAbstract
Introduction: acute diarrhea is one of the main causes of mortality in children under 5 years of age around the world. They disproportionately affect underdeveloped countries, where access to health services, drinking water and sanitation is limited. Objective: this review identifies the most relevant and recent studies associated with the topic, recognizes the most common infectious agents and determines the laboratory techniques used for their diagnosis. Methods: the literature was reviewed from sources such as Elsevier, PubMed, Scopus, SciELO and Google Scholar during the period March-May 2024, published in the last 5 years and several studies prior to 2019 that contributed relevant information to the topic. Results: previous studies reveal that acute childhood diarrhea is mainly characterized by its fecal-oral transmission, caused by Rotavirus and Adenovirus, and sometimes by Escherichia coli, Salmonella spp., Giardia lamblia and Entamoeba histolytica, among others. Acute diarrhea is characterized by the presence of three or more soft or liquid stools per day, and is classified according to its duration. Fecal increase, dehydration and electrolyte abnormalities are associated complications and constitute clinically useful elements for its diagnosis. For viruses, rapid tests and PCR are used, for bacteria, cultures and antibiograms, and for parasites, coproparasites, ELISA and PCR. Conclusion: These disorders represent a significant health challenge, with a considerable impact on morbidity and mortality, originating from viruses, bacteria and parasites. The diagnosis is made through physical, coprological examinations, immunochromatographic and molecular tests
References
1. Guandalini, S., Fry, R., Windle, M., Cuffari, C. Diarrhea: Practice Essentials, Background, Pathophysiology. Medscape. 2020
2. Galeão, K., Castro, M., Alves, G. Acute diarrhea: evidence-based management. J Pediatr (Rio J). 2015;91(6):36–43.
3. Younis, M., Rastogi, R., Chugh, A., Rastogi, S., Aly, H. Congenital Diarrheal Diseases. Clin Perinatol. 2020;47(2):301–21.
4. Hidalgo, J., Huailas, W. View of Incidence of pediatric patients with diarrheal diseases in the health post tres cerritos - pasaje in the period 2020 - 2022. Salud, Ciencia y Tecnología. 2023;3:398.
5. Organización Mundial de la Salud. Enfermedades diarreicas. 2024
6. Piguave-Reyes, J., Castellano-González, M., Pionce-Pibaque, M., Ávila-Ávila, J. Etiología de la diarrea infantil en Shushufindi, Ecuador. Casmera. 2019;47(1):21-28.
7. Prescilla, P., Windle, M., Domachowske, J. Pediatric Gastroenteritis: Practice Essentials, Pathophysiology, Etiology. Medscape. 2023
8. Radlović, N., Leković, Z., Vuletić, B., Radlović, V., Simić, D. Acute Diarrhea in Children. Srp Arh Celok Lek. 2015;143:755–62.
9. Arancibia, G., Diarrea aguda en el lactante y preescolar. Gastroenterol latinoam. 2019;30.
10. Park, Y., Son, M., Jekarl, DW., Choi, H., Kim, S., Lee, S. Clinical Significance of Inflammatory Biomarkers in Acute Pediatric Diarrhea. Pediatric Gastroenterology, Hepatology & Nutrition. 2019;22(4):369–76.
11. Kang, H., Yoo, I., Jeong, D. The role of rapid syndromic diagnostic testing of gastrointestinal pathogens as a clinical decision support tool in a pediatric emergency department. Ann Clin Microbiol Antimicrob. 2024;23(1):3.
12. Rahmat, D., Firmansyah, A., Timan, I., Bardosono, S., Prihartono, J., Gayatri, P. Risk factors of prolonged diarrhea in children under 2 years old. Clin Exp Pediatr. 2023;66(12):538.
13. Rojas, K., Urrego, L., Dietista, N. Enfermedades transmitidas por alimentos: Diarrea. Revista RECITEIA. 2021;19(2):25-40.
14. Quintero, G., Romero, R., Aviles, A., Cejudo, M., Calleja, P., Domínguez M., Cantú, S., García, R., Soñanez, J., Rodríguez, J., Romo, C., Tamez, P., Flores, L., González, G. Viral agents of gastroenteritis and their correlation with clinical symptoms in rotavirus-vaccinated children. Infect Genet Evol. 2019;73:190–6.
15. Posovszky, C., Buderus, S., Claßen, M., Lawrenz, B., Keller, K., Koletzko, S. Acute Infectious Gastroenteritis in Infancy and Childhood. Dtsch Arztebl Int. 2020; 117(37):615.
