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Investigation of Children with Acute Gastroenteritis by Multiplex PCR Method in Central Part of Turkey
Objective Gastroenteritis is a disease that affects all age groups, especially children, and causes high mortality and morbidity in all countries. The most common agents of acute gastroenteritis are viral agents. As a result, millions of diarrhea attacks and hospital admissions occur worldwide every year due to viral gastroenteritis. This study uses the multiplex polymerase chain reaction (PCR) method to investigate the viruses that are the causative agents of viral gastroenteritis in the pediatric patient group in Konya, Turkey.
Methods Stool samples of 94 patients aged 0 to 18 years sent from Emergency clinics and Pediatric outpatient clinics, Meram Medical Faculty Hospital Pediatric clinics, Konya Necmettin Erbakan University to Medical Microbiology Laboratory with a diagnosis of gastroenteritis between February and December 2018 were included in the study. Stool samples were stored at –80°C until the time of the analysis. Deoxyribonucleic acid/ribonucleic acid isolation from stool samples was performed with EZ1 Virus Mini Kit v2.0 (Qiagen, Hilden, Germany) using an automatic extraction system (BioRobot EZ1 system, Qiagen). The presence of astrovirus, rotavirus, adenovirus, norovirus (GI, GII), and sapovirus agents was investigated by the multiplex PCR method (Fast Track Diagnostics, Luxembourg) viral gastroenteritis kit.
Results Viral gastroenteritis agents were detected in 56.3% of the patients. One viral agent was detected in 47 (50%) of these patients and at least two viral agents in 6 (6.3%) of them. Norovirus GII was detected in 20 (21.2%) of the children included in the study, adenovirus in 13 (13.8%), rotavirus in 11 (12.8%), astrovirus in 11 (11.7%), sapovirus in 4 (4.2%), and norovirus GI in 1 (1.06%). When the distribution of viral agents was examined by months, the most number of agents were observed (21; 35%) in May, followed by April and June (12; 20%). Considering the distribution of the prevalence of the agents by age, it was seen to be mainly between 0 and 12 months (42%).
Conclusion Considering that the most common viral agent in our region is norovirus GII, it will be useful to investigate the norovirus that is not routinely examined in children who are admitted to clinics with the complaint of gastroenteritis. It will be appropriate to examine routinely adenovirus, rotavirus, and norovirus in the laboratory, especially in children with diarrhea and vomiting in the winter and spring months.
Keywordsgastroenteritis - multiplex PCR - rotavirus - adenovirus - norovirus - sapovirus - astrovirus
Received: 24 June 2021
Accepted: 19 October 2021
Article published online:
06 January 2022
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- 1 Gürbüz F, Tezer H, Şaylı TR. Etiologic factors and clinical findings of patients hospitalized children for acute gastroenteritis: epidemiologic study. Turkish J Pediatr Dis 2010; 4 (04) 211-218
- 2 Anderson EJ. Prevention and treatment of viral diarrhea in pediatrics. Expert Rev Anti Infect Ther 2010; 8 (02) 205-217
- 3 Li J, Yang Y, Liang ZC. et al. Analysis of pathogenic composition and clinical characteristics of viral acute gastroenteritis in children under five years old in Beijing [in Chinese]. Zhonghua Yu Fang Yi Xue Za Zhi 2020; 54 (10) 1104-1110
- 4 Gülen A, Hacımustafaoğlu M. General evaluation of acute gastroenteritis in children. ANKEM Derg 2013; 27 (03) 147-157
- 5 Pickering LK, Shane AL. Approach to the diagnosis and management of gastrointestinal tract infections. In: Long SS, Prober CG, Fischer M. eds. Principles and Practice of Pediatric Infectious Diseases. Edinburg: Elsevier Saunders; 2012: 372-377
