Details:

Alternative Title:
PLoS Negl Trop Dis
Personal Author:
Wang, Lin ; Xiao, Lihua ; Duan, Liping ; Ye, Jianbin ; Guo, Yaqiong ; ... More +
Wang, Lin ; Xiao, Lihua ; Duan, Liping ; Ye, Jianbin ; Guo, Yaqiong ; Guo, Meijin ; Liu, Lili ; Feng, Yaoyu Less -
Description:
Background

Over 200 cryptosporidiosis outbreaks have been reported, but little is known if other enteric pathogens were also involved in some of these outbreaks. Recently, an outbreak of cryptosporidiosis linked to poor hygiene by two Cryptosporidium hominis subtypes occurred in a pediatric hospital ward (Ward A) in China, lasting for more than 14 months. In this study, the concurrence during the outbreak of three other enteric pathogens with a similar transmission route, Giardia duodenalis, Enterocytozoon bieneusi, and Clostridium difficile, was assessed.

Methods/Principal Findings

The occurrence of G. duodenalis, E. bieneusi, and C. difficile in 78 inpatients from Ward A and 283 and 216 inpatients from two control wards (Wards C and D) in the same hospital was examined using molecular diagnostic tools. Significantly higher infection rates were found in children in Ward A for all study pathogens than in Wards C and D (P<0.01): 9.5% versus 1.4% and 0% for G. duodenalis, 10.8% versus 2.8% and 3.7% for E. bieneusi, and 60.8% versus 37.8% and 27.8% for C. difficile, respectively. These differences were mostly seen in children ≤12 months. Enteric pathogen-positive children in Ward A (31/58 or 53.4%) were more likely to have mixed infections than those in Ward C (4/119 or 3.4%) or D (5/68, 7.4%; P<0.01). Having cryptosporidiosis was a risk factor for G. duodenalis (OR = 4.3; P = 0.08), E. bieneusi (OR = 3.1; P = 0.04), and C. difficile (OR = 4.7; P<0.01) infection. In addition, a lower diversity of G. duodenalis, E. bieneusi, and C. difficile genotypes/subtypes was observed in Ward A.

Conclusions/Significance

Data from this study suggest that multiple pathogens were concurrently present during the previous cryptosporidiosis outbreak. Examination of multiple enteric pathogens should be conducted when poor hygiene is the likely cause of outbreaks of diarrhea.


Subjects:
[+]
Adolescent Child Child, Preschool Clostridium Difficile Coinfection Cryptosporidiosis Cryptosporidium Disease Outbreaks Enterocytozoon Female Giardia Lamblia Hospitals, Pediatric Humans Infant Infant, Newborn Male Molecular Sequence Data Sequence Analysis, DNA
Source:
PLoS Negl Trop Dis. 2013; 7(9).
Document Type:
Journal Article
Place as Subject:
China
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:a175f5ae8a3e8d8cc60287e189f6f27ec6c77bf8459cbacab9bb3471e5b45a08
Download URL:
https://stacks.cdc.gov/view/cdc/21155/cdc_21155_DS1.pdf
File Type:

Supporting Files

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  	pntd.0002437.nxml	txt
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  	license.txt	txt
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  	pntd.0002437.g001.jpg	jpeg
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  	pntd.0002437.g002.jpg	jpeg
  	pntd.0002437.g003.gif	gif
  	pntd.0002437.g003.jpg	jpeg
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