16. Dian, Z., Sun, Y., Zhang, G., Xu, Y., Fan, X., Yang, X., Qiuwei Pan, Q., Peppelenbosch, M., Miau, Z. Rotavirus-related systemic diseases: clinical manifestation, evidence and pathogenesis. Crit Rev Microbiol. 2021;47(5):580–95.
17. Crawford, E., Ramani, S., Tate, J., Parashar, U., Svensson, L., Hagbom, M., Franco, M., Greenberg, H., Ryan, M., Kang, G., Desselberger, U., Estes, M. Rotavirus infection HHS Public Access. 2017;3:17083.
18. Blanco, R., Alcalá, A., Fernández, R., Ramírez, V., Rosales, M., Páez, H., González, R.,Zerpa, J., Maldonado, A., Vizzia, E. Molecular characterization of human adenovirus causing infantile acute gastroenteritis in Venezuela before and after rotavirus vaccine implementation. Diagn Microbiol Infect Dis. 2023;107(3):116056.
19. Ghebremedhin, B., Ghebremedhin, B. HUMAN ADENOVIRUS: VIRAL PATHOGEN WITH INCREASING IMPORTANCE. Eur J Microbiol Immunol. 2014;4:26–33.
20. Shieh, W. Human adenovirus infections in pediatric population - An update on clinico–pathologic correlation. Biomed J. 2022;45(1):38–49.
21. Chhabra, P., Graaf, M., Parra, G., Chi-Wai, M., Green, K., Martella, V., Wang, Q., White, P., Katayama, K., Vennema, H, Koopmans., Vinjé, M. Updated classification of norovirus genogroups and genotypes. J Gen Virol. 2019;100:1393–406.
22. Morillo, S., TimeneTSky, M. Norovirus: an overview. Rev Assoc Med Bras. 2011;57(4):462–7.
23. Arias, A., Emmott, E., Vashist, S., Goodfellow, I. Progress towards the prevention and treatment of norovirus infections. Future microbiology. 2013;8(11):1475–1487.
24. Varela, M., Rivadulla, E., Lema, A., Romalde, J. Human Sapovirus among Outpatients with Acute Gastroenteritis in Spain: A One-Year Study. Viruses. 2019;11(2):144.
25. Euller-Nicolas, G., Le, C., Schaeffer, J., Zeng, X., Ettayebi, K., Atmar, R., Le, F., Estes, M., Desdouits. Human Sapovirus Replication in Human Intestinal Enteroids. Journal of virology. 2023;97(4):e0038323.
26. Oka, T., Wang, Q., Katayama, K., Saif, L., Comprehensive Review of Human Sapoviruses. Clinical microbiology reviews. 2015;28(1):32-53.
27. Meliopoulos, V., Marvin, S., Freiden, P., Moser, L., Nighot, P., Ali, R., Blikslager, A., Reddivari, M., Heath, R., Koci, M., Schultz-Cherry, S. Oral Administration of Astrovirus Capsid Protein Is Sufficient To Induce Acute Diarrhea In Vivo. mBio. 2016;7(6):e01494-16.
28. Moser, L., Carter, M., Schultz-Cherry, S. Astrovirus Increases Epithelial Barrier Permeability Independently of Viral Replication. J Virol. 2007;81(21):11937–45.
29. El M, Zaki S, El-Saeed Mashaly G, Latif Alsayed MA, Nomir M. Molecular study of human astrovirus in Egyptian children with acute gastroenteritis. Germs. 2020;10(4):167-173.
30. Cortez, V., Meliopoulos, V., Karlsson, E., Hargest, V., Johnson, C., Schultz-Cherry, S. Annual Review of Virology. Annu Rev Virol. 2017; 4:327-348.
31. Vu, D., Cordey, S., Brito, F., Kaiser, L. Novel human astroviruses: Novel human diseases? J Clin Virol. 2016;82:56–63.
32. Comas, A., Reyes, U., Reyes, K., Vargas, M., Luévanos, A., Mercado, M., Cuevas, L., Guerrero, M., Reyes, M., Hernández, R. Gastroenteritis en niños por otros agentes virales diferentes al rotavirus. Enfermedades Infecc y Microbiol. 2020; 40(3):100–107.
33. Diriba, K., Awulachew, E., Anja, A. Prevalence and associated factor of Campylobacter species among less than 5-year-old children in Ethiopia: a systematic review and meta-analysis. Eur J Med Res. 2021;26(1):2.
34. Same, R., Tamma, P. Campylobacter Infections in Children. Pediatr Rev. 2018;39(11): 533–541.
35. Heimesaat, M., Backert, S., Alter, T., Bereswill, S. Molecular Targets in Campylobacter Infections. Biomolecules. 2023; 13(3), 409.