- 6 Özdemir S, Delialioğlu N, Emekdaş G. Investigation of rotavirus, adenovirus and astrovirus frequencies in children with acute gastroenteritis and evaluation of epidemiological features [in Turkish]. Mikrobiyol Bul 2010; 44 (04) 571-578
- 7 Nakanishi K, Tsugawa T, Honma S. et al. Detection of enteric viruses in rectal swabs from children with acute gastroenteritis attending the pediatric outpatient clinics in Sapporo, Japan. J Clin Virol 2009; 46 (01) 94-97
- 8 Shigemoto N, Hisatsune Y, Toukubo Y. et al. Detection of gastroenteritis viruses among pediatric patients in Hiroshima Prefecture, Japan, between 2006 and 2013 using multiplex reverse transcription PCR-based assays involving fluorescent dye-labeled primers. J Med Virol 2017; 89 (05) 791-800
- 9 Ulukanlıgil M, Bakır M, Arslan G, Soran M, Seyrek A. Investigation of diarrhoeal agents among 0–5 years old children. Mikrobiyol Bul 2001; 35: 307-312
- 10 Tekin A. The frequency of rotavirus and enteric adenovirus in children with acute gastroenteritis in Mardin. J Clin Exp Invest 2010; 1: 41-45
- 11 Akihara S, Phan TG, Nguyen TA, Hansman G, Okitsu S, Ushijima H. Existence of multiple outbreaks of viral gastroenteritis among infants in a day care center in Japan. Arch Virol 2005; 150 (10) 2061-2075
- 12 Özdemir M, Demircili ME, Feyzioğlu B, Yavru S, Baysal B. Investigation of acute viral gastroenteritis agents in diarrhaeic patients. Selçuk Med J 2013; 29 (03) 127-130
- 13 Timurkan MÖ, Aydin H, Aktaş O. Frequency and molecular characterization of human norovirus in Erzurum, Turkey. Turk J Med Sci 2017; 47 (03) 960-966
- 14 Oldak E, Sulik A, Rozkiewicz D, Liwoch-Nienartowicz N, Zawadzka E. Norovirus and Rotavirus–two major causative agents of sporadic viral gastroenteritis in hospitalized Polish children. Adv Med Sci 2009; 54 (02) 183-186
- 15 Altay A, Bozdayı G, Meral M. et al. Investigation of norovirus infection incidence among 0-5 years old children with acute gastroenteritis admitted to two different hospitals in Ankara, Turkey [in Turkish]. Mikrobiyol Bul 2013; 47 (01) 98-108
- 16 Zeng M, Xu X, Zhu C. et al. Clinical and molecular epidemiology of norovirus infection in childhood diarrhea in childhood diarrhea in China. J Med Virol 2012; 84: 145-151
- 17 Karadag A, Acikgoz ZC, Avci Z. et al. Childhood diarrhoea in Ankara, Turkey: epidemiological and clinical features of rotavirus-positive versus rotavirus-negative cases. Scand J Infect Dis 2005; 37 (04) 269-275
- 18 Kurugöl Z, Geylani S, Karaca Y. et al. Rotavirus gastroenteritis among children under five years of age in Izmir, Turkey. Turk J Pediatr 2003; 45 (04) 290-294
- 19 Velázquez FR, Matson DO, Guerrero ML. et al. Serum antibody as a marker of protection against natural rotavirus infection and disease. J Infect Dis 2000; 182 (06) 1602-1609
- 20 Akdoğan D, Çınar S, Şahin İ, Per H, Kılıç H.. Investigation of Rotavirus in age of 0–5 in pediatric diarrhae. Infek Derg 2001; 15: 291-294
- 21 Qiu FZ, Shen XX, Li GX. et al. Adenovirus associated with acute diarrhea: a case-control study. BMC Infect Dis 2018; 18 (01) 450
- 22 Aktaş O, Aydin H, Timurkan MO. A molecular study on the prevalence and coinfections of Rotavirus, Norovirus, Astrovirus and Adenovirus in children with gastroenteritis. Minerva Pediatr 2019; 71 (05) 431-437
- 23 El Sayed Zaki M, Mashaly GE, Alsayed MAL, Nomir MM. Molecular study of human astrovirus in Egyptian children with acute gastroenteritis. Germs 2020; 10 (04) 167-173
- 24 Lekana-Douki SE, Kombila-Koumavor C, Nkoghe D, Drosten C, Drexler JF, Leroy EM. Molecular epidemiology of enteric viruses and genotyping of rotavirus A, adenovirus and astrovirus among children under 5 years old in Gabon. Int J Infect Dis 2015; 34: 90-95