Agentes infecciosos associados à diarréia aguda em crianças até três anos de idade : estudo em um hospital de referência no município de Vitória-ES
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2005-10-14
Autores
Sadovsky, Ana Daniela Izoton de
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Universidade Federal do Espírito Santo
Resumo
Acute diarrhea is one of the main causes of infantile mortality worldwide (WHO), mainly in developing countries. In the present work, the prevalence of Rotavirus (RV), adenovirus (Ad), diarrheogenic E. coli (EPEC, ETEC, EIEC, EHEC, EAEC, DAEC), Salmonella, Shigella, Cryptosporidium spp., Entamoeba histolytica and Giardia lamblia was studied among children up to 3 years old with acute diarrhea. From February 2003 to June 2004, stools samples were obtained prospectly from 253 children with acute diarrhea and 78 without diarrhea attending to the emergency room in a pediatric hospital - Hospital Infantil Nossa Senhora da Glória (HINSG), in Vitória Espírito Santo state, Brazil. Bacterial detection was done in 241 stools samples (12 were excluded because were in use of antimicrobian drugs) and E. coli were isolated in 219 and 68 cases with and without diarrhea, respectively. These cases were submited to serology with policlonal anti-seros (EPEC e EIEC) and hybridization tests (Hybr) to detect virulence genes of EPEC, ETEC, EIEC, EHEC, EAEC e DAEC. RV were studied in 147 cases for immune enzymatic assay (EIARA) and in 230 cases by poliacrylamide gel electrophoresis (PAGE) and Ad, only in 147 cases for immune enzymatic assay (EIARA). Protozoan infection was studied in 88 cases for immune enzymatic assay (EIA). Children with diarrhea were divided in Group I (88 cases = all enteropathogens studied), Group II (147 cases = bacterias, RV e Ad - EIARA) and Group III (230 cases = bacterias and RV - PAGE) and children without diarrhea were Group IV (78 cases = bactérias and RV - PAGE). Enteropathogens were detected in more than 60% in children with acute diarrhea and bacterial infection was the most prevalent: DEC were detected in 41,1%; EPEC in 3,6% (serology) e 9,1% (Hybr); Typical EPEC (0,9%); Atypical EPEC (8,2%); EAEC (9,1%); DAEC (20,6%); EIEC (0,9%); ETEC (4,2%). In stools samples from children without diarrhea, we found Atypical EPEC (10,3%); EAEC (20,6%); DAEC (16,2%); ETEC (1,5%). EHEC was not detected in the studied population. Shigella and Salmonella were detected in 4,6% e 2,9%, respectively, only in children with acute diarrhea. RV were detected in 35,2% (GEPA) and 50% (EIARA); Ad, in 8,2% and E. histolytica, Cryptosporidium spp. and G. lamblia in 8%, 11,4% and 14,8% of cases with diarrhea, respectively. In conclusion, Typical EPEC, EIEC and ETEC were detected only or predominantly in children with acute diarrhea. Atypical EPEC, EAEC and DAEC were not causes of acute diarrhea, except for EAEC in children more than two years old (p = 0,026). RV was the most prevalent agent when the classic enteropathogen DEC (Tipical EPEC, ETEC, EIEC and Shigella e Salmonella) was considered in this study. RV was more frequent in children below 18 months of life and in a period of March, 2003 up September, 2003. Associations among enteropathogens were frequent in the studied population and protozoa were the most of them. Comparing all of protozoa detected, only G. lamblia suggesting being a cause of acute diarrhea, isolately.
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Gastroenterite infantil , Diarréia aguda infecciosa , Enterobactérias , Rotavírus
Citação
SADOVSKY, Ana Daniela Izoton de. Agentes infecciosos associados à diarréia aguda em crianças até três anos de idade: estudo em um hospital de referência no município de Vitória ES. 2005. 138 f. Dissertação (Mestrado em Doenças infecciosas) - Programa de Pós-Graduação em Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, 2005.