36. Grzybowska-Chlebowczyk, U., Kalita, B., Flak-Wancerz, A., Jasielska, M., Więcek, S., Wojcieszyn, M. Clinical course of Campylobacter infections in children Przebieg kliniczny infekcji Campylobacter u dzieci. Pediatria Polska. 2013;88(4):329-334.
37. Gut, A., Vasiljevic, T., Yeager, T., Donkor, O. Salmonella infection-prevention and treatment by antibiotics and probiotic yeasts: a review. Microbiology. 2018;164(11):1327–1344.
38. Ferrari, R., Rosario, D., Cunha-Neto, A., Mano, S., Figueiredo, E., Conte-Junior, C. Worldwide Epidemiology of Salmonella Serovars in Animal-Based Foods: a Meta-analysis. Applied and environmental microbiology. 2019;85(14): e00591-19.
39. Duarte, R., Hernández, C., Mesa, Z., García, D., Bermúdez, R., María, R. Meras, R. Resistencia antimicrobiana de cepas de Shigella aisladas en el Hospital Pediátrico Universitario “José Luis Miranda.” Acta Médica del Cent. 2021;15(2):270-279
40. Grenón, S., Leguizamón, L., Del Valle, A., Pallares. S., Salvi, M., Von Specht, M. Prevalence and antimicrobial profile of Shigella causing acute diarrheal disease in pediatrics in Posadas, Misiones. Revista De Ciencia Y Tecnología. 2022;38(1):71–75.
41. Baker, S., Chung, H. Recent insights into Shigella: a major contributor to the global diarrhoeal disease burden. Current opinion in infectious diseases. 2018;31(5):449–454.
42. Lee, J., Kim, S., & Yoon, J. Pathophysiology of enteropathogenic Escherichia coli during a host infection. Journal of veterinary science. 2022;23(2),28.
43. Urbina-Salazar, A., Inca-Torres, A., Urbina-Salazar, B., Urbina, N. Etiología infecciosa de la diarrea aguda pediátrica, un problema de la Salud Pública. Revis Bionatura. 2023;8(3):9.
44. Cermeño, J., Hernández, I., Camaripano, M., Guevara, A., Hernández, C. Etiología de diarrea aguda en niños menores de 5 años Ciudad Bolívar, Venezuela. Rev. Soc. Ven. Microbiol. 2008;28(1):55–60.
45. Akinlabi, O., Nwoko, E., Dada, R., Ekpo, S., Omotuyi, A., Nwimo, C., Adepoju, A., Popoola, O., Dougan, G., Thomson, N. R., & Okeke, I. Epidemiology and Risk Factors for Diarrheagenic Escherichia coli Carriage among Children in Northern Ibadan, Nigeria. The American journal of tropical medicine and hygiene. 2023;109(6):1223–1232.
46. Naz, A., Nawaz, Z., Rasool, M., & Zahoor, M. Cross-sectional epidemiological investigations of Giardia lamblia in children in Pakistan. Sao Paulo medical journal = Revista paulista de medicina. 2018;136(5):449–453.
47. Fink, M., Shapiro, D., & Singer, S. Giardia lamblia: Laboratory Maintenance, Lifecycle Induction, and Infection of Murine Models. Current protocols in microbiology. 2020;57(1):102.
48. Adam R. Biology of Giardia lamblia. Clinical microbiology reviews. 2001;14(3):447–475.
49. Kalantari, N., Ghaffari, S. y Bayani, M. Criptosporidio spp. Infección en niños iraníes y pacientes inmunosupresores: una revisión sistemática y un metanálisis. Revista Caspian de medicina interna. 2018;9(2):106-115.
50. Huang, D., Chappell, C., Okhuysen, P. Cryptosporidiosis in children. Semin Pediatr Infect Dis. 2004;15(4):253–259.
51. Kantor, M., Abrantes, A., Estevez, A., Schiller, A., Torrent, J., Gascon, J., Hernandez, R., Ochner, C. Entamoeba Histolytica: Updates in Clinical Manifestation, Pathogenesis, and Vaccine Development. Can J Gastroenterol Hepatol. 2018; 4601420.
52. Cheepsattayakorn, A., Cheepsattayakorn R. Parasitic Pneumonia and Lung Involvement. Biomed Res Int. 2014; 874021.
Published
Issue
Section
License
Copyright (c) 2024 Edwin Alexander Rodríguez Naranjo, Carlos Fernando Yauli Flores (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